How are the preferences of older Chinese patients with operable breast cancer different from their younger counterparts?

Abstract

Background/purpose: Age is an independent factor affecting the choice of surgical treatment among Chinese breast cancer patients (Suen et al., 2008). The decision‐making for breast cancer surgery is multifactorial (Gu et al., 2018). This study aims to investigate how the preferences of older patients are different from their young counterparts. Methods: Chinese patients with operable breast cancer diagnosed between September 2009 to August 2015 were recruited. Participants were invited to complete a questionnaire to score the importance of a list of items while deciding the surgical option (0 = entirely not important, 5 = extremely important). Results: During the study period, 911 patients with primary operable breast cancer received surgery in our unit. 131 patients (14.4%) were aged 70 and above (older age group). 87.0% of patients in the older group had mastectomy whereas 36.4% of patients aged less than 70 had breast conservation (P = 0.000). 837 patients had completed the questionnaire (participation rate 91.9%). Concerns about complete cure from cancer (mean score 4.64 + 0.62) and recurrence (mean score 4.65 + 0.66) are the two top‐ranked items considered as important by patients. Patients in the older age group scored less importance for physical considerations (P = 0.000), complete cure from cancer (P = 0.042), and role of spouse and friends (P = 0.000) as compared to their young counterparts. Older patients considered side effects (P = 0.013) and accessibility of radiation (P = 0.002) as more important. Conclusions: Identifying the factors influencing breast cancer treatment decisions helps health care professionals to provide adequate information and support to older patients in their decision‐making process.