New Study Finds Usual Care Enough to Promote the Well Adjustment to Early Breast Cancer

Women with early stage breast cancer who receive the usual care available in medical centers experience physical, emotional, and social adjustment over time without the additional interventions of standardized educational/supportive videotapes or individualized telephone counseling offered during each of the breast cancer stages.

Deborah Witt Sherman, PhD, CRNP, professor, University of Maryland School of Nursing, led an intervention study that appears in the current issue of the journal Applied Nursing Research, to evaluate the effectiveness of educational and supportive videotapes and/or telephone counseling compared to usual (standard care) on the adjustment of women with early-stage breast cancer during the stages of diagnosis, post-surgery, adjuvant therapy, and ongoing recovery.

The researchers enrolled 249 patients with early stage breast cancer from three major medical centers and one community hospital in New York City. They randomly assigned the patients into four groups. All four received usual care consisting of inpatient care and office visits provided by the medical team, including their physician, and nursing staff.

In addition to the usual care group, another group of women received the standardized educational supportive videotapes specific to the stage of breast cancer they were experiencing. A third group received individualized telephone counseling specific to each stage. A fourth group received both the educational videotapes and telephone counseling.
The videotapes included interviews with women and their family members, as well as interviews with breast surgeons, oncologists, and nurse experts. Consistent with crisis and stress-coping theories that guided the study, the educational videotapes were created to provide information about what the patients can expect physically, emotionally, and socially during each stage of the breast cancer experience.

As the telephone counseling was individualized, each session helped women normalize their experience and offered guidance and counseling to address their specific needs. Sherman says the counseling sessions explored whether breast cancer was viewed as a threat or as a challenge by the patient, as well as what types of support were valued by women.

Can breast cancer be found early? Screening refers to tests and exams used to find a disease, like cancer, in people who do not have any symptoms. The goal of screening exams, such as mammograms, is to find cancers before they start to cause symptoms. Breast cancers that are found because they can be felt tend to be larger and are more likely to have already spread beyond the breast. In contrast, breast cancers found during screening exams are more likely to be small and still confined to the breast. The size of a breast cancer and how far it has spread are important factors in predicting the prognosis (outlook) for a woman with this disease.

Most doctors feel that early detection tests for breast cancer save many thousands of lives each year, and that many more lives could be saved if even more women and their health care providers took advantage of these tests. Following the American Cancer Society's guidelines for the early detection of breast cancer improves the chances that breast cancer can be diagnosed at an early stage and treated successfully.