权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Individualizing surveillance mammography for older breast cancer survivors

对老年乳腺癌幸存者进行个体化监测乳房X光检查

基本信息

批准号：
9889945
负责人：
Rachel Ann Freedman
金额：
$ 19.25万
依托单位：
DANA-FARBER CANCER INST
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-03-15 至 2021-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9889945
关键词：
Address Age Attitude Benefits and Risks Breast Breast Cancer Patient Breast Cancer survivor Cancer Etiology Cancer Survivor Caring Communication Communication Tools Conflict (Psychology)Consensus Data Data Collection Decision Making Diagnosis Discipline Discipline of Nursing Feedback Focus Groups Geography Geriatrics Goals Guidelines Intervention Intervention Studies Interview Knowledge Lead Learning Life Expectancy Longevity Mammary Gland Parenchyma Mammographic screening Mammography Mission National Health Interview Survey Older Population Oncologist Oncology Outcome Measure Patient advocacy Patients Perception Population Practice Guidelines Primary Health Care Provider Quality of Care Radiology Specialty Randomized Recommendation Recording of previous events Recurrence Research Residual state Risk Side Specialist Standardization Telephone Testing Thinking United States United States National Institutes of Health Variant Woman Work aged base breast cancer diagnosis cancer recurrence care coordination clinical practice cognitive testing evidence base follow-up improved malignant breast neoplasm medical specialties novel older patient older women patient population post intervention prospective risk minimization screening surveillance strategy surveillance study tool

项目摘要

PROJECT SUMMARY/ABSTRACT The long-term goals of this work are to optimize surveillance mammography use for older breast cancer survivors and decrease overscreening for a group in critical need of evidence-based, unified approaches for follow-up care. The proposed study will address significant knowledge gaps through expert consensus and prospective data collection. This study will provide a framework for discussions on how/when to stop mammography in older breast cancer survivors with limited life expectancy (who typically have a low risk for in- breast recurrences with rates similar to that of screening populations) and how to optimally discuss life expectancy with patients, with the goal to enhance communication between patients and clinicians as well as between primary care clinicians (PCs) and specialists. In this unique, multilevel proposal, we will build on our prior work to develop consensus on mammography and follow-up care for breast cancer survivors aged ≥75 by (a) refining expert-panel recommendations, (b) examining clinician and patient attitudes towards these recommendations and discussing life expectancy, and (c) testing a communication tool to facilitate decision- making, all through direct engagement of clinicians and patients. In Aim 1, we will convene experts and patients to refine recommendations for mammography and follow-up care for breast cancer survivors age ≥75 and further develop and cognitively test a communication tool that summarizes recommendations for clinicians and patients with a focus on how to comfortably include conversations on life expectancy comfortably. We will then conduct 30 telephone-based patient interviews and 4-6 focus groups with oncologists and PCs to obtain their opinions about the communication tool, how to communicate the benefits/risks of mammography, and optimal strategies for discussing life expectancy and cessation of mammography and coordination of care. In Aim 2, we will test the communication tool with 45 older breast cancer survivors age ≥75 and their oncologists using a pre-post intervention study. Here, we will examine the feasibility and acceptability of the tool and the effect of using the tool on women's intentions for mammography. We will also explore communication strategies across medical specialties. We hypothesize that our communication tool will be feasible, acceptable for patients and providers, and lead to fewer women intending to receive mammography in the next year. This study will provide preliminary data for a larger pilot and eventual, prospective, randomized study, with the overarching goal to further assess impact, improve coordination of care, and disseminate our novel and urgently needed intervention. The goals of this study are undoubtedly in line with the missions set forth by the NIH and NCI to address the research gaps in older patients. Further, with approximately 70,000 women age ≥75 per year diagnosed with breast cancer in the United States and a growing population of older breast cancer patients, efforts to improve and equalize the quality of follow-up care we deliver will become increasingly important.

项目总结/文摘