Slippery Slope of Patient-Physician Communication: Health Practices of Breast Cancer Patients After Primary Treatment

Background. Patient-provider communication can foster informed patient decisions about behaviors that are associated with reduced rates of recurrence and mortality for more than 2.3 million breast cancer survivors in the United States. Engaging patients in discussions that deliver evidence-based guidelines; identify preferences regarding screening, lifestyle modification, and chemoprevention; and provide information about the risks and benefits of their choices, can promote compliance with follow-up care recommendations. Methods. Telephone survey interviews were conducted with 100 women, within 5 years of their diagnosis and primary treatment for breast cancer, to investigate: 1) physician communication about follow-up treatment, screening, and diet and physical activity guidelines ; 2) patient perceptions of susceptibility to recurrence;and 3) patient compliance with physician recommendations. Results. Recruited participants were 30% African American (AA) and 70% Caucasian (Cau) socio-economically diverse survivors, whose mean age was 58 years. AAs reported significantly more co-morbidities, primarily diabetes and hypertension, than Caus (p=0.02), which was associated with their poorer rates of treatment completion (p=0.008). While 50% reported having thorough discussions with physicians about making changes in diet and physical activity that could enhance survival, less than one-third were able to implement these evidence-based recommendations on a regular basis. Conclusions. Breast cancer survivors need comprehensive guidance from physicians to develop plans of care as survivors, which target the context of their health status and lifestyles. However, this often does not occur in the medical setting. Physicians need support mechanisms for tailoring evidence-based lifestyle recommendations, along with strategies for assessing and optimizing the likelihood of patient compliance.