Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN, USA.
Med Decis Making. 2020 May;40(4):540-544. doi: 10.1177/0272989X20918606. Epub 2020 May 20.
Having dependent children may affect cancer treatment decisions. We sought to describe women's surgery and chemotherapy decisions in nonmetastatic breast cancer by parental status. We conducted a secondary analysis of the 2015 cross-sectional Share Thoughts on Breast Cancer Study, conducted in 7 Midwestern states in the United States, restricted to women of prime parenting age (aged 20-50 years) who consented to the use of their medical records ( = 225). We examined treatment decisions using data visualization and logistic regression (adjusted for age, stage, family history of breast cancer, income, education, race, health insurance, and partner status). Women with dependent children received bilateral mastectomy more often than women without dependent children (adjusted odds ratio 3.09, 95% confidence interval 1.44-6.62).We found no differences in the receipt of chemotherapy by parental status. Women reported more active roles in surgery than in chemotherapy decision making. As a likely factor in cancer treatment decisions, parental status should be addressed in clinical practice and research. Future research should assess patients' sense of ownership in treatment decision making by treatment type.
有子女依赖可能会影响癌症治疗决策。我们旨在通过父母身份描述非转移性乳腺癌女性的手术和化疗决策。我们对 2015 年横断面性乳腺癌分享研究进行了二次分析,该研究在美国中西部 7 个州进行,仅包括同意使用其病历的主要育儿年龄(20-50 岁)的女性(n=225)。我们使用数据可视化和逻辑回归检查了治疗决策(调整了年龄、阶段、乳腺癌家族史、收入、教育、种族、医疗保险和伴侣状况)。有子女依赖的女性比没有子女依赖的女性更常接受双侧乳房切除术(调整后的优势比 3.09,95%置信区间 1.44-6.62)。我们没有发现父母身份对接受化疗的差异。女性报告在手术决策中比化疗决策中更积极。作为癌症治疗决策的一个可能因素,父母身份应在临床实践和研究中得到解决。未来的研究应该根据治疗类型评估患者在治疗决策中的所有权感。