Skip to main content
SpringerLink
Log in

Framing of outcome and probability of recurrence: Breast cancer patients' choice of adjuvant chemotherapy (ACT) in hypothetical patient scenarios

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose.To examine the effects of framing of outcome and probabilities of cancer occurrence on the treatment preference which breast cancer patients indicate for hypothetical patient scenarios.

Methods.A modified version of the Decision Board Instrument (Levine et al. 1992) was administered to 35 breast cancer patients with past ACT experience. Patients expressed their choice regarding ACT for six scenarios which were characterized by either negative or positive framing of outcome and by one of the three levels of probability of recurrence (high, medium, low).

Results.The framing had no influence on ACT choices over all three probability levels. The majority chose ACT for high and medium risk and one third switched from ACT to No ACT in the low-risk condition. This switch was statistically significant.

Conclusion.Hypothetical treatment decisions against ACT occur only when the probability of recurrence is low and the benefit of ACT is small. This finding for patients with past experience of ACT is similar to those reported for other oncological patient groups still in treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McQuellon RP, Muss HB, Hoffman SL, Russell G, Craven B, Yellen SB: Patient preferences for treatment of metastatic breast cancer: A study of women with early stage breast cancer. J Clin Oncol 13: 858–868, 1995

    Google Scholar 

  2. Levine MN, Gafni A, Markham B, MacFarlane D: A bedside instrument to elicit a patient' preference concerning adjuvant chemotherapy for breast cancer. Ann Intern Med 117: 53–58, 1992

    Google Scholar 

  3. Cassileth BR, Zupkis RV, Sutton Smith K, March V: Information and participation preferences among cancer patients. Ann Intern Med 92: 832–836, 1980

    Google Scholar 

  4. Penman DT, Holland JC, Bahna GF, Morrow G, Schmale AH, Derogatis LR, Carnike CL Jr, Cherry R: Informed consent for investigational chemotherapy: Patient' and physician' perceptions. J Clin Oncol 2: 849–855, 1984

    Google Scholar 

  5. Rimer B, Jones WH, Keintz MK, Catalano RB, Engstrom PF: Informed consent: A crucial step in cancer patient education. Health Educ Q 10: 30–42, 1984

    Google Scholar 

  6. Siminoff LA, Fetting JH, Abeloff MD: Doctor–patient communication about breast cancer adjuvant therapy. J Clin Oncol 7: 1192–1200, 1989

    Google Scholar 

  7. Beaver K, Luker KA, Owens RG, Leinster SJ, Degner LF: Treatment decision making in women newly diagnosed with breast cancer Canc Nurs 19: 8–19, 1995

    Google Scholar 

  8. Sebban C, Browman G, Gafni A, Norman G, Levine M, Assouline D, Fiere D: Design and validation of a bedside decision instrument to elicit a patient' preference concerning allogenic bone marrow transplantation in chronic myeloid leukemia. Am J Hematol 48: 221–227, 1995

    Google Scholar 

  9. Siminoff AL, Fetting JH: Effects of outcome framing on treatment decisions in the real word. Med Decis Making 9: 262–271, 1989

    Google Scholar 

  10. O'Connor AM: Effects of framing and level of probability on patients' preferences for cancer chemotherapy. J Clin Epidemiol 42: 119–126, 1989

    Google Scholar 

  11. Hayman JA, Fairclough Dl, Harris JR, Weeks JC: Patient preferences concerning the trade off between the risks and benefits of routine radiation therapy after conservative surgery for early stage breast cancer. J Clin Oncol 15: 1252–1260, 1997

    Google Scholar 

  12. Llewellyn-Thomas HA, Sutherland HJ, Cummings BJ: The selection of values in laryngeal cancer: Reliability of measurement methods. J Chron Dis 37: 283–291, 1984

    Google Scholar 

  13. O'Connor AMC, Warde P. Stolbach L, Till JE: Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique, and treatment experience on preferences. J Chron Dis 40: 811–818, 1987

    Google Scholar 

  14. Callahan RD: Letter to the Editor. Ann Intern Med 118: 76, 1993

    Google Scholar 

  15. Yellen SB, Cella DF, Leslie WT: Age and clinical decision making in oncology patients. J Natl Cancer Inst 86: 1766–1770, 1994

    Google Scholar 

  16. Yellen SB, Cella DF: Someone to live for: social well-being, parenthood status, and decision making in oncology. J Clin Oncol 13: 1255–1264, 1995

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Medicina e Sanità Pubblica, Servizio di Psicologia Medica, Università di Verona, Verona, Italy

    Christa Zimmermann & Carla Baldo

  2. Divisione di Oucologia Medica Università di Verona, Verona, Italy

    Annamaria Molino

Authors
  1. Christa Zimmermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carla Baldo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Annamaria Molino
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zimmermann, C., Baldo, C. & Molino, A. Framing of outcome and probability of recurrence: Breast cancer patients' choice of adjuvant chemotherapy (ACT) in hypothetical patient scenarios. Breast Cancer Res Treat 60, 9–14 (2000). https://doi.org/10.1023/A:1006342316373

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006342316373

Search

Navigation