Breast Cancer Research and Treatment

, Volume 161, Issue 3, pp 557–565

Recurrence risk perception and quality of life following treatment of breast cancer

  • Sarah T. Hawley
  • Nancy K. Janz
  • Kent A. Griffith
  • Reshma Jagsi
  • Christopher R. Friese
  • Allison W. Kurian
  • Ann S. Hamilton
  • Kevin C. Ward
  • Monica Morrow
  • Lauren P. Wallner
  • Steven J. Katz
Epidemiology

DOI: 10.1007/s10549-016-4082-7

Cite this article as:
Hawley, S.T., Janz, N.K., Griffith, K.A. et al. Breast Cancer Res Treat (2017) 161: 557. doi:10.1007/s10549-016-4082-7

Abstract

Purpose

Little is known about different ways of assessing risk of distant recurrence following cancer treatment (e.g., numeric or descriptive). We sought to evaluate the association between overestimation of risk of distant recurrence of breast cancer and key patient-reported outcomes, including quality of life and worry.

Methods

We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer identified through SEER registries of Los Angeles County & Georgia (2013–14) ~2 months after surgery (N = 2578, RR = 71%). Actual 10-year risk of distant recurrence after treatment was based on clinical factors for women with DCIS & low-risk invasive cancer (Stg 1A, ER+, HER2−, Gr 1–2). Women reported perceptions of their risk numerically (0–100%), with values ≥10% for DCIS & ≥20% for invasive considered overestimates. Perceptions of “moderate, high or very high” risk were considered descriptive overestimates. In our analytic sample (N = 927), we assessed factors correlated with both types of overestimation and report multivariable associations between overestimation and QoL (PROMIS physical & mental health) and frequent worry.

Results

30.4% of women substantially overestimated their risk of distant recurrence numerically and 14.7% descriptively. Few factors other than family history were significantly associated with either type of overestimation. Both types of overestimation were significantly associated with frequent worry, and lower QoL.

Conclusions

Ensuring understanding of systemic recurrence risk, particularly among patients with favorable prognosis, is important. Better risk communication by clinicians may translate to better risk comprehension among patients and to improvements in QoL.

Keywords

Breast cancer Risk Perception Quality of life 

Funding information

Funder NameGrant NumberFunding Note
National Cancer Institute
  • HHSN261201300015I, Task Order HHSN26100006
  • HHSN261201000140C
  • HHSN261201000035C
  • HHSN261201000034C
National Cancer Institute (US)
  • P01CA163233
Centers for Disease Control and Prevention
  • 5NU58DP003862-04/DP003862
  • 5NU58DP003875-04-00

Copyright information

© Springer Science+Business Media New York (outside the USA) 2016

Authors and Affiliations

  • Sarah T. Hawley
    • 1
    • 2
    • 3
  • Nancy K. Janz
    • 4
  • Kent A. Griffith
    • 5
  • Reshma Jagsi
    • 6
  • Christopher R. Friese
    • 7
  • Allison W. Kurian
    • 8
  • Ann S. Hamilton
    • 9
  • Kevin C. Ward
    • 10
  • Monica Morrow
    • 11
  • Lauren P. Wallner
    • 1
    • 12
  • Steven J. Katz
    • 1
    • 2
  1. 1.Division of General Medicine, Department of Internal MedicineUniversity of MichiganAnn ArborUSA
  2. 2.Department of Health Management and PolicyUniversity of MichiganAnn ArborUSA
  3. 3.Ann Arbor VA Center for Clinical Management Research, Ann Arbor VA Health Care SystemUniversity of MichiganAnn ArborUSA
  4. 4.Department of Health Behavior and Health EducationUniversity of MichiganAnn ArborUSA
  5. 5.Center for Cancer Biostatistics, School of Public HealthUniversity of MichiganAnn ArborUSA
  6. 6.Department of Radiation OncologyUniversity of MichiganAnn ArborUSA
  7. 7.Department of Systems, Populations, and Leadership, School of NursingUniversity of MichiganAnn ArborUSA
  8. 8.Departments of Medicine and Health Research and PolicyStanford UniversityStanfordUSA
  9. 9.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  10. 10.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA
  11. 11.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  12. 12.Department of EpidemiologyUniversity of MichiganAnn ArborUSA

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