Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, Canada; Dept of Oncology, Queen's University, Kingston, Canada.
Breast. 2013 Oct;22(5):919-25. doi: 10.1016/j.breast.2013.04.020. Epub 2013 May 28.
To identify the information that post-menopausal women with hormone-receptor positive, early-stage breast cancer want, to help them decide among six treatment options for adjuvant-endocrine therapy.
We surveyed women with early-stage breast cancer who were eligible for adjuvant endocrine-therapy 3-18 months earlier. Participants rated the importance of getting each of 95 questions answered before this decision is made (options: essential/desired/not important/avoid). For questions rated essential or desired, participants identified the purpose(s) for having the question answered: to help them understand, make the decision, plan, or other. Participants indicated the role they played in their actual decision and the role they would prefer if the decision was made today. They also indicated whether they felt they had had a choice of endocrine therapy treatments.
188 of 343 questionnaires were returned (response rate 55%). Mean age was 67 yr (range 38-88 yr); 76% were married, and 39% had secondary school education or less. On average, respondents rated 18 questions (range 0-94) essential for decision making. Each question was rated essential for decision making by ≥ 7% of participants but only 1 question by >50%. Regarding roles, 89% of respondents had participated in their actual decision and would want to again; an additional 9% had not participated in their actual decision but would want to at the time of the survey. The percentage of respondents who felt they had no choice of endocrine therapy treatments varied between centres, 25% vs 41% and 49%.
Most patients want to participate in the decision but they vary widely in the amount and which specific details they want to help them make the decision.
The wide variation in questions considered important means the support should be tailored to the needs of the individual patient.
确定激素受体阳性、早期乳腺癌绝经后妇女希望获得的信息，帮助她们在六种辅助内分泌治疗方案中做出选择。
我们调查了 3-18 个月前有资格接受辅助内分泌治疗的早期乳腺癌患者。参与者对在做出该决定之前获得 95 个问题中的每一个答案的重要性进行了评分（选项：必要/需要/不重要/避免）。对于评分必要或需要的问题，参与者确定回答问题的目的（帮助理解、做出决定、计划或其他）。参与者表示他们在实际决策中扮演的角色以及如果今天做出决策他们希望扮演的角色。他们还表示是否认为自己有选择内分泌治疗方案的机会。
343 份问卷中，188 份（回应率为 55%）被收回。平均年龄为 67 岁（范围 38-88 岁）；76%已婚，39%受过中学或以下教育。平均而言，受访者认为 18 个问题（范围 0-94）对决策至关重要。但只有 1 个问题被≥7%的参与者评为必备，而>50%的参与者认为有 1 个问题是必备的。关于角色，89%的受访者参与了他们的实际决策，并希望再次参与；另外 9%的受访者虽然没有参与他们的实际决策，但希望在调查时参与。不同中心的患者对是否有选择内分泌治疗方案的机会的看法存在差异，分别为 25%、41%和 49%。
大多数患者希望参与决策，但他们在参与程度和帮助他们做出决策所需的具体细节方面存在很大差异。
认为重要的问题差异很大，这意味着支持应该根据患者的个体需求进行调整。
