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Medline ® Abstract for Reference 16

of 'Discussing serious news'

Women's preferences for discussion of prognosis in early breast cancer.
Lobb EA, Kenny DT, Butow PN, Tattersall MH
Health Expect. 2001 Mar;4(1):48-57.
OBJECTIVES: To determine preference for prognostic information in women with early breast cancer.
DESIGN: Cross sectional survey.
PARTICIPANTS: 100 women with early stage breast cancer attending six teaching hospitals in Sydney, Australia.
MAIN OUTCOME MEASURES: Women's preference for prognostic information.
RESULTS: This study identifies new elements to consider in the prognostic consultation. Whilst 91% of women wanted to know their prognosis prior to commencing adjuvant treatment, 63% wanted their cancer specialist to check with them first before giving it. Seventy-seven percent wanted to be asked if they would like a second opinion. Seventy-five percent wanted to know about complementary therapies. Most wanted their cancer specialist to check their understanding, provide an opportunity to ask questions, and explain medical terms (98%). The majority wanted information summarized (94%), supported by published information (88%) and written down (79%). Ninety-seven percent wanted their fears and concerns listened to and 79% wanted emotional support. In addition 80% of women wanted their cancer specialist to tell them where they could go to get additional emotional support for themselves and their families. Seventy-two percent of women wanted their cancer specialist to make sure they had a relative or friend with them.
CONCLUSIONS: Data from this study suggests that a variety of techniques are needed to communicate prognosis. Whilst acknowledging individual women's preferences, and not wanting to appear prescriptive, recommendations emerge for effective discussion of prognosis with women with early stage breast cancer.
Medical Psychology Unit, Department of Psychological Medicine, The University of Sydney, Camperdown, NSW 2050, Australia. lizlobb@blackburn.med.usyd.edu.au