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Gaps in Online Breast Cancer Treatment Information for Older Women

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

For women older than 70 years with early-stage breast cancer, the routine use of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy offers no overall survival benefit and may be perceived as undesirable by many women. National guidelines allow possible omission of these practices for older women. This study aimed to assess the availability of web-based educational materials targeting older women and their age-specific treatment recommendations.

Methods

The study systematically assessed the websites of the top 25 “Best Hospitals for Cancer” ranked by the U.S. News & World Report, as well as the websites of four prominent national cancer organizations.

Results

Websites for the leading cancer hospitals and national cancer organizations contain extremely limited information directed toward older patients with breast cancer. Both SLNB and adjuvant radiotherapy are described as treatments “typically,” “most often,” or “usually” used in combination with breast-conserving surgery without circumstances noted for possible omission. Specifically, no hospital website and only one national organization in this study included information on the recommendation to avoid routine SLNB. Only two hospitals and two national organizations included information suggesting possible omission of adjuvant radiotherapy for patients older than 70 years.

Conclusion

The absence of online material for older patients with breast cancer represents a gap potentially contributing to overtreatment by framing SLNB and adjuvant radiotherapy as necessary. Informational resources available to women aged 70 years or older may aid in informed physician–patient communication and decision-making, which may reduce SLNB and adjuvant radiotherapy for patients who might opt out of these procedures if fully informed about them.

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Acknowledgement

Financial support for this study was provided by an internal grant from the University of Michigan Rogel Cancer Center. Dr. Dossett is supported by a grant from the Agency for Healthcare Research and Quality (AHRQ) K08 HS026030-02. Dr. Wang is supported by a grant from the National Cancer Institute T32 CA009672.

Author information

Authors and Affiliations

  1. University of Michigan Medical School, Ann Arbor, MI, USA

    Alison S. Baskin BA & Nicole M. Mott BS

  2. Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA

    Ton Wang MD, MS & Lesly A. Dossett MD, MPH

  3. Department of Surgery, University of Michigan, Ann Arbor, MI, USA

    Ton Wang MD, MS & Lesly A. Dossett MD, MPH

  4. Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA

    Sarah T. Hawley PhD, MPH & Reshma Jagsi MD, DPhil

  5. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA

    Reshma Jagsi MD, DPhil

Authors
  1. Alison S. Baskin BA
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  2. Ton Wang MD, MS
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  3. Nicole M. Mott BS
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  4. Sarah T. Hawley PhD, MPH
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  5. Reshma Jagsi MD, DPhil
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  6. Lesly A. Dossett MD, MPH
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Corresponding author

Correspondence to Lesly A. Dossett MD, MPH.

Ethics declarations

Dr. Dossett is supported by grant K08 HS026030-02 from the Agency for Healthcare Research and Quality (AHRQ). Dr. Wang is supported by grant T32 CA009672 from the National Cancer Institute. Dr. Jagsi has stock options as compensation for her advisory board role in Equity Quotient, a company that evaluates culture in health care companies. She has received personal fees from Amgen and Vizient and grants for unrelated work from the National Institutes of Health, the Doris Duke Foundation, the Greenwall Foundation, the Komen Foundation, and Blue Cross Blue Shield of Michigan for the Michigan Radiation Oncology Quality Consortium. Dr. Jagsi has a contract to conduct an investigator-initiated study with Genentech, has served as an expert witness for Sherinian and Hasso and Dressman Benzinger LaVelle and is an uncompensated founding member of TIME’S UP Healthcare and a member of the Board of Directors of ASCO. The remaining authors have no conflicts of interest.

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Baskin, A.S., Wang, T., Mott, N.M. et al. Gaps in Online Breast Cancer Treatment Information for Older Women. Ann Surg Oncol 28, 950–957 (2021). https://doi.org/10.1245/s10434-020-08961-1

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  • DOI: https://doi.org/10.1245/s10434-020-08961-1

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