Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2014

Open Access 01-12-2014 | Research

Patient age is related to decision-making, treatment selection, and perceived quality of life in breast cancer survivors

Authors: Terence T Sio, Kenneth Chang, Ritujith Jayakrishnan, Difu Wu, Mary Politi, Dominique Malacarne, James Saletnik, Maureen Chung

Published in: World Journal of Surgical Oncology | Issue 1/2014

Login to get access

Abstract

Background

Patients with breast cancer must choose among a variety of treatment options when first diagnosed. Patient age, independent of extent of disease, is also related to quality of life. This study examined the impact of patient age on treatment selected, factors influencing this selection, and perceived quality of life.

Methods

A 62-question survey evaluating breast cancer treatment and quality of life was mailed to breast cancer survivors. Responses were stratified by age (<50, 50-65, >65 years) and extent of disease.

Results

Of the 1,131 surveys mailed, 402 were included for analysis. There were 104, 179, and 119 women aged <50, 50-65, and >65 years, respectively. The median patient age was 58 years, and the average interval from diagnosis to survey participation was 31.5 months.

Conclusions

Young women were more likely to have undergone aggressive therapies and had better physical functioning than old women. Old patients reported good quality of life and body image. Clinicians should consider patient age when discussing breast cancer treatment options.
Appendix
Available only for authorised users
Literature
1.
go back to reference Siegel R, Ward E, Brawley O, Jemal A: Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011, 61: 212-236. 10.3322/caac.20121.CrossRefPubMed Siegel R, Ward E, Brawley O, Jemal A: Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011, 61: 212-236. 10.3322/caac.20121.CrossRefPubMed
2.
go back to reference Petrisek AC, Laliberte LL, Allen SM, Mor V: The treatment decision-making process: age differences in a sample of women recently diagnosed with nonrecurrent, early-stage breast cancer. Gerontologist. 1997, 37: 598-608. 10.1093/geront/37.5.598.CrossRefPubMed Petrisek AC, Laliberte LL, Allen SM, Mor V: The treatment decision-making process: age differences in a sample of women recently diagnosed with nonrecurrent, early-stage breast cancer. Gerontologist. 1997, 37: 598-608. 10.1093/geront/37.5.598.CrossRefPubMed
3.
go back to reference Bleicher RJ, Abrahamse P, Hawley ST, Katz SJ, Morrow M: The influence of age on the breast surgery decision-making process. Ann Surg Oncol. 2008, 15: 854-862. 10.1245/s10434-007-9708-x.CrossRefPubMed Bleicher RJ, Abrahamse P, Hawley ST, Katz SJ, Morrow M: The influence of age on the breast surgery decision-making process. Ann Surg Oncol. 2008, 15: 854-862. 10.1245/s10434-007-9708-x.CrossRefPubMed
4.
go back to reference Vogel BA, Leonhart R, Helmes AW: Communication matters: the impact of communication and participation in decision making on breast cancer patients’ depression and quality of life. Patient Educ Couns. 2009, 77: 391-397. 10.1016/j.pec.2009.09.005.CrossRefPubMed Vogel BA, Leonhart R, Helmes AW: Communication matters: the impact of communication and participation in decision making on breast cancer patients’ depression and quality of life. Patient Educ Couns. 2009, 77: 391-397. 10.1016/j.pec.2009.09.005.CrossRefPubMed
5.
go back to reference Montazeri A: Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008, 27: 32-10.1186/1756-9966-27-32.PubMedCentralCrossRefPubMed Montazeri A: Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008, 27: 32-10.1186/1756-9966-27-32.PubMedCentralCrossRefPubMed
6.
go back to reference Wedding U, Pientka L, Hoffken K: Quality-of-life in elderly patients with cancer: a short review. Eur J Cancer. 2007, 43: 2203-2210. 10.1016/j.ejca.2007.06.001.CrossRefPubMed Wedding U, Pientka L, Hoffken K: Quality-of-life in elderly patients with cancer: a short review. Eur J Cancer. 2007, 43: 2203-2210. 10.1016/j.ejca.2007.06.001.CrossRefPubMed
7.
go back to reference Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, De Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993, 85: 365-376. 10.1093/jnci/85.5.365.CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, De Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993, 85: 365-376. 10.1093/jnci/85.5.365.CrossRefPubMed
