Information Needs of Older Women With Early-Stage Breast Cancer When Making Radiation Therapy Decisions

Purpose: To identify the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. Methods and Materials: We surveyed (through face-to-face interview, telephone, or mail) women aged >= 65 years who received lumpectomy and were considering or receiving adjuvant radiation therapy for early-stage breast cancer. The survey instrument was constructed with input from patient and professional advisory committees, including breast cancer survivors, advocates of breast cancer care and aging, clinicians, and researchers. Participants rated the importance (on a 4-point scale) of 24 statements describing the benefits, side effects, impact on daily life, and other issues of radiation therapy in relation to radiation therapy decision making. Participants also designated who was considered the key decision maker. Results: The response rate was 56.4% (93 of 165). Mean age was 72.5 years, ranging from 65 to 93 years. More than 96% of participants indicated they were the main decision maker on receiving radiation therapy. There was wide variation in information needs regarding radiation therapy decision making. Participants rated a mean of 18 (range, 3-24) items as "essential." Participants rated items related to benefits highest, followed by side effects. Participants who were older than 75 years rated 13.9 questions as essential, whereas participants aged <= 74 years rated 18.7 as essential (P=.018). Conclusions: Older women desire information and have more agency and input in the decision-making process than prior literature would suggest. The variation in information needs indicates that future decision support tools should provide options to select what information would be of interest to the participants. (C) 2017 Elsevier Inc. All rights reserved.