The Impact of Doctor-Patient Communication on Patients’ Perceptions of their Risk of Breast Cancer Recurrence ; Breast Cancer Res Treat

Purpose ; Doctor-patient communication is the primary way women diagnosed with breast cancer learn about their risk of distant recurrence. Yet little is known about how doctors approach these discussions. ; Methods ; A weighted random sample of newly diagnosed early stage breast cancer patients identified through SEER registries of Los Angeles and Georgia (2013–2015) were sent surveys ~about 2 months after surgery (Phase 2, N=3930, RR 68%). We assessed patient perceptions of doctor communication of risk of recurrence (i.e., amount, approach, inquiry about worry). Clinically-determined 10-year risk of distant recurrence was established for low and intermediate invasive cancer patients. Women’s perceived risk of distant recurrence (0–100%) was categorized into subgroups: overestimation, reasonably accurate, zero risk. Understanding of risk and patient factors (e.g., health literacy, numeracy and anxiety/worry) on physician communication outcomes was evaluated in multivariable regression models (analytic sample for substudy = 1295). ; Results ; About 33% of women reported doctors discussed risk of recurrence “quite a bit� or “a lot� while 14% said “not at all.� Over half of women reported doctors used words and numbers to describe risk, while 24% used only words. Overestimators (OR =.50, CI 0.31, 0.81) or those who perceived zero risk (OR =.46, CI 0.29,0.72) more often said their doctor did not discuss risk. Patients with low numeracy reported less discussion. Over 60% reported their doctor almost never inquired about worry. ; Conclusions ; Effective doctor-patient communication is critical to patient understanding of risk of recurrence. Efforts to enhance physicians’ ability to engage in individualized communication around risk are needed. ; HHSN261201000035C/PC,CA/None/None ; HHSN261201000140C/CA/NCI NIH HHS/United States ; P30 CA046592/CA/NCI NIH HHS/United States ; P01 CA163233/CA/NCI NIH HHS/United States ; U58 DP003875/DP/NCCDPHP CDC HHS/United States ; HHSN261201300015C/RC/CCR NIH ...