8.
go back to reference Sprangers MA, Groenvold M, Arraras JI, Franklin J, Te Velde A, Muller M, Franzini L, Williams A, De Haes HC, Hopwood P, Cull A, Aaronson NK: The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996, 14: 2756-2768.PubMed Sprangers MA, Groenvold M, Arraras JI, Franklin J, Te Velde A, Muller M, Franzini L, Williams A, De Haes HC, Hopwood P, Cull A, Aaronson NK: The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996, 14: 2756-2768.PubMed
9.
go back to reference Brehaut JC, O'Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, Feldman-Stewart D: Validation of a decision regret scale. Med Decis Making. 2003, 23: 281-292. 10.1177/0272989X03256005.CrossRefPubMed Brehaut JC, O'Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, Feldman-Stewart D: Validation of a decision regret scale. Med Decis Making. 2003, 23: 281-292. 10.1177/0272989X03256005.CrossRefPubMed
10.
go back to reference Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV: Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas. 2009, 62: 153-159. 10.1016/j.maturitas.2008.12.006.CrossRefPubMed Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV: Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas. 2009, 62: 153-159. 10.1016/j.maturitas.2008.12.006.CrossRefPubMed
11.
go back to reference Lam WW, Fielding R, Ho EY, Chan M, Or A: Surgeon’s recommendation, perceived operative efficacy and age dictate treatment choice by Chinese women facing breast cancer surgery. Psychooncology. 2005, 14: 585-593. 10.1002/pon.877.CrossRefPubMed Lam WW, Fielding R, Ho EY, Chan M, Or A: Surgeon’s recommendation, perceived operative efficacy and age dictate treatment choice by Chinese women facing breast cancer surgery. Psychooncology. 2005, 14: 585-593. 10.1002/pon.877.CrossRefPubMed
12.
go back to reference Gorman JR, Usita PM, Madlensky L, Pierce JP: Young breast cancer survivors: their perspectives on treatment decisions and fertility concerns. Cancer Nurs. 2011, 34: 32-40. 10.1097/NCC.0b013e3181e4528d.PubMedCentralCrossRefPubMed Gorman JR, Usita PM, Madlensky L, Pierce JP: Young breast cancer survivors: their perspectives on treatment decisions and fertility concerns. Cancer Nurs. 2011, 34: 32-40. 10.1097/NCC.0b013e3181e4528d.PubMedCentralCrossRefPubMed
13.
go back to reference Osborn GD, Hodin M, Drew PJ, Fielder H, Vaughan-Williams E, Sweetland HM: Patient demographics and treatment for early breast cancer: an observational study. Breast. 2006, 15: 377-381. 10.1016/j.breast.2005.07.004.CrossRefPubMed Osborn GD, Hodin M, Drew PJ, Fielder H, Vaughan-Williams E, Sweetland HM: Patient demographics and treatment for early breast cancer: an observational study. Breast. 2006, 15: 377-381. 10.1016/j.breast.2005.07.004.CrossRefPubMed
14.
go back to reference Gumus M, Ustaalioglu BO, Garip M, Kiziltan E, Bilici A, Seker M, Erkol B, Salepci T, Mayadagli A, Turhal NS: Factors that affect patients’ decision-making about mastectomy or breast conserving surgery, and the psychological effect of this choice on breast cancer patients. Breast Care (Basel). 2010, 5: 164-168. 10.1159/000314266.CrossRef Gumus M, Ustaalioglu BO, Garip M, Kiziltan E, Bilici A, Seker M, Erkol B, Salepci T, Mayadagli A, Turhal NS: Factors that affect patients’ decision-making about mastectomy or breast conserving surgery, and the psychological effect of this choice on breast cancer patients. Breast Care (Basel). 2010, 5: 164-168. 10.1159/000314266.CrossRef
15.
go back to reference Metcalfe KA, Goel V, Lickley L, Semple J, Narod SA: Prophylactic bilateral mastectomy: patterns of practice. Cancer. 2002, 95: 236-242. 10.1002/cncr.10680.CrossRefPubMed Metcalfe KA, Goel V, Lickley L, Semple J, Narod SA: Prophylactic bilateral mastectomy: patterns of practice. Cancer. 2002, 95: 236-242. 10.1002/cncr.10680.CrossRefPubMed
16.
go back to reference Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002, 347: 1233-1241. 10.1056/NEJMoa022152.CrossRefPubMed Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002, 347: 1233-1241. 10.1056/NEJMoa022152.CrossRefPubMed
17.
go back to reference Sammarco A: Quality of life among older survivors of breast cancer. Cancer Nurs. 2003, 26: 431-438.CrossRefPubMed Sammarco A: Quality of life among older survivors of breast cancer. Cancer Nurs. 2003, 26: 431-438.CrossRefPubMed
18.
go back to reference Greenfield S, Blanco DM, Elashoff RM, Ganz PA: Patterns of care related to age of breast cancer patients. JAMA. 1987, 257: 2766-2770. 10.1001/jama.1987.03390200106023.CrossRefPubMed Greenfield S, Blanco DM, Elashoff RM, Ganz PA: Patterns of care related to age of breast cancer patients. JAMA. 1987, 257: 2766-2770. 10.1001/jama.1987.03390200106023.CrossRefPubMed
19.
go back to reference Hwang ES, Nelson H: Reframing treatment for ductal carcinoma in situ: could less be more?. Bull Am Coll Surg. 2012, 97: 50-51.PubMed Hwang ES, Nelson H: Reframing treatment for ductal carcinoma in situ: could less be more?. Bull Am Coll Surg. 2012, 97: 50-51.PubMed
20.
go back to reference Sivell S, Edwards A, Elwyn G, Manstead AS: Understanding surgery choices for breast cancer: how might the theory of planned behaviour and the common sense model contribute to decision support interventions?. Health Expect. 2011, 14 (Suppl 1): 6-19.CrossRefPubMed Sivell S, Edwards A, Elwyn G, Manstead AS: Understanding surgery choices for breast cancer: how might the theory of planned behaviour and the common sense model contribute to decision support interventions?. Health Expect. 2011, 14 (Suppl 1): 6-19.CrossRefPubMed
21.
go back to reference Fancher TT, Palesty JA, Thomas R, Healy T, Fancher JM, Ng C, Dudrick SJ: A woman’s influence to choose mastectomy as treatment for breast cancer. J Surg Res. 2009, 153: 128-131. 10.1016/j.jss.2008.04.031.CrossRefPubMed Fancher TT, Palesty JA, Thomas R, Healy T, Fancher JM, Ng C, Dudrick SJ: A woman’s influence to choose mastectomy as treatment for breast cancer. J Surg Res. 2009, 153: 128-131. 10.1016/j.jss.2008.04.031.CrossRefPubMed
22.
go back to reference Yanez B, Stanton AL, Maly RC: Breast cancer treatment decision making among Latinas and non-Latina Whites: a communication model predicting decisional outcomes and quality of life. Health Psychol. 2012, 31: 552-561.PubMedCentralCrossRefPubMed Yanez B, Stanton AL, Maly RC: Breast cancer treatment decision making among Latinas and non-Latina Whites: a communication model predicting decisional outcomes and quality of life. Health Psychol. 2012, 31: 552-561.PubMedCentralCrossRefPubMed
23.
go back to reference Andersen MR, Bowen DJ, Morea J, Stein KD, Baker F: Involvement in decision-making and breast cancer survivor quality of life. Health Psychol. 2009, 28: 29-37.CrossRefPubMed Andersen MR, Bowen DJ, Morea J, Stein KD, Baker F: Involvement in decision-making and breast cancer survivor quality of life. Health Psychol. 2009, 28: 29-37.CrossRefPubMed
24.
go back to reference Andersen MR, Urban N: Involvement in decision-making and breast cancer survivor quality of life. Ann Behav Med. 1999, 21: 201-209. 10.1007/BF02884834.CrossRefPubMed Andersen MR, Urban N: Involvement in decision-making and breast cancer survivor quality of life. Ann Behav Med. 1999, 21: 201-209. 10.1007/BF02884834.CrossRefPubMed
25.
go back to reference Bloom JR, Stewart SL, Chang S, Banks PJ: Then and now: quality of life of young breast cancer survivors. Psychooncology. 2004, 13: 147-160. 10.1002/pon.794.CrossRefPubMed Bloom JR, Stewart SL, Chang S, Banks PJ: Then and now: quality of life of young breast cancer survivors. Psychooncology. 2004, 13: 147-160. 10.1002/pon.794.CrossRefPubMed
26.
go back to reference Helgesson O, Lissner L, Mansson J, Bengtsson C: Quality of life in cancer survivors as observed in a population study of Swedish women. Scand J Prim Health Care. 2007, 25: 220-225. 10.1080/02813430701669535.PubMedCentralCrossRefPubMed Helgesson O, Lissner L, Mansson J, Bengtsson C: Quality of life in cancer survivors as observed in a population study of Swedish women. Scand J Prim Health Care. 2007, 25: 220-225. 10.1080/02813430701669535.PubMedCentralCrossRefPubMed
27.
go back to reference Klein D, Mercier M, Abeilard E, Puyraveau M, Danzon A, Dalstein V, Pozet A, Guizard AV, Henry-Amar M, Velten M: Long-term quality of life after breast cancer: a French registry-based controlled study. Breast Cancer Res Treat. 2011, 129: 125-134. 10.1007/s10549-011-1408-3.CrossRefPubMed Klein D, Mercier M, Abeilard E, Puyraveau M, Danzon A, Dalstein V, Pozet A, Guizard AV, Henry-Amar M, Velten M: Long-term quality of life after breast cancer: a French registry-based controlled study. Breast Cancer Res Treat. 2011, 129: 125-134. 10.1007/s10549-011-1408-3.CrossRefPubMed
28.
go back to reference Hormes JM, Bryan C, Lytle LA, Gross CR, Ahmed RL, Troxel AB, Schmitz KH: Impact of lymphedema and arm symptoms on quality of life in breast cancer survivors. Lymphology. 2010, 43: 1-13.PubMed Hormes JM, Bryan C, Lytle LA, Gross CR, Ahmed RL, Troxel AB, Schmitz KH: Impact of lymphedema and arm symptoms on quality of life in breast cancer survivors. Lymphology. 2010, 43: 1-13.PubMed
29.
go back to reference Sackey H, Sandelin K, Frisell J, Wickman M, Brandberg Y: Ductal carcinoma in situ of the breast. Long-term follow-up of health-related quality of life, emotional reactions and body image. Eur J Surg Oncol. 2010, 36: 756-762. 10.1016/j.ejso.2010.06.016.CrossRefPubMed Sackey H, Sandelin K, Frisell J, Wickman M, Brandberg Y: Ductal carcinoma in situ of the breast. Long-term follow-up of health-related quality of life, emotional reactions and body image. Eur J Surg Oncol. 2010, 36: 756-762. 10.1016/j.ejso.2010.06.016.CrossRefPubMed
30.
go back to reference Romanek KM, McCaul KD, Sandgren AK: Age differences in treatment decision making for breast cancer in a sample of healthy women: the effects of body image and risk framing. Oncol Nurs Forum. 2005, 32: 799-806. 10.1188/05.ONF.799-806.CrossRefPubMed Romanek KM, McCaul KD, Sandgren AK: Age differences in treatment decision making for breast cancer in a sample of healthy women: the effects of body image and risk framing. Oncol Nurs Forum. 2005, 32: 799-806. 10.1188/05.ONF.799-806.CrossRefPubMed
31.
go back to reference Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Holzel D: Predictors of quality of life of breast cancer patients. Acta Oncol. 2003, 42: 710-718. 10.1080/02841860310017658.CrossRefPubMed Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Holzel D: Predictors of quality of life of breast cancer patients. Acta Oncol. 2003, 42: 710-718. 10.1080/02841860310017658.CrossRefPubMed
32.
go back to reference Fu OS, Crew KD, Jacobson JS, Greenlee H, Yu G, Campbell J, Ortiz Y, Hershman DL: Ethnicity and persistent symptom burden in breast cancer survivors. J Cancer Surviv. 2009, 3: 241-250. 10.1007/s11764-009-0100-7.CrossRefPubMed Fu OS, Crew KD, Jacobson JS, Greenlee H, Yu G, Campbell J, Ortiz Y, Hershman DL: Ethnicity and persistent symptom burden in breast cancer survivors. J Cancer Surviv. 2009, 3: 241-250. 10.1007/s11764-009-0100-7.CrossRefPubMed
33.
go back to reference Chopra I, Kamal KM: A systematic review of quality of life instruments in long-term breast cancer survivors. Health Qual Life Outcomes. 10: 14- Chopra I, Kamal KM: A systematic review of quality of life instruments in long-term breast cancer survivors. Health Qual Life Outcomes. 10: 14-
34.
go back to reference Northouse LL, Mood D, Kershaw T, Schafenacker A, Mellon S, Walker J, Galvin E, Decker V: Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol. 2002, 20: 4050-4064. 10.1200/JCO.2002.02.054.CrossRefPubMed Northouse LL, Mood D, Kershaw T, Schafenacker A, Mellon S, Walker J, Galvin E, Decker V: Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol. 2002, 20: 4050-4064. 10.1200/JCO.2002.02.054.CrossRefPubMed
35.
go back to reference Giedzinska AS, Meyerowitz BE, Ganz PA, Rowland JH: Health-related quality of life in a multiethnic sample of breast cancer survivors. Ann Behav Med. 2004, 28: 39-51. 10.1207/s15324796abm2801_6.CrossRefPubMed Giedzinska AS, Meyerowitz BE, Ganz PA, Rowland JH: Health-related quality of life in a multiethnic sample of breast cancer survivors. Ann Behav Med. 2004, 28: 39-51. 10.1207/s15324796abm2801_6.CrossRefPubMed
Metadata
Title
Patient age is related to decision-making, treatment selection, and perceived quality of life in breast cancer survivors
Authors
Terence T Sio
Kenneth Chang
Ritujith Jayakrishnan
Difu Wu
Mary Politi
Dominique Malacarne
James Saletnik
Maureen Chung
Publication date
01-12-2014
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2014
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-12-230

Other articles of this Issue 1/2014

World Journal of Surgical Oncology 1/2014 Go to the issue