Predictors of surgery preference and quality of life in DCIS after breast MRI: A trial of the ECOG-ACRIN Cancer Research Group (E4112).

• DOI: 10.1200/jco.2021.39.15_suppl.6564
• Publication Date: 2021-06-02T14:28:38Z
• Authors: Soudabeh Fazeli; Bradley Snyder; Ilana F. Gareen; Constance Dobbins...; Seema Ahsan Khan; Justin Romanoff; Constantine Gatsonis; Ralph L Corsetti; Habib Rahbar; Derrick W. Spell; Kenneth Bruce Bla...; Linda K. Han; Jennifer L. Sabol; John R Bumberry; Kathy Miller; Joseph A. Sparano; Christopher Comstock; Lynne I. Wagner; Ruth Carlos
• Keywords: Concordance

6564 Background: Management of ductal carcinoma in situ (DCIS) remains variable, requiring an understanding patient preferences and concerns to enhance the treatment decision-making process. Pre-operative MRI surgeon recommendation can further inform surgery choice. Quality life (QoL) is also important consideration decision-making. The aims this study were assess patients’ before after consultation, concordance between preference received, trends health-related QoL (HRQL) among a prospective cohort women newly diagnosed with DCIS. Methods: A nonrandomized clinical trial by ECOG-ACRIN Cancer Research Group (E4112) enrolled unilateral DCIS from 75 institutions March 2015 April 2016. Participants underwent either wide local excision (WLE) or mastectomy. Surveys queried patient-reported outcomes (PRO) including concerns, HRQL surgery. Logistic regression models used associate actual received demographic, PRO data. Change baseline was assessed using linear regression. Results: At entry, age (OR 0.39, per 5-year increment, 95%CI, 0.21-0.75; p = 0.005) goals related importance keeping one’s breast 0.51, 95%CI 0.34-0.76; 0.001) removal for peace mind 1.46, 1.09-1.95; 0.01) drove mastectomy vs. WLE. After receipt primarily mediated upstaging 11.18, 3.19-39.16; < 0.001). Only 4% type that did not match their final preference. strongest predictors 15.80, 4.85-51.46) 4.60, 1.52-13.94). Receipt single associated significantly improved mental health one year definitive (p 0.02 mastectomy; 0.003 WLE). Self-reported Black race independent predictor worsened physical 0.04) at surgery, despite no significant racial differences HRQL. Conclusions: Our findings highlight communication providers patients regarding goals, significance findings, benefits/risks available options. Future research identify modifiable factors declining needed targeted interventions mitigate disparities