Diagnosis Terminology Affects Treatment Decisions

According to a recent study published online on August 26, 2013, in JAMA Internal Medicine, women diagnosed with ductal carcinoma in situ (DCIS), a noninvasive breast malignancy, may be more likely to choose surgery over noninvasive options when the condition is described using the word “cancer.”

Recognizing that many women are unable to distinguish between invasive and noninvasive cancers, especially with inconsistent terminology, the researchers investigated whether women’s treatment decisions would be affected by the words used to describe the diagnosis. The study enrolled 394 healthy women and presented them with 3 terms to describe a DCIS diagnosis: noninvasive breast cancer, breast lesion, and abnormal cells. Each term was accompanied by an identical table of risks and 3 treatment options, including surgery, medication, and active surveillance. Women viewed each term separately and were asked to make a treatment decision for each.

The results indicated that women changed their treatment decision when different terms were used to describe DCIS. When the condition was described as “noninvasive breast cancer,” 47% of women said they would want surgery. However, when DCIS was described as a “breast lesion,” 34% wanted surgery, and 31% selected surgery when “abnormal cells” was used.

The authors suggest that many women want nonsurgical treatment when they better understand the risks, but the word “cancer” may scare patients and prevent them from choosing less aggressive treatment.