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'Lack of understanding' about disease common in women with breast cancer
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Many women with breast cancer possessed a poor understanding of their tumors and disease characteristics, according to study results.
These knowledge deficiencies were more apparent among Hispanic and black women compared with non-Hispanic white women, results showed.
“Our results illustrate the lack of understanding many patients have about their cancers and have identified a critical need for improved patient education and provider awareness on this issue,” researcher Rachel Freedman, MD, MPH, a physician at Dana-Farber Cancer Institute and assistant professor of medicine at Harvard Medical School, said in a press release. “Improving patients’ understanding about why a particular treatment is important for her individual situation may lead to more informed decisions and better adherence to treatment.”
Freedman and colleagues evaluated survey data from 500 women who were diagnosed with stage 0 to stage III breast cancer in 2010 or 2011. The population included 222 non-Hispanic white women, 142 black women and 136 Hispanic women.
The women were surveyed about four disease characteristics. They were asked if they thought they knew the information, and then they were asked to report the characteristic about their disease.
Fifty-five percent of women reported knowing their ER status, and 56% reported the correct ER status. Only 33% of women reported knowing their HER-2 status, but 58% reported the correct HER-2 status.
However, results showed a knowledge gap with regard to disease stage and tumor grade. Most women (82%) indicated they thought they knew their disease stage, but only 57% reported it correctly. About one-third (32%) of women indicated they thought they knew the grade of their tumor, but only 20% reported it correctly.
Fourteen percent of women surveyed felt they knew all four of these characteristics, and 14% of women indicated they knew none of them. Eight percent of women actually answered all four questions correctly.
Adjusted analyses indicated that black and Hispanic women were less likely to report knowing more of their disease characteristics (black, OR=0.5; 95% CI, 0.33-0.75; Hispanic, OR=0.3; 95% CI, 0.2-0.46) and less likely to report the correct characteristics (black, OR=0.42; 95% CI, 0.28-0.64; Hispanic, OR=0.34; 95% CI, 0.23-0.51) than non-Hispanic white women.
When researchers further adjusted the analyses for education and health literacy, these associations persisted. However, the significance narrowed for Hispanic women.
Hormone receptor status knowledge also was associated with hormonal therapy use. Hormonal therapy self-treatment was more common among women who knew their ER status (86% vs. 71%; P˂.05) and who correctly reported having ER-positive disease (88% vs. 69%; P˂.05).
“Our findings underscore the major deficits in women’s knowledge about their cancers, with minority women less likely than white women to know and report accurate information about their tumor characteristics,” Freedman and colleagues concluded. “These observations highlight the need to better educate our patients about their tumors and to further examine how knowledge about one’s cancer may contribute to receipt of care, adherence and, ultimately, outcomes.
Disclosure: The researchers report no relevant financial disclosures.
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