With limited data on the patterns and correlations of recurrence risk in patients with breast cancer, a study explored numeric and descriptive patient risk perception in a large population of patients with breast cancer who had favorable prognosis to assess associations between overestimation and quality of life (QOL). The researchers presented the study at the ASCO Annual Meeting

Newly diagnosed patients (N = 2,632) with early-stage breast cancer who were treated between 2013 and 2014 were identified through the Surveillance, Epidemiology, and End Results registries in Los Angeles, CA, and Georgia, approximately three months after surgical treatment. 

Ten-year risk of distant recurrence after treatment was constructed based on clinical factors for women with ductal carcinoma in situ (DCIS; n = 502) and low-risk invasive cancer (LRI; n = 520). The women were asked to report their perceived risk numerically (0%–100%), as well as describe the perceived risk as “moderate,” “high,” or “very high.”

The researchers evaluated the overestimation of recurrence risk and then evaluated QOL measures of worry and physical and mental health, as determined by the Patient Reported Outcomes Measurement Information System (PROMIS).

Among those with DCIS, 38% overestimated their numerical perceived risk of recurrence, compared with 27% of those with LRI. When describing their recurrence risk, 13% and 18%, respectively, overestimated.  Both risk overestimation measures were significant (p < 0.01) and associated with more frequent worry about recurrence, whereas description overestimation led to lower PROMIS physical and mental health (p < 0.01); thus, descriptive overestimation was more strongly associated with poor outcomes compared with numerical overestimation. 

The researchers concluded, “Marked overestimation of risk after treatment was common. Strong associations between risk overestimation and lower QOL underscores the importance of correcting risk perception. In particular, the strong influence of descriptive assessments of risk suggests the need for clinicians to discuss actual risk in ways that can be clearly understood.”

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