What quality-of-life issues do women with ductal carcinoma in situ (DCIS) consider important when making treatment decisions?

Purpose To explore quality-of-life (QOL) issues considered important when deciding on treatment for ductal carcinoma in situ (DCIS). Methods Breast Cancer Network of Australia members diagnosed with DCIS in the past 5 years (self-identified) participated in an online survey (Sep–Nov 2015). From a li...

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Bibliographic Details
Published in:Breast cancer (Tokyo, Japan) Japan), 2017-09, Vol.24 (5), p.720-729
Main Authors: Mercieca-Bebber, Rebecca, King, Madeleine T., Boxer, Miriam M., Spillane, Andrew, Winters, Zoë E., Butow, Phyllis N., McPherson, Joan, Rutherford, Claudia
Format: Article
Language:English
Subjects:
Analysis
Antineoplastic Agents, Immunological - therapeutic use
Associations, institutions, etc
Australia
Body Image - psychology
Breast Neoplasms - psychology
Breast Neoplasms - therapy
Cancer
Cancer Research
Carcinoma, Ductal
Carcinoma, Intraductal, Noninfiltrating - psychology
Carcinoma, Intraductal, Noninfiltrating - therapy
Care and treatment
Chemotherapy
Combined Modality Therapy - adverse effects
Decision Making
Disease Progression
Esthetics - psychology
Fatigue
Fear
Female
Health aspects
Health Literacy - statistics & numerical data
Humans
Literacy
Lumpectomy
Mastectomy - adverse effects
Mastectomy - psychology
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Quality of Life - psychology
Radiotherapy
Radiotherapy - adverse effects
Radiotherapy - psychology
Self Report
Societies
Surgery
Surgical Oncology
Surveys
Surveys and Questionnaires
Trastuzumab - therapeutic use
Women
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Summary:Purpose To explore quality-of-life (QOL) issues considered important when deciding on treatment for ductal carcinoma in situ (DCIS). Methods Breast Cancer Network of Australia members diagnosed with DCIS in the past 5 years (self-identified) participated in an online survey (Sep–Nov 2015). From a list of 74 QOL issues, participants selected all issues they experienced during DCIS diagnosis, treatment or recovery, then the issues they felt important to making a DCIS treatment decision, and completed the Health Literacy Questionnaire (HLQ). Associations between QOL issues and self-reported treatment received were assessed with χ 2 tests. Results The primary analysis included 38 participants treated with breast-conserving surgery ( n  = 15), mastectomy ( n  = 23), and/or radiotherapy ( n  = 14). Fatigue-related symptoms (82%) and “fear of progression” (50%) were the most frequently-experienced issues. When deciding on DCIS treatment, the most important consideration was “fear of progression” (50%). A higher proportion of mastectomy (compared to non-mastectomy) patients considered “difficultly looking at yourself naked” ( p  = 0.03). Radiotherapy (compared to non-radiotherapy) patients were more likely to consider “feeling unwell” important ( p  = 0.006). Results were similar in a sensitivity analysis involving all 101 respondents (i.e., including 63 respondents who reported receiving chemotherapy, endocrine therapy, and/or Herceptin, suggesting that they may have been treated for invasive breast cancer). Health literacy was high across all nine HLQ scales. Conclusion Fear of progression is a key consideration in DCIS treatment decision making for women with high health literacy. QOL treatment considerations differed by treatments received. Women diagnosed with DCIS may benefit from evidence about QOL to inform treatment decision making.
ISSN:1340-6868
1880-4233
DOI:10.1007/s12282-017-0765-0