Grant Details
Grant Number: |
1R01CA088370-01A1 Interpret this number |
Primary Investigator: |
Katz, Steven |
Organization: |
University Of Michigan At Ann Arbor |
Project Title: |
Surgical Treament for Early State Breast Cancer |
Fiscal Year: |
2001 |
Abstract
DESCRIPTION (provided by applicant): The incidence of ductal carcinoma in situ
of the breast (DCIS) has risen dramatically among women in the United States
since the early 1980's. Survival for DCIS is very high regardless of the type
of surgical treatment and, for patients with favorable histopathology, the risk
of local recurrence post-lumpectomy is very low. There are, however, large
variations in the surgical management of DCIS patients. Although many women
with DCIS appear to be ideal candidates for breast conserving therapy,
mastectomy rates for this particular form of breast cancer remain high. This
has led to concerns about "over treatment" among clinicians and patient
advocacy groups alike. Unfortunately, we do not know enough about the factors
that influence breast cancer surgery choice and the processes by which complex
treatment decisions are made to fully inform these debates. Furthermore, we
have little information about outcomes such as patient satisfaction or
subsequent quality of life for women with DCIS, and to what extent these
important outcomes may differ between women with DCIS and those with invasive
breast cancer.
We propose a multi-center population-based study to examine a broad array of
determinants (external influences, clinical factors, predisposing/enabling
factors, and patient knowledge and attitudinal factors) that are associated
with three outcomes for women recently diagnosed with breast cancer: 1)
surgical treatment choice (mastectomy vs lumpectomy with or without radiation);
2) short-term patient satisfaction with the treatment decision and the
treatment-making process; and 3) health-related quality of life. The study will
be conducted using a population-based sample of breast cancer patients in three
racially and socioeconomically diverse urban areas in the United States
(Detroit, Los Angeles and Atlanta). An initial sample of 2900 women recently
diagnosed will be selected prospectively from three Surveillance, Epidemiology
and End Results (SEER) catchment areas over a 15-month period using a rapid
case ascertainment process. This sample will be stratified by level of disease
(1450 women with DCIS and 1450 with invasive disease), and we will oversample
African-American women. Eligible women consenting to be in the study will
receive a standardized survey questionnaire in the mail for
self-administration. Based on our pilot experience in the Detroit SEER site, we
expect that approximately 75 percent of patients eligible for the study will
complete questionnaires (N=l880).
Publications
From policy to patients and back: surgical treatment decision making for patients with breast cancer.
Authors: Katz S.J.
, Hawley S.T.
.
Source: Health affairs (Project Hope), 2007 May-Jun; 26(3), p. 761-9.
PMID: 17485755
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