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Patient preferences for adjuvant radiotherapy in early breast cancer are strongly influenced by treatment received through random assignment
Author(s) -
Corica Tammy,
Saunders Christobel M.,
Bulsara Max K.,
Taylor Mandy,
Joseph David J.,
Nowak Anna K.
Publication year - 2019
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12985
Subject(s) - medicine , radiation therapy , intraoperative radiotherapy , external beam radiotherapy , breast cancer , adjuvant radiotherapy , cancer , surgery , brachytherapy
Abstract Objective TARGIT ‐A randomised women with early breast cancer to receive external beam radiotherapy ( EBRT ) or intraoperative radiotherapy ( TARGIT ‐ IORT ). This study aimed to identify what extra risk of recurrence patients would accept for perceived benefits and risks of different radiotherapy treatments. Methods Patient preferences were determined by self‐rated trade‐off questionnaires in two studies: Stage (1) 209 TARGIT ‐A participants ( TARGIT ‐ IORT n = 108, EBRT n = 101); Stage (2) 123 non‐trial patients yet to receive radiotherapy (pre‐treatment group), with 85 also surveyed post‐radiotherapy. Patients traded‐off risks of local recurrence in preference selection between TARGIT ‐ IORT and EBRT . Results TARGIT ‐ IORT patients were more accepting of IORT than EBRT patients with 60% accepting the highest increased risk presented (4%–6%) compared to 12% of EBRT patients, and 2% not accepting IORT at all compared to 43% of EBRT patients. Pre‐treatment patients were more accepting of IORT than post‐treatment patients with 23% accepting the highest increased risk presented compared to 15% of post‐treatment patients, and 15% not accepting IORT at all compared to 41% of pre‐treatment patients. Conclusions Breast cancer patients yet to receive radiotherapy accept a higher recurrence risk than the actual risk found in TARGIT ‐A. Measured patient preferences are highly influenced by experience of treatment received. This finding challenges the validity of post‐treatment preference studies.