Featured Research

from universities, journals, and other organizations

Confusing Risk Information May Lead Breast Cancer Patients To Make Poor Treatment Choices

Date:
December 8, 2008
Source:
University of Michigan Health System
Summary:
A new study found that a tool commonly used by doctors to estimate the risk of a woman's breast cancer returning after surgery is not very effective at explaining risk to patients. As a result, women with breast cancer may not find these tools helpful when deciding whether to have chemotherapy.

A new study from researchers at the University of Michigan Comprehensive Cancer Center found that a tool commonly used by doctors to estimate the risk of a woman’s breast cancer returning after surgery is not very effective at explaining risk to patients. As a result, women with breast cancer may not find these tools helpful when deciding whether to have chemotherapy.

The tool itself is very useful to doctors, many of whom print out information from this tool and give it to patients when they are discussing chemotherapy. Nearly all women diagnosed with early stage breast cancer will have surgery, but many will also consider chemotherapy to help prevent the cancer from coming back.

“The main benefit of additional treatments such as chemotherapy after surgery is long-term risk reduction. But chemotherapy does not provide much benefit for some women, and those women can potentially avoid unnecessary side effects by skipping chemotherapy. So understanding how large or small the risk reduction is can help women make the right choice,” says lead study author Brian Zikmund-Fisher, Ph.D., research assistant professor of general medicine at the U-M Medical School and a researcher at the VA Ann Arbor Healthcare System.

The currently available risk-assessment tools present risk statistics in a bar graph format that compares four different potential choices: hormonal therapy alone, chemotherapy alone, both hormonal and chemotherapy, or no treatment at all. The problem, Zikmund-Fisher points out, is that most women are really only choosing between two options: For women whose cancers are sensitive to the hormone estrogen, hormonal treatments provide large benefits with few side effects. The real question is whether chemotherapy is also necessary.

Because the tool shows statistics about all four options, however, the researchers found that it is more difficult for women to find and focus on the number that most matters to their choice: the benefit of adding chemotherapy to hormonal therapy.

In the study, published Dec. 15 in the journal Cancer, researchers surveyed 1,619 women, presenting them with a hypothetical breast cancer diagnosis. All women were given identical risk factors for recurrence. The women viewed one of four graphical formats to describe how chemotherapy would reduce the risk of dying from a return of cancer.

When respondents saw the risk information in the bar graph format that current risk-assessment tools use, only 51 percent correctly understood how much their chance of surviving would increase if they took chemotherapy. When women were shown a simpler graph that showed only the two key options, 65 percent were accurate. And, when the simpler graph used a pictograph format that showed a set of 100 small rectangles to represent the possible outcomes, a full 77 percent were able to correctly report the benefit of chemotherapy.

“Even when patients are given the information they need, they have to be able to understand it well enough to make the right choice. We’re making patients work too hard. Discussions of risk need to be simple and transparent so doctors can spend as little time as possible explaining the numbers to patients and as much time as possible talking about what those numbers mean. That’s the best way to make sure that each patient can make the right choice for her situation,” says Zikmund-Fisher, a member of the Center for Behavioral and Decision Sciences in Medicine at U-M.

The researchers hope that eventually these risk tools will incorporate better ways to show these risks to both doctors and patients. In the meantime, Zikmund-Fisher suggests that patients confused about risk information think of it in terms of frequency, rather than percentages. In other words, if you are told you have an 82 percent chance of surviving 10 years, imagine there are 100 people just like you and that 82 of them are still alive to come back to a 10-year reunion.

“Thinking about those different people and what happens to each of them will help you to realize both possible outcomes and how likely each one is,” Zikmund-Fisher says.

Breast cancer statistics: 184,450 Americans will be diagnosed with breast cancer this year and 40,930 will die from the disease, according to the American Cancer Society

Additional authors: Angela Fagerlin, Ph.D.; Peter A. Ubel, M.D.

Funding: National Institutes of Health, American Cancer Society, U.S. Department of Veterans Affairs

Reference: Cancer, Vol. 113, No. 12, pp. 3382-3390


Story Source:

The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.


Cite This Page:

University of Michigan Health System. "Confusing Risk Information May Lead Breast Cancer Patients To Make Poor Treatment Choices." ScienceDaily. ScienceDaily, 8 December 2008. <www.sciencedaily.com/releases/2008/12/081208140154.htm>.
University of Michigan Health System. (2008, December 8). Confusing Risk Information May Lead Breast Cancer Patients To Make Poor Treatment Choices. ScienceDaily. Retrieved September 17, 2014 from www.sciencedaily.com/releases/2008/12/081208140154.htm
University of Michigan Health System. "Confusing Risk Information May Lead Breast Cancer Patients To Make Poor Treatment Choices." ScienceDaily. www.sciencedaily.com/releases/2008/12/081208140154.htm (accessed September 17, 2014).

Share This



More Health & Medicine News

Wednesday, September 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

President To Send 3,000 Military Personnel To Fight Ebola

President To Send 3,000 Military Personnel To Fight Ebola

Newsy (Sep. 16, 2014) President Obama is expected to send 3,000 troops to West Africa as part of the effort to contain Ebola's spread. Video provided by Newsy
Powered by NewsLook.com
Obama Orders Military Response to Ebola

Obama Orders Military Response to Ebola

AP (Sep. 16, 2014) Calling the Ebola outbreak in West Africa a potential threat to global security, President Barack Obama is ordering 3,000 U.S. military personnel to the stricken region amid worries that the outbreak is spiraling out of control. (Sept. 16) Video provided by AP
Powered by NewsLook.com
UN: 20,000 Could Be Infected With Ebola by Year End

UN: 20,000 Could Be Infected With Ebola by Year End

AFP (Sep. 16, 2014) Nearly $1.0 billion dollars is needed to fight the Ebola outbreak raging in west Africa, the United Nations say, warning that 20,000 could be infected by year end. Duration: 00:40 Video provided by AFP
Powered by NewsLook.com
Obama: Ebola Outbreak Threat to Global Security

Obama: Ebola Outbreak Threat to Global Security

AP (Sep. 16, 2014) President Obama is ordering U.S. military personnel to West Africa to deal with the Ebola outbreak, which is he calls a potential threat to global security. (Sept. 16) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins