title: Racial/ethnic disparities in knowledge about risks and benefits of breast cancer treatment: does it matter where you go?
abstract: OBJECTIVE
  To evaluate the association between provider characteristics and treatment location and racial/ethnic minority patients' knowledge of breast cancer treatment risks and benefits.
  
  
  METHODS
  Survey responses and clinical data from breast cancer patients of Detroit and Los Angeles SEER registries were merged with surgeon survey responses (N=1,132 patients, 277 surgeons).
  
  
  METHODS
  Cross-sectional survey. Multivariable regression was used to identify associations between patient, surgeon, and treatment setting factors and accurate knowledge of the survival benefit and recurrence risk related to mastectomy and breast conserving surgery with radiation.
  
  
  RESULTS
  Half (51 percent) of respondents had survival knowledge, while close to half (47.6 percent) were uncertain regarding recurrence knowledge. Minority patients and those with lower education were less likely to have adequate survival knowledge and more likely to be uncertain regarding recurrence risk than their counterparts (p<.001). Neither surgeon characteristics nor treatment location attenuated racial/ethnic knowledge disparities. Patient-physician communication was significantly (p<.001) associated with both types of knowledge, but did not influence racial/ethnic differences in knowledge.
  
  
  CONCLUSIONS
  Interventions to improve patient understanding of the benefits and risks of breast cancer treatments are needed across surgeons and treatment setting, particularly for racial/ethnic minority women with breast cancer.
authors.affiliation: Division of General Medicine, University of Michigan Health System and Ann Arbor VA Medical Center, 300 N. Ingalls Room 7C27, Ann Arbor, MI, USA. sarahawl@umich.edu
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Hawley
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Janz
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Katz
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000208:ethnology* / Q000523:psychology / Q000601:surgery*; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D018864:Cultural Diversity; D003657:Decision Making; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006801:Humans; D008408:Mastectomy / Q000523:psychology; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000208:ethnology; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States