Peers Play a Key Role in Breast Cancer Treatment Decision-Making

From deciding what to wear to determining breast cancer treatment, many women seem to revert to one key strategy: asking their friends and family.

A team of researchers from the University of Michigan conducted a study analyzing the decision-support persons (DSPs) who helped with treatment decisions in 2,502 newly diagnosed women between the ages of 20 and 79 who had early-stage breast cancer.

“In breast cancer, women are faced with really complicated and complex treatment decisions,” study author Lauren Wallner, Ph.D., MPH, assistant professor in the Department of Medicine and Department of Epidemiology at the University of Michigan, said in an interview with CURE.

More than half of the participants (51 percent) had three or more DSPs; 20 percent had two; 18 percent had one; and 11 percent had no DSPs. For these people without DSPs, Waller said that it is important for health care providers to understand that this group may need more support in gathering resources and information about breast cancer treatment.

As for the people who did rely on others to help with their treatment decisions, Wallner said that the number was higher than expected. “One thing we found was that this wasn’t always the partner or spouse, which was suggested in previous studies,” she said.

Instead, many people turn to their children, friends or coworkers. Further, the person who accompanies the patient to their doctors’ appointments may not always be the one who is called upon when it is time to make a decision.

“Women with more people involved were more likely to say that they had more deliberative decisions. They’re weighing the pros and cons,” Wallner said.

According to the study, the women who were married or in a serious relationship, younger than 45 years old or African American were more likely to report a larger network size. For the first group, Wallner noted that she was not surprised, as people in serious relationship typically always discuss important decisions together. For African American women, culture can play a role, as they often have larger, more close-knit families.

Finally, most women who are diagnosed with breast cancer are over the age of 45, so when someone younger than that receives a diagnosis, there is a strong chance that they may have some sort of a genetic factor playing in their breast cancer, and likely have a family member who has been diagnosed, too.

Understanding that women often seek out advice from their friends and family can help health care professionals guide women through their treatment decisions.

“Future initiatives to improve treatment decision-making among women with breast cancer should acknowledge and engage DSPs,” the authors of the study concluded. Health care providers should make more resources available for these decision-support persons, who play a key role in the patient’s treatment.

“We should be thinking about adapting the tools — such as online resources — so that the informal support people can learn about the different treatment options as well,” Wallner said.