Involvement in Decision-Making and Breast Cancer Survivor Quality of Life

Objective: This study examined the long-term effects on women's health related quality of life (HRQOL) of involvement in decision-making about their treatment for breast cancer and about follow-up care after treatment. Methods: Using a cross-sectional survey design, a sample of breast cancer survivors from Western Washington who were 2, 5, and 10 years postdiagnosis were recruited via a cancer registry and interviewed about their HRQOL and their involvement in decision-making about their cancer treatment and follow-up care. Main Outcome Measures: HRQOL was assessed using the SF-36. Results: Multiple regression analyses examining demographic and disease characteristics revealed age, and education, but not stage of cancer at diagnosis, to be significant predictors of perceived involvement in decision-making about cancer treatment and follow-up. Controlling for demographic and disease characteristics, perceived involvement in decision-making about treatment overall, surgery, chemotherapeutic treatment, and follow-up care were each associated with improved HRQOL, including the general health and vitality subscales of the SF-36 (p < .05). Involvement in decision-making about surgery was also associated with better mental health among survivors of breast cancer. Congruence of involvement in decision-making with a patient's preferred level of involvement was also associated with improved survivor HRQOL on several subscales. Conclusions: Perceived involvement in decision-making about breast cancer treatment, and about follow-up care is associated with better HRQOL for survivors 2, 5, and 10 years postdiagnosis. Prospective studies may be warranted to determine the. possible mechanisms by which perceived involvement in decision-making about aspects of treatment other than surgery type might influence survivor HRQOL.