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The influence of familial factors on the choice of the place of death for terminally ill breast cancer patients: a retrospective single-center study

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Abstract

Background

The social or familial factors influencing the location chosen for end-of-life (EOL) care for terminally ill breast cancer patients are unknown.

Methods

We retrospectively analyzed 195 patients with recurrent or progressive breast cancer who received anticancer treatment at the National Cancer Center Hospital between January 2008 and May 2012. Detailed data concerning the patients’ demographic, familial, and clinical characteristics were collected, and multivariate and Cox logistic regression analyses were performed to evaluate the impact of these characteristics on the place of EOL care and on survival, respectively.

Results

Sixty-eight patients (34.9 %) died in a hospital, 26 patients (13.3 %) at home, and 101 patients (51.8 %) in hospice. Most of the patients having caregivers received EOL care at palliative care facilities (hospice or home) [odds ratio (OR) 2.57; 95 % confidence interval (CI) 1–6.6; p = 0.05]. In contrast, patients with factors suggesting a clinically severe status (performance status ≥2, use of opioids, delirium, and ascites) more often received EOL care in a hospital. Among patients who received EOL care at hospice or home, patients with minor children received EOL care at home (OR 0.08; 95 % CI 0.02–0.38; p = 0.001). Patients with brain metastases chose hospice (OR 12.37; 95 % CI 2.25–68.13; p = 0.004). Furthermore, having a caregiver was associated with prolonged survival (hazard ratio 0.62; 95 % CI 0.39–0.97; p = 0.035).

Conclusion

Familial factors such as having children and caregivers significantly influenced the place of EOL care for terminally ill breast cancer patients.

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Acknowledgments

This study was supported by a public grant from the Ministry of Health, Labor, and Welfare of Japan (H24-GanRinSho-Wakate-001).

Author information

Authors and Affiliations

  1. Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan

    Kenichi Harano, Kan Yonemori, Chikako Shimizu, Yasuhiro Fujiwara & Kenji Tamura

  2. Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-0063, Japan

    Kenichi Harano & Noriyuki Katsumata

  3. Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan

    Akihiro Hirakawa

  4. Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

    Akihiko Gemma

Authors
  1. Kenichi Harano
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  2. Kan Yonemori
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  3. Akihiro Hirakawa
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  4. Chikako Shimizu
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  5. Noriyuki Katsumata
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  7. Yasuhiro Fujiwara
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  8. Kenji Tamura
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Corresponding author

Correspondence to Kenichi Harano.

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Harano, K., Yonemori, K., Hirakawa, A. et al. The influence of familial factors on the choice of the place of death for terminally ill breast cancer patients: a retrospective single-center study. Breast Cancer 23, 797–806 (2016). https://doi.org/10.1007/s12282-015-0643-6

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  • DOI: https://doi.org/10.1007/s12282-015-0643-6

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