Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul;134(2):867-74.
doi: 10.1007/s10549-012-2116-3. Epub 2012 Jun 21.

The influence of non-clinical patient factors on medical oncologists' decisions to recommend breast cancer adjuvant chemotherapy

T May Pini  1 , Sarah T Hawley, Yun Li, Steven J Katz, Jennifer J Griggs
Affiliations

The influence of non-clinical patient factors on medical oncologists' decisions to recommend breast cancer adjuvant chemotherapy

T May Pini et al. Breast Cancer Res Treat. 2012 Jul.

Abstract

The extent to which medical oncologists consider non-clinical patient factors when deciding to recommend adjuvant chemotherapy is unknown. Medical oncologists who treated a population-based sample of early stage breast cancer patients reported to the Los Angeles and Detroit Surveillance, Epidemiology, and End Results registries 2005-2007 were asked how strongly they consider a patient's ability to follow instructions, level of social support, and level of work support/flexibility in decisions to recommend adjuvant chemotherapy. Responses of 4 (Quite strongly) or 5 (Very strongly) on a five-point Likert scale defined strong consideration. Associations between oncologist/practice characteristics and strong consideration of each non-clinical factor were examined. 134 oncologists (66 %) reported strong consideration of one or more factor. Ability to follow instructions was strongly considered by 120 oncologists (59 %), social support by 78 (38 %), and work support/flexibility by 73 (36 %). Larger percent of practice devoted to breast cancer was associated with lower likelihood of strongly considering ability to follow instructions [odds ratio (OR) 0.98, 95 % confidence interval (CI) 0.97-0.99; P = 0.04]. Increased years in practice was associated with lower likelihood of strongly considering social support (OR 0.96, CI 0.93-0.99; P = 0.011), while non-white race (OR 2.1, CI 1.03-4.26; P = 0.041) and tumor board access (OR 2.04, CI 1.01-4.12; P = 0.048) were associated with higher likelihood. Non-white race was associated with strongly considering work support/flexibility (OR 2.44, CI 1.21-4.92; P = 0.013). Tumor board access (OR 2, CI 1.00-4.02; P = 0.051) was borderline significant. Non-clinical patient factors play a role in medical oncologist decision-making for breast cancer adjuvant chemotherapy recommendations.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Percent of oncologists reporting strong consideration of non-clinical patient factors* (N = 203) *Not mutually exclusive
Figure 2
Figure 2
Percent of medical oncologists by count of total number of non-clinical patient factors strongly considered (N = 203)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. National Comprehensive Cancer Network NCCN Clinical Practice Guidelines in Oncology Version 2. 2011 http://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
    1. Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24(23):3726–3734. - PubMed
    1. Levine MN, Whelan T. Adjuvant chemotherapy for breast cancer--30 years later. N Engl J Med. 2006;355(18):1920–1922. - PubMed
    1. Duric VM, Butow PN, Sharpe L, Boyle F, Beith J, Wilcken NRC, Heritier S, Coates AS, John Simes R, Stockler MR. Psychosocial factors and patients’ preferences for adjuvant chemotherapy in early breast cancer. Psychooncology. 2007;16(1):48–59. - PubMed
    1. Leighl N, Gattellari M, Butow P, Brown R, Tattersall MH. Discussing adjuvant cancer therapy. J Clin Oncol. 2001;19(6):1768–1778. - PubMed

Publication types