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A survey of breast cancer physicians regarding patient involvement in breast cancer treatment decisions

Authors:	Grace Clarke Hillyer Dawn L Hershman Lawrence H Kushi Lois Lamerato Christine B Ambrosone Dana H Bovbjerg Jeanne S Mandelblatt Sargam Rana Alfred I Neugut

Institution:	1. Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032, United States;2. Department of Medicine, College of Physicians and Surgeons, New York, NY, United States;3. Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, New York, NY, United States;4. Division of Research, Kaiser-Permanente of Northern California, Oakland, CA, United States;5. Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, United States;6. Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, United States;7. Department of Psychiatry, Psychology and Behavioral & Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, United States;8. University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States;9. Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States;1. Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;2. Lynn Sage Comprehensive Breast Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;1. Department of Pharmacotherapy and Pharmacotherapy Outcomes Research Center, University of Utah, 421 Wakara Way, Suite 208, Salt Lake City, UT 84108, USA;2. Information Technology Services Data Warehouse, University of Utah, 585 Komas, Salt Lake City, UT 84108, USA;3. Radiation Oncology, University of Utah School of Medicine and Huntsman Cancer Hospital, 1950 Circle of Hope, Room 1570, Salt Lake City, UT 84112, USA;4. Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936-1080, USA;1. Department of Oncology, Sahlgrenska Academy and University Hospital, Gothenburg, Sweden;2. Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden;3. Department of Oncology/Pathology, Cancer Centre Karolinska, Karolinska Institutet, Stockholm, Sweden;4. Department of Surgery, Linköping University Hospital, Linköping, Sweden;5. Department of Clinical and Experimental Medicine, Division of Oncology, Faculty of Health Sciences, Linköping University, County Council of Östergötland, Linköping, Sweden;1. Department of Oncology and Hematology, Research Institute INCLIVA, Hospital Clinico Universitario Valencia (HCUV), Avda Blasco Ibañez 17, 46010 Valencia, Spain;2. Research Institute INCLIVA, University of Valencia, Spain;3. Department of Pathology, Breast Cancer Unit, Research Institute INCLIVA, HCUV, Spain;4. Department of Statistics, University of Valencia, Spain;5. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center Houston Texas, USA;1. Clinique de Genolier, Switzerland;2. Leiden University Medical Center, The Netherlands;3. Medical School, University of Athens, Athens, Greece;4. Ontario Institute for Cancer Research, Toronto, Canada;5. Weston Park Hospital NHS Trust, Sheffield, United Kingdom

Abstract:	PurposeShared breast cancer treatment decision-making between patients and physicians increases patient treatment satisfaction and compliance and is influenced by physician-related factors. Attitudes and behaviors about patient involvement in breast cancer treatment decisions and treatment-related communication were assessed by specialty among breast cancer physicians of women enrolled in the Breast Cancer Quality of Care Study (BQUAL).ResultsOf 275 BQUAL physicians identified, 50.0% responded to the survey. Most physicians spend 46–60 min with the patient during the initial consult visit and 51.5% report that the treatment decision is made in one visit. Oncologists spend more time with new breast cancer patients during the initial consult (p = 0.021), and find it more difficult to handle their own feelings than breast surgeons (p = <0.001).ConclusionBreast surgeons and oncologists share similar attitudes and behaviors related to patient involvement in treatment decision-making, yet oncologists report more difficulty managing their own feelings during the decision-making process.

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