Cancer Control Research
1R03CA075140-01A1
Lantz, Paula M.
TREATMENT DECISIONS COMPARING DCIS/INVASIVE BC PATIENTS
AbstractDESCRIPTION (Applicant's Description) The incidence of ductal carcinoma in
situ of the breast (DCIS) has increased dramatically during the past decade
largely due to the concurrent rise in the use of screening mammography.
Since mastectomy remains the most common surgical treatment for DCIS
patients, there is concern among clinicians and advocacy groups that many
women with DCIS are being "over-treated" with the receipt of mastectomy. At
the present time, no population-based studies have investigated whether the
determinants of surgical treatment choice and satisfaction with choice
differ for women with DCIS versus those with invasive disease. Thus, we
propose to conduct an interdisciplinary pilot study of the determinants of
surgical treatment choice across stages of disease using a population-based
and racially/socioeconomically diverse sample of patients. We aim to
develop and pilot test a mailed survey instrument in a sample of 280
recently diagnosed women (140 patients with DCIS and 140 patients with
invasive disease) gathered prospectively as they are reported to the
Detroit-area SEER registry. We anticipate a 70% response rate, which will
result in approximately 200 respondents. In addition, we aim to use our
experience and preliminary data from this pilot study to refine and set a
hypotheses about the relationship of socioeconomic, psychological and
clinical factors (including stage of disease) to surgical treatment choice
and subsequent satisfaction with that choice. Finally, we will evaluate the
study methodology to assess the feasibility of using self- administered
mailed surveys to investigate breast cancer treatment decision-making, and
to articulate the strengths, limitations and costs of this approach. The
results of this study will serve as the foundation for a larger
population-based study of factors associated with surgical treatment choice
and satisfaction among breast cancer patients with DCIS versus invasive
disease. Increasing knowledge in this area is likely to increase patient
satisfaction with treatment decisions, improve patient adherence to
treatment plans, and thus decrease negative sequelae costs (both economic
and psychosocial) in the recovery process.
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