Breast Cancer Research and Treatment

, Volume 134, Issue 2, pp 867–874

The influence of non-clinical patient factors on medical oncologists’ decisions to recommend breast cancer adjuvant chemotherapy

  • T. May Pini
  • Sarah T. Hawley
  • Yun Li
  • Steven J. Katz
  • Jennifer J. Griggs

DOI: 10.1007/s10549-012-2116-3

Cite this article as:
Pini, T.M., Hawley, S.T., Li, Y. et al. Breast Cancer Res Treat (2012) 134: 867. doi:10.1007/s10549-012-2116-3


The extent to which medical oncologists consider non-clinical patient factors when deciding to recommend adjuvant chemotherapy is unknown. Medical oncologists who treated a population-based sample of early stage breast cancer patients reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries 2005–2007 were asked how strongly they consider a patient’s ability to follow instructions, level of social support, and level of work support/flexibility in decisions to recommend adjuvant chemotherapy. Responses of 4 (Quite strongly) or 5 (Very strongly) on a five-point Likert scale defined strong consideration. Associations between oncologist/practice characteristics and strong consideration of each non-clinical factor were examined. 134 oncologists (66 %) reported strong consideration of one or more factor. Ability to follow instructions was strongly considered by 120 oncologists (59 %), social support by 78 (38 %), and work support/flexibility by 73 (36 %). Larger percent of practice devoted to breast cancer was associated with lower likelihood of strongly considering ability to follow instructions [odds ratio (OR) 0.98, 95 % confidence interval (CI) 0.97–0.99; P = 0.04]. Increased years in practice was associated with lower likelihood of strongly considering social support (OR 0.96, CI 0.93–0.99; P = 0.011), while non-white race (OR 2.1, CI 1.03–4.26; P = 0.041) and tumor board access (OR 2.04, CI 1.01–4.12; P = 0.048) were associated with higher likelihood. Non-white race was associated with strongly considering work support/flexibility (OR 2.44, CI 1.21–4.92; P = 0.013). Tumor board access (OR 2, CI 1.00–4.02; P = 0.051) was borderline significant. Non-clinical patient factors play a role in medical oncologist decision-making for breast cancer adjuvant chemotherapy recommendations.


Decision making Breast cancer Chemotherapy Social environment Socioeconomic factors 

Supplementary material

10549_2012_2116_MOESM1_ESM.pdf (56 kb)
Supplementary material 1 (PDF 56 kb)

Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • T. May Pini
    • 1
  • Sarah T. Hawley
    • 2
  • Yun Li
    • 3
  • Steven J. Katz
    • 4
  • Jennifer J. Griggs
    • 5
  1. 1.Department of Clinical Cancer Prevention, Division of Cancer Prevention and Population SciencesThe University of Texas M.D. Anderson Cancer CenterHoustonUSA
  2. 2.Division of General Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  3. 3.Department of BiostatisticsUniversity of MichiganAnn ArborUSA
  4. 4.Division of General Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  5. 5.Division of Hematology/Oncology, Department of Internal MedicineUniversity of MichiganAnn ArborUSA

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