Project Overview +

Making individualized choices about surgery and radiation is challenging for patients and clinicians. This project is looking at ways to help make these choices with testing. Evaluative tests can help inform who might benefit from certain treatments and how much.

Aims +

Aim 1: Examine use of breast MRI and genetic testing for the BRCA1/2 mutation and the patient and clinician correlates of this testing.

Aim 2: Examine receipt of more or less aggressive surgical and radiation treatment and the patient and clinician correlates of these approaches.

Aim 3: Examine the extent to which patients are informed about treatments and satisfied with the decision-making process.

Participants +

Newly diagnosed patients with breast cancer from the SEER registries in New Jersey and Georgia, as well as their surgeons.

Intervention +

Study 1: Develop a survey to administer to 800 radiation oncologists who treat breast cancer in the United States to:

  • evaluate the knowledge of radiation oncologists regarding the results of recent clinical trials that reveal equivalence less burdensome approaches to radiotherapy;
  • describe radiation oncologistsí perceptions of barriers to the reduction of radiation overtreatment;
  • assess patterns and correlates of radiation oncologistsí practice in different clinical circumstances, using clinical vignettes developed in previous work.
Study 2: Develop a tablet-based patient decision aid to:
  • assist patients with radiation therapy decision-making;
  • evaluate the impact of the decision aid on patient knowledge and decision satisfaction;
  • evaluate in a randomized trial whether use of the decision aid increases the proportion of patients age 70 and older with Stage I ER+ tumors (in whom there is no benefit in survival or mastectomy prevention) electing to forego radiation therapy and receive endocrine therapy alone.
Study 3: Develop a web-based provider support tool that incorporates insights from Studies 1 and 2 to improve dissemination of clinical trial findings and address challenges faced by providers in reducing breast cancer overtreatment. Evaluate providersí attitudes and practices before and after use of the tool.

Individualized CANcer Care (I Can Care): Project 1

07/01/2012 - 06/30/2017


National Cancer Institute

Principal Investigator:

Reshma Jagsi, MD, DPhil