Same gain, less pain: potential patient preferences for adjuvant treatment in premenopausal women with early breast cancer

Eur J Cancer. 2004 Nov;40(16):2403-10. doi: 10.1016/j.ejca.2004.07.013.

Abstract

The aim of this study was to determine the treatment preferences (adjuvant goserelin or cyclophosphamide, methotrexate and fluorouracil (CMF) chemotherapy) of healthy premenopausal women should they hypothetically develop oestrogen-receptor (ER) positive early breast cancer. Two hundred pre or peri-menopausal women read two scenarios describing goserelin or chemotherapy. Information included: How and where treatments were administered, side-effects, their likely persistence and impact on fertility. Women stated their unprompted initial and final preferences with reasons for the choices made. Respondents showed an overwhelming preference for goserelin. 156 (78%) women favoured goserelin, 22 (11%) chemotherapy and 22 (11%) remained undecided (P<0.0001). Primary reasons for preferring goserelin for were 105 (71%) avoidance of chemotherapy side-effects, especially hair loss, perceived convenience and less disruption to normal life 54 (36%). The minority who preferred chemotherapy, valued the treatment finishing more quickly. These results together with clinical trial data showing equivalence of goserelin with CMF regimens suggest that premenopausal women with ER-positive tumours should at least be offered the choice of either adjuvant hormone therapy or chemotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / psychology
  • Chemotherapy, Adjuvant / methods
  • Cyclophosphamide / administration & dosage
  • Female
  • Fertility / drug effects
  • Fluorouracil / administration & dosage
  • Goserelin / therapeutic use*
  • Humans
  • Interpersonal Relations
  • Methotrexate / administration & dosage
  • Middle Aged
  • Patient Satisfaction*
  • Premenopause
  • Time Factors

Substances

  • Antineoplastic Agents, Hormonal
  • Goserelin
  • Cyclophosphamide
  • Fluorouracil
  • Methotrexate

Supplementary concepts

  • CMF regimen