Association of clinical experiences with patient-reported outcomes among breast cancer surgery patients: breast cancer quality care study

Abstract

Background We aimed to clarify the association of breast cancer patients' clinical experiences with patient-reported outcomes (PRO) of satisfaction with care, choice of the same type of surgery again, and health-related quality of life (HRQOL). Methods There were 2,403 (25.9%) of 9,283 eligible women who had undergone primary curative surgery for breast cancer in one of five selected hospitals between 1993 and 2002 who responded to a survey questionnaire including information about care experiences, satisfaction with care, and HRQOL. Results Treatment satisfaction was independently associated with cancer recurrence, problems obtaining surgery, receiving adjuvant hormonal therapy, being involved in treatment decisions, having opinions reflected in treatment decisions, experiencing treatment toxicity, or being hospitalized for treatment toxicity (P < 0.01). Breast-conserving surgery with radiotherapy, receiving adjuvant hormone therapy, being involved in treatment decisions, having opinion reflected in treatment decisions, having no treatment toxicity, and receiving regular follow-up care were associated with choosing the same treatment over again (P < 0.01). Good care experiences, except for regular follow-ups, were significantly associated with good HRQOL in most functioning subscales (P < 0.01). Conclusions Our findings suggest that timely referral for treatment, reflection of the patient's opinions in treatment decisions, and prevention of treatment toxicity might be important to HRQOL.