Influence of decision support persons on breast cancer treatment decisions among Latinas

AbstractPurpose:Latinx experiences within cancer treatment decision-making remain largely understudied. We examined breast cancer treatment decision-making among Latina patients and their Latinx decision support persons (DSP).Methods:Women with newly diagnosed early-stage breast cancer (2014-2015) as reported to Surveillance, Epidemiology, and End Results (SEER) registries of Georgia and Los Angeles County, were surveyed (N=2502). Respondents identified the key DSPs in their treatment decisions, who were also surveyed (N=1203). Among 1,173 dyads, we examined: (1) bivariate associations of DSP characteristics with DSP-reported engagement, (informed about decisions, involvement (extent/satisfaction), and awareness of patient preferences), (2) DSP engagement with patient-reported subjective decision quality (SDQ) and treatment deliberation using multivariable linear regression, and (3) correlation between treatment received with DSPs treatment preferences.Results:Among Latina dyads (N=292), 78%, 17%, and 5% of DSPs identified as Latinx, White, and Asian/Black/Other, respectively. The key DSP for the Latina/Latinx dyads was more often a daughter (37%), over a husband/partner (21%) when compared to all other Latina/DSP and non-Latina/DSP dyads. Latinx DSPs also reported being more informed (p=0.058), and this was positively associated with higher patient SDQ (adjusted mean difference 0.176, p=0.034). Latinx DSPs also had a higher preference for mastectomy, especially with reconstruction compared to non-Latinx DSPs (40% vs 28%, p<.001).Conclusions:There are key differences in the characteristics and decision-making experiences among Latina patients when their DSP is also Latinx. This is important for clinicians to recognize, promote their inclusion, and meet their information needs, which our findings suggest positively impacts Latina SDQ.