PDF(Pubmed)
Abstract：
BACKGROUND: Ductal carcinoma in situ (DCIS) can progress to invasive breast cancer (IBC), but often never will. As we cannot predict accurately which DCIS-lesions will or will not progress to IBC, almost all women with DCIS undergo breast-conserving surgery supplemented with radiotherapy, or even mastectomy. In some countries, endocrine treatment is prescribed as well. This implies many women with non-progressive DCIS undergo overtreatment. To reduce this, the LORD patient preference trial (LORD-PPT) tests whether mammographic active surveillance (AS) is safe by giving women with low-risk DCIS a choice between treatment and AS. For this, sufficient knowledge about DCIS is crucial. Therefore, we assessed women\'s DCIS knowledge in association with socio-demographic and clinical characteristics.
METHODS: LORD-PPT participants (N = 376) completed a questionnaire assessing socio-demographic and clinical characteristics, risk perception, treatment choice and DCIS knowledge after being informed about their diagnosis and treatment options.
RESULTS: 66 % of participants had poor knowledge (i.e., answered ≤3 out of 7 knowledge items correctly). Most incorrect answers involved overestimating the safety of AS and misunderstanding of DCIS prognostic risks. Overall, women with higher DCIS knowledge score perceived their risk of developing IBC as being somewhat higher than women with poorer knowledge (p = 0.049). Women with better DCIS knowledge more often chose surgery whilst most women with poorer knowledge chose active surveillance (p = 0.049).
CONCLUSIONS: Our findings show that there is room for improvement of information provision to patients. Decision support tools for patients and clinicians could help to stimulate effective shared decision-making about DCIS management.
METHODS: LORD-PPT participants (N = 376) completed a questionnaire assessing socio-demographic and clinical characteristics, risk perception, treatment choice and DCIS knowledge after being informed about their diagnosis and treatment options.
RESULTS: 66 % of participants had poor knowledge (i.e., answered ≤3 out of 7 knowledge items correctly). Most incorrect answers involved overestimating the safety of AS and misunderstanding of DCIS prognostic risks. Overall, women with higher DCIS knowledge score perceived their risk of developing IBC as being somewhat higher than women with poorer knowledge (p = 0.049). Women with better DCIS knowledge more often chose surgery whilst most women with poorer knowledge chose active surveillance (p = 0.049).
CONCLUSIONS: Our findings show that there is room for improvement of information provision to patients. Decision support tools for patients and clinicians could help to stimulate effective shared decision-making about DCIS management.
摘要：
背景：导管原位癌（DCIS）可以发展为浸润性乳腺癌（IBC），但往往永远不会。由于我们无法准确预测哪些DCIS病变会或不会进展为IBC，几乎所有患有DCIS的女性都接受保乳手术辅以放疗，甚至是乳房切除术.在一些国家,内分泌治疗也有规定。这意味着许多患有非进行性DCIS的女性接受过度治疗。为了减少这种情况，LORD患者偏好试验(LORD-PPT)通过给予低风险DCIS患者在治疗和AS之间的选择,测试了乳房X线摄影主动监测(AS)是否安全.为此，关于DCIS的足够知识是至关重要的。因此,我们评估了女性的DCIS知识与社会人口统计学和临床特征的相关性.
方法：LORD-PPT参与者（N=376）填写了一份评估社会人口统计学和临床特征的问卷，风险感知，在了解他们的诊断和治疗方案后，治疗选择和DCIS知识。
结果：66％的参与者知识不足（即回答正确≤7条知识项中的3条)。大多数错误的答案涉及高估AS的安全性和对DCIS预后风险的误解。总的来说,DCIS知识得分较高的女性认为其发生IBC的风险略高于知识较差的女性(p=0.049).具有更好的DCIS知识的女性更经常选择手术，而大多数知识较差的女性选择主动监测（p=0.049）。
结论：我们的研究结果表明，向患者提供信息仍有改进的空间。患者和临床医生的决策支持工具可以帮助激发有关DCIS管理的有效共享决策。
方法：LORD-PPT参与者（N=376）填写了一份评估社会人口统计学和临床特征的问卷，风险感知，在了解他们的诊断和治疗方案后，治疗选择和DCIS知识。
结果：66％的参与者知识不足（即回答正确≤7条知识项中的3条)。大多数错误的答案涉及高估AS的安全性和对DCIS预后风险的误解。总的来说,DCIS知识得分较高的女性认为其发生IBC的风险略高于知识较差的女性(p=0.049).具有更好的DCIS知识的女性更经常选择手术，而大多数知识较差的女性选择主动监测（p=0.049）。
结论：我们的研究结果表明，向患者提供信息仍有改进的空间。患者和临床医生的决策支持工具可以帮助激发有关DCIS管理的有效共享决策。
