DECISION-MAKING ABOUT TAMOXIFEN: A NEW PREVENTIVE TREATMENT
FOR WOMEN AT HIGH RISK FOR BREAST CANCER
Department of Psychiatry, Beth Israel Deaconess Medical Center
Sharon L. Bober, Ph.D., and Lizbeth A. Hoke, Ph.D.
Little is known about how women at high risk for breast cancer make decisions about chemo-prevention (e.g., tamoxifen), a relatively new treatment option that requires weighing significant health risks and benefits. The purpose of the present study is to explore cognitive, affective, interpersonal and health-related factors that may influence treatment choices, as well as satisfaction with treatment decisions. Eligible high-risk women complete a series of questionnaires and then participate in 2, 4, and 12 month follow-up interviews. Preliminary findings suggest that although all of the participants receive physician recommendations to take chemo-prevention, close to half of the women decide against treatment. Moreover, a significant number of women remain "unsure" about whether to begin treatment and over half of the women obtaining a second physician opinion report receiving a contradictory recommendation. These initial results raise several concerns. Drs. Bober and Hoke are currently exploring the development of informational and educational support that may help high risk women make better informed and more satisfying decisions about chemo-prevention.
Keywords: breast cancer, chemo-prevention, decision-making
Grant Support. Massachusetts Department of Public Health, Breast Cancer Research Grant.
Program Site. Department of Psychiatry, Beth Israel Deaconess Medical Center, including the Department of Hematology/Oncology, Beth Israel Deaconess Medical Center.
Program Director. S. L. Bober, Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA. 02215.
Contact Person. S. L. Bober, 617-667-1573. (Fax) 617-576-0313. Email: sbober@caregroup.harvard.edu
Training Opportunities. No trainees currently. Opportunities may be available for pre-doctoral students who would like to work with this population.
Representative Publications.
Bober, S.L., Hoke, L.A., Tung, N.M., & Duda, R. B. (2000). Women's perceptions of worry, behavior change, and satisfaction after attending breast/ovarian cancer risk counseling. Annals of Behavioral Medicine, 22 (Suppl), 165.
Bober, S.L., Hoke, L.A., Tung, N.M., & Duda, R. B. (2001). Decision-making about tamoxifen: A new treatment for women at high risk for breast cancer. Annals of Behavioral Medicine, 23 (Suppl), 78.
November, 2001