Abstract PO2-11-11: 'Who’s gonna take care of my babies?' The Impact of Children on Treatment Decisions for Women with Metastatic Breast