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Treatment Decision Study

Researcher
David Spiegel, MD, Amit Etkin, MD, PhD, James Gross, PhD, and Allison Kurian, MD, MSc, Stanford University School of Medicine. The study is funded by the National Cancer Institute.
Study abstract

Women diagnosed with breast cancer are choosing bilateral mastectomy (BLM) at increasing rates, currently 14.3%, and 33% of those under 40. This is happening despite evidence that there is no survival benefit from BLM, along with surgical complications and other serious medical and personal costs, compared with more conservative approaches. Women’s anxiety about recurrence is critical to this decision, so their choice may in large part reflect the way they experience and regulate affect. To understand the neurobiological and affective determinants of the choice of BLM, and thereby identify future opportunities for new interventions, we propose to examine the relationship between affect reactivity and regulation and women’s decisions regarding BLM after initial diagnosis of breast cancer. We will also examine the impact of affect management and treatment decisions on subsequent psychosocial functioning. Our Specific Aims are to: 1) Examine affect reactivity and regulation among women with a recent diagnosis of breast cancer in comparison to healthy controls; 2) Relate affect reactivity and regulation to choice of BLM; and 3) Assess long term functional consequences of BLM decision and affect reactivity and regulation. This study will provide an empirical basis for better assisting patients in making difficult but important choices regarding breast cancer treatment alternatives.

Study review

The goal of this study is to better understand what women are thinking about and feeling as they decide on their cancer treatments. The AOW provided the researchers with 219 women who were interested in participating. The results of this study may help researchers develop new interventions that may better assist women newly diagnosed with breast cancer with their treatment decisions.