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It has long been known a breast cancer diagnosis can be particularly distressing as it carries a risk for emotional turmoil, psychological disruption, and physical disfigurement (Maguire, 1994). Despite public knowledge of great strides in successful treatment of breast cancer, recent findings confirmed the distress and other challenges that surround receiving the diagnosis (Campbell-Enns et al., 2017; Inan et al., 2016; Williams & Jeanetta, 2016). International literature pertaining to receiving breast cancer diagnoses showed that patient-centered, tailored, and empathetic communication leads to lower patient anxiety and higher trust in the clinician (Zwingmann et al., 2017), and directly influences patient decisions to continue or cease medical treatment (Sobczak et al., 2018).
Research on giving a cancer diagnosis entails what details should be addressed and how clinicians should convey the information (Attai et al., 2016; Fujimori & Uchitomi, 2009). Patient preferences for disclosure of bad news include their preferred setting, manner of physician communicating, what and how much information is provided, and emotional support (Fujimori et al., 2017; Fujimori & Uchitomi, 2009). Disparities between patient expectations and provider practices can negatively influence breast cancer patient outcomes (Diefenbach et al., 2009; Seifart et al., 2014). An important consideration when giving a cancer diagnosis is patient age and how that might impact the diagnostic experience and subsequent overall therapeutic relationship. Herein we focus on the population of breast cancer survivors age ≥65 years, as geriatric oncology generally remains greatly understudied despite the unique challenges of the interface of cancer and aging (Bellizzi et al., 2008; Hewitt et al., 2006; Institute of Medicine [IOM], 2013).
The prevalence of breast cancer is especially high among older women (44.5% of breast cancers are diagnosed in women age >65 years) (Howlader et al., 2020), but little is known about the diagnostic experience of older breast cancer survivors. Age-related factors have been found to strongly influence overall breast cancer treatment recommendations and decisions (Mustacchi et al., 2007). Outside of oncology settings, ageism (or negative views of age and aging) has been found to lead to significantly worse health outcomes all over the world (Chang et al.,...