Chemotherapy Decisions and Outcomes in Older Women With Newly Diagnosed Breast Cancer

OBJECTIVES:

• Determine the relationship between preferences and chemotherapy decisions in women age 65 and over with operable, newly diagnosed breast cancer.
• Determine how factors that could be targets for intervention affect the relationship between preferences and chemotherapy decisions in these patients.
• Determine the relationships between preference-based chemotherapy decisions, quality of life, and satisfaction with treatment decisions in these patients.
• Determine the disease-free survival and competing causes of mortality of these patients.
• Determine the types of physician providers who care for older breast cancer survivors after initial cancer treatment is completed and explore how women decide about which physicians to see.
• Measure quality indicators for the survivorship phase of care and evaluate if quality varies by type of physician provider model.
• Determine if long-term patient-reported satisfaction varies as a function of physician model for providing follow-up care post-treatment.
• Determine whether physician-patient communication and coordination of care after treatment ends mediate follow-up quality and outcomes post-treatment.

OUTLINE: This is a cohort study.

Patients participate in interviews over 30-45 minutes at baseline, at 6 months, and at 1 and 2 years.

Patients are followed annually for at least 5 years.

PROJECTED ACCRUAL: A total of 1,296 patients will be accrued for this study within 18-24 months.

DISEASE CHARACTERISTICS:

• Histologically confirmed primary adenocarcinoma of the breast

• Operable disease
• Invasive and unilateral tumor
• No more than 20 weeks since diagnosis
• T1-4 (tumor size ≥ 1 cm), N0, M0 OR
• T1-4, N1-3, M0
• No prior carcinoma in situ, lobular carcinoma in situ, ductal carcinoma in situ, or invasive breast cancer
• Hormone receptor status:

• Any estrogen receptor status

PATIENT CHARACTERISTICS:

Age

• 65 and over

Sex

• Female

Other

• No other malignancy except those for which the patient has completed treatment AND is considered to be at less than 30% risk of recurrence
• History of non-melanoma skin cancer allowed
• Sufficient cognitive function to consent to and complete interviews
• English or Spanish speaking