Estimate of Recurrence Risk
Posted 3/29/2010
Posted in
This is more evidence of the reality that most of us do not really hear what our doctors tell us. Presumably, wowomen interviewed in this study from Washington University in St Louis were given accurate information about their risk of recurrence. It is striking that only 17% could report "their stats" with accuracy. Especially in the beginning, during the first days after diagnosis when treatment decisions are being made, our anxiety is so high that we really cannot understand and hold on to everything we are told. My take home lesson om this report is the importance of having ongoing converations with our doctors. Ask again, if you want to know, about your personal risks of reccurence. It is quite likely to be lower than you imagine, and that will be reassuring.
Accuracy of Perceived Risk of Recurrence Among Patients With Early-Stage Breast Cancer
Ying Liu
1, Maria Pérez1, Rebecca L. Aft2,3,4, Kerry Massman5, Erica Robinson6
, Stephanie Myles
3, Mario Schootman1,3, William E. Gillanders2,3
and Donna B. Jeffe
1,3
Author Affiliations
Corresponding Author:
Donna B. Jeffe, Division of Health Behavior Research, Department of Medicine, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 6700, St. Louis, MO 63108. Phone: 314-286-1914; Fax: 314-286-1919.
E-mail: djeffe@dom.wustl.edu
Abstract
Background:
Accurate breast cancer recurrence risk perceptions might motivate health-promoting behaviors and alleviate undue anxiety. Although a few studies have examined early-stage breast cancer survivors' perceived risk of recurrence, none have assessed the accuracy of survivors' perceived risk of recurrence.
Methods:
First primary ductal carcinoma in situ and early-invasive breast cancer survivors reported their perceived risk of recurrence during 6- and 12-month postsurgery interviews. We estimated the patients' 10-year risk of recurrence from published clinical trials, and for early-invasive breast cancer patients, risk of distant recurrence was based on their breast cancer-specific mortality calculated using
Patients' perceived risk was compared with their calculated risk and categorized as "Accurate," "Underestimated," "Overestimated," and "Uncertain." Multinomial logit marginal effect models were fitted using Accurate as the reference.
Results:
Only 17% of 531 patients accurately perceived their risk at 6 months, most of whom inaccurately perceived their risk at 12 months (P = 0.0143). Patients who were nonwhite [odds ratio (OR), 1.70; 95% confidence interval (95% CI), 1.12-2.56] and received radiation therapy (OR, 2.01; 95% CI, 1.07-3.77) were more likely to underestimate their risk. Patients with ductal carcinoma (OR, 1.69; 95% CI, 1.08- 2.70), lower social support (OR, 0.71; 95% CI, 0.53-0.95), and anxiety (OR, 1.58; 95% CI, 1.01-2.47) were more likely to overestimate their risk.
Conclusion:
Few breast cancer survivors accurately perceived their risk of recurrence.
Impact:
The accuracy of perceived risk may be increased by better physician-patient communications about their prognosis, provision of social support, and treatment for coexisting anxiety. Cancer Epidemiol Biomarkers Prev; 19(3); 675-80
Keywords
breast cancer risk perception recurrence cancer survivor anxiety
Footnotes
Note:
Supplementary data for this article are available at Cancer Epidemiology Biomakers and Prevention Online (http://cebp.aacrjournals.org/).
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