Treatments for cancer impose substantial burden and morbidity but net survival benefit of different strategies is often small and virtually always uncertain. Thus, clinicians may do more harm than good if treatment is too aggressive. There are a number of management strategies for breast cancer aimed at reducing unnecessary morbidity and burden on patients with favorable disease. A key barrier to advancing these initiatives is the need for a better understanding of the challenges of individualizing cancer care The goal of this program is to improve population health by helping clinicians and their patients address the challenges of individualizing treatment of breast cancer for patients with favorable prognosis. Objective 1: To examine the challenges of individualizing treatment for women with breast cancer. Two projects will each undertake an observational study of patients newly diagnosed with breast cancer (including their attending clinicians) who were reported to the SEER registries of Georgia and New Jersey during an 18 month period to examine patient and clinician factors associated with key evaluative tests, treatments, and patient appraisal of decision quality. Project 1 will focus on challenges for surgeons and their patients with regard to locoregional therapy. Project 2 will focus on challenges for medical oncologists and their patients with regard to systemic therapy. Objective 2: To improve treatment decision quality. Project 3 will perform a randomized controlled trial of a practice based online decision tool for patients newly diagnosed with breast cancer in the Detroit and Atlanta SEER regions intended to improve decision quality. Objective 3: To accelerate the dissemination of SEER-based research findings by implementing and evaluating a tailored online portal aimed at all surgeons and medical oncologists who treated the patient samples in P1 and P2 to evaluate whether our research findings can more directly and promptly inform clinicians knowledge and attitudes about individualizing treatment. Objective 4: To advance methods in SEER population translational research focused on quality of cancer care. We propose four shared resource cores that will support program project activities, advance innovative methods in oncology population sciences, and advance team mission and long-term strategic planning.

Public Health Relevance

Results from the proposed program will improve public health by addressing the challenges of individualizing cancer care. This includes evaluating a compelling conceptual framework salient to patients and their physicians, informing the challenges of communication in the exam room, improving breast cancer treatment decision-making, and advancing innovative methods in population-based oncology outcomes research.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
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Special Emphasis Panel (ZCA1-RPRB-B (M1))
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Arora, Neeraj K
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University of Michigan Ann Arbor
Internal Medicine/Medicine
Schools of Medicine
Ann Arbor
United States
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Wallner, Lauren P; Li, Yun; McLeod, M Chandler et al. (2017) Decision-support networks of women newly diagnosed with breast cancer. Cancer 123:3895-3903
Taylor, Carolyn; Correa, Candace; Duane, Frances K et al. (2017) Estimating the Risks of Breast Cancer Radiotherapy: Evidence From Modern Radiation Doses to the Lungs and Heart and From Previous Randomized Trials. J Clin Oncol 35:1641-1649
Katz, Steven J; Wallner, Lauren P; Abrahamse, Paul H et al. (2017) Treatment experiences of Latinas after diagnosis of breast cancer. Cancer 123:3022-3030
Li, Yun; Kurian, Allison W; Bondarenko, Irina et al. (2017) The influence of 21-gene recurrence score assay on chemotherapy use in a population-based sample of breast cancer patients. Breast Cancer Res Treat 161:587-595
Hawley, Sarah T; Morris, Arden M (2017) Cultural challenges to engaging patients in shared decision making. Patient Educ Couns 100:18-24
Kurian, Allison W; Griffith, Kent A; Hamilton, Ann S et al. (2017) Genetic Testing and Counseling Among Patients With Newly Diagnosed Breast Cancer . JAMA 317:531-534
Katz, Steven J; Hawley, Sarah T; Bondarenko, Irina et al. (2017) Oncologists' influence on receipt of adjuvant chemotherapy: does it matter whom you see for treatment of curable breast cancer? Breast Cancer Res Treat 165:751-756
Hawley, Sarah T; Janz, Nancy K; Griffith, Kent A et al. (2017) Recurrence risk perception and quality of life following treatment of breast cancer. Breast Cancer Res Treat 161:557-565
Jagsi, Reshma; Hawley, Sarah T; Griffith, Kent A et al. (2017) Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients With Early-Stage Breast Cancer. JAMA Surg 152:274-282
Katz, Steven J; Janz, Nancy K; Abrahamse, Paul et al. (2017) Patient Reactions to Surgeon Recommendations About Contralateral Prophylactic Mastectomy for Treatment of Breast Cancer. JAMA Surg 152:658-664

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