Accuracy of perceived risk of recurrence among patients with early-stage breast cancer.
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.
Liu
Ying
Y
Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA.
Pérez
Maria
M
Aft
Rebecca L
RL
Massman
Kerry
K
Robinson
Erica
E
Myles
Stephanie
S
Schootman
Mario
M
Gillanders
William E
WE
Jeffe
Donna B
DB
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