Decision regret in breast cancer patients after adjuvant radiotherapy

Purpose: Breast cancer patients often engage in shared decision-making to select an individualized treatment regimen from multiple options. However, dissatisfaction with treatment outcomes can lead to decision regret. We evaluated decision regret and physical and psychological well-being among breast cancer patients who under-went adjuvant radiotherapy and explored their associations with patient, tumor, treatment, and symptom characteristics. Methods: This cross-sectional study involved retrospectively obtaining clinical data and data collected through interviews carried out as part of regular long-term medical aftercare. Decision regret regarding the radiotherapy was assessed using the Ottawa Decision Regret Scale, physical and psychological well-being were assessed using the PROMIS Global Health-10 questionnaire, and patients were asked about their treatment outcomes and symptoms. The questionnaire was administered 14 months to 4 years after completion of radiotherapy.Results: Of the 172 included breast cancer patients, only 13.9% expressed high decision regret, with most patients expressing little or no decision regret. More decision regret was associated with volumetric modulated arc therapy, chest wall irradiation, use of docetaxel as a chemotherapy agent, lymphangiosis carcinomatosa, new heart disease after radiotherapy, and lower psychological well-being.Conclusion: Although most patients reported little or no decision regret, we identified several patient, treatment, and symptom characteristics associated with more decision regret. Our findings suggest that psychological well-being influences patients' satisfaction with therapy decisions, implying that practitioners should pay special attention to maintaining psychological well-being during shared decision-making and ensuring that psycho-logical assessment and treatment is provided after cancer therapy to deal with long-term effects of radiotherapy.

Automated summary

This study evaluates decision regret and physical and psychological well-being among breast cancer patients who underwent adjuvant radiotherapy and explores their associations with patient, tumor, treatment, and symptom characteristics. The findings suggest that most patients have little or no decision regret, but several characteristics such as radiation therapy and psychological well-being are associated with higher levels of regret.