Patient Preference and Demographic Factors Influencing Treatment Decisions in Early-Stage Breast Cancer

Abstract

<h3>Purpose/Objective(s)</h3> To evaluate the treatment option preference for women with early-stage breast cancer undergoing radiotherapy. <h3>Materials/Methods</h3> Women were considered candidates for this study if they were eligible for accelerated partial breast irradiation (APBI) according to American Society for Radiation Oncology (ASTRO) guidelines. The ethics approved study protocol (HREBA.CC-19-0485) was designed to enroll 250 patients. Participants completed a demographic survey and selected between treatment options of 42.5 Gy in 16 fractions to the whole breast (Canadian hypofractionation), 26 Gy in 5 fractions to the whole breast (FAST-Forward), and 27 Gy in 5 fractions APBI (ACCEL). After radiotherapy, patients were surveyed at 3, 6, 12, and 24 months using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire BR-23 and self-rated breast appearance and symptom scoring criteria used in the RAPID and ACCEL trials. In this analysis of nominal demographic data, two cohorts of participants were defined: (i) short commute: patients traveling less than 30 minutes to the treating institution, and (ii) long commute: patients traveling more than 30 minutes. The chi-squared test of independence was used to measure statistical significance (alpha = 0.05). <h3>Results</h3> As of March 2022, 27 patients participated in the study. Fifteen patients selected 5-fraction partial breast, seven selected 5-fraction whole breast, and five selected 16-fraction whole breast. Of these, 15 had a short commute and 12 had a long commute. For participants with a short commute, 5 selected the 16-fraction option and 10 selected a 5-fraction option. For participants with a long commute, all selected a 5-fraction treatment option. The chi-squared test yielded a significant difference (p = 0.03), indicating that travel time for treatment is a factor in the treatment selection process. <h3>Conclusion</h3> At this early phase of patient accrual, the patient preference study indicates that travel time for treatment is a factor in selecting the preferred treatment option when fraction number as well as whole and partial breast options are available. The final study analysis is intended to address the participants' satisfaction in their treatment selection at follow-up time points.