title: Accuracy of perceived risk of recurrence among patients with early-stage breast cancer.
abstract: BACKGROUND
  Accurate breast cancer recurrence risk perceptions might motivate health-promoting behaviors and alleviate undue anxiety. Although a few studies have examined early-stage breast cancer survivors' perceived risk of recurrence, none have assessed the accuracy of survivors' perceived risk of recurrence.
  
  
  METHODS
  First primary ductal carcinoma in situ and early-invasive breast cancer survivors reported their perceived risk of recurrence during 6- and 12-month postsurgery interviews. We estimated the patients' 10-year risk of recurrence from published clinical trials, and for early-invasive breast cancer patients, risk of distant recurrence was based on their breast cancer-specific mortality calculated using Adjuvant! Online. Patients' perceived risk was compared with their calculated risk and categorized as "Accurate," "Underestimated," "Overestimated," and "Uncertain." Multinomial logit marginal effect models were fitted using Accurate as the reference.
  
  
  RESULTS
  Only 17% of 531 patients accurately perceived their risk at 6 months, most of whom inaccurately perceived their risk at 12 months (P = 0.0143). Patients who were nonwhite [odds ratio (OR), 1.70; 95% confidence interval (95% CI), 1.12-2.56] and received radiation therapy (OR, 2.01; 95% CI, 1.07-3.77) were more likely to underestimate their risk. Patients with ductal carcinoma in situ (OR, 1.76; 95% CI, 1.11-2.79), [corrected] lower social support (OR, 0.71; 95% CI, 0.53-0.95), and anxiety (OR, 1.58; 95% CI, 1.01-2.47) were more likely to overestimate their risk.
  
  
  CONCLUSIONS
  Few breast cancer survivors accurately perceived their risk of recurrence.
  
  
  CONCLUSIONS
  The accuracy of perceived risk may be increased by better physician-patient communications about their prognosis, provision of social support, and treatment for coexisting anxiety.
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Maria
authors.initials: M
authors.lastname: Pérez
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Aft
authors.forename: Kerry
authors.initials: K
authors.lastname: Massman
authors.forename: Erica
authors.initials: E
authors.lastname: Robinson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Myles
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: William E
authors.initials: WE
authors.lastname: Gillanders
authors.forename: Donna B
authors.initials: DB
authors.lastname: Jeffe
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology*; D002278:Carcinoma in Situ / Q000523:psychology*; D018270:Carcinoma, Ductal, Breast / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D010465:Perception; D018570:Risk Assessment