What quality-of-life issues do women with ductal carcinoma in situ (DCIS) consider important when making treatment decisions?

被引：18

作者：

Mercieca-Bebber, Rebecca ^{[1
,2
]}

King, Madeleine T. ^{[1
,2
]}

Boxer, Miriam M. ^{[3
,4
]}

Spillane, Andrew ^{[5
,6
,7
,8
]}

Winters, Zoe E. ^{[9
]}

Butow, Phyllis N. ^{[2
,10
]}

McPherson, Joan ^{[11
]}

Rutherford, Claudia ^{[2
]}

机构：

[1] Univ Sydney, Sydney Med Sch, Cent Clin Sch, Camperdown, NSW, Australia

[2] Univ Sydney, Sch Psychol, Psychooncol Cooperat Res Grp, Qual Life Off, Level 6 North,Lifehouse C39Z, Sydney, NSW 2006, Australia

[3] Liverpool Hosp, Liverpool Canc Therapy Ctr, Liverpool, NSW, Australia

[4] Univ New South Wales, South Western Sydney Clin Sch, Sydney, NSW, Australia

[5] Univ Sydney, Sydney Med Sch, Northern Clin Sch, Sydney, NSW, Australia

[6] Poche Ctr, Breast & Surg Oncol, Sydney, NSW, Australia

[7] Mater Hosp Sydney, Sydney, NSW, Australia

[8] Royal North Shore Hosp, Sydney, NSW, Australia

[9] Univ Bristol, Breast Canc Surg Patient Reported & Clin Outcomes, Sch Clin Sci, Southmead Hosp, Bristol, Avon, England

[10] Univ Sydney, Ctr Med Psychol & Evidence Based Decis Making CeM, Sydney, NSW, Australia

[11] Breast Canc Network Australia, Camberwell, Vic, Australia

来源：

BREAST CANCER | 2017年 / 24卷 / 05期

关键词：

Ductal carcinoma in situ (DCIS); Decision making; Quality of life; Patient-reported outcomes; PATIENT-REPORTED OUTCOMES; BREAST-CANCER; EUROPEAN-ORGANIZATION; PSYCHOLOGICAL MORBIDITY; ACTIVE SURVEILLANCE; NEW-ZEALAND; RECONSTRUCTION; RISK; INSTRUMENT; PREDICTORS;

D O I：

10.1007/s12282-017-0765-0

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

To explore quality-of-life (QOL) issues considered important when deciding on treatment for ductal carcinoma in situ (DCIS). Breast Cancer Network of Australia members diagnosed with DCIS in the past 5 years (self-identified) participated in an online survey (Sep-Nov 2015). From a list of 74 QOL issues, participants selected all issues they experienced during DCIS diagnosis, treatment or recovery, then the issues they felt important to making a DCIS treatment decision, and completed the Health Literacy Questionnaire (HLQ). Associations between QOL issues and self-reported treatment received were assessed with chi (2) tests. The primary analysis included 38 participants treated with breast-conserving surgery (n = 15), mastectomy (n = 23), and/or radiotherapy (n = 14). Fatigue-related symptoms (82%) and "fear of progression" (50%) were the most frequently-experienced issues. When deciding on DCIS treatment, the most important consideration was "fear of progression" (50%). A higher proportion of mastectomy (compared to non-mastectomy) patients considered "difficultly looking at yourself naked" (p = 0.03). Radiotherapy (compared to non-radiotherapy) patients were more likely to consider "feeling unwell" important (p = 0.006). Results were similar in a sensitivity analysis involving all 101 respondents (i.e., including 63 respondents who reported receiving chemotherapy, endocrine therapy, and/or Herceptin, suggesting that they may have been treated for invasive breast cancer). Health literacy was high across all nine HLQ scales. Fear of progression is a key consideration in DCIS treatment decision making for women with high health literacy. QOL treatment considerations differed by treatments received. Women diagnosed with DCIS may benefit from evidence about QOL to inform treatment decision making.

引用

页码：720 / 729

页数：10

共 31 条

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