Breast cancer patients' expectations in respect of the physician–patient relationship and treatment management results of a survey of 617 patients

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Abstract
Background: The following study was conducted to explore patients' information needs and preferences with a special focus on doctor–patient communication. Patients and methods: A 62-item questionnaire developed by a multidisciplinary team and validated in a phase-I study was given to breast cancer patients via the Internet (homepage) or in a hard copy version. Results: A total of 617 patients responded, 552 on line and 65 via the hard copy questionnaire. The median age of the on-line group was 47 (21–85) and 55 (40–92) in the hard copy group. Sixty-five per cent of the patients were treated with the intention of achieving a cure and 35% of the patients had metastatic disease. The median length of the consultation communicating the information ‘You have breast cancer’ was 15 min (0–300). The most effective and patient-relevant source of information about the disease and the treatment options was consultation with the physician (84%). When asked to suggest areas for improvement, patients' most common answers were: more complementary therapies should be offered by the physician (54%); physicians should take more time to explain things (51%); and cooperation between the physicians involved in the patient's care should be improved (39%). The questions most relevant to patients were: ‘Am I getting the right therapy?’ (89%); ‘How many patients with my condition does my doctor treat?’ (46%) and ‘Can I be enrolled into a trial?’ (46%). An independent second opinion centre was desired by 94% of the respondents but only 20% knew of any such resource. Conclusions: This study underlines the need to give patients with breast cancer the full details on treatment options and cancer management. The results provide a suitable basis for a broader interdisciplinary discussion of the patient–physician relationship and should be useful in generating hypotheses for subsequent prospective studies.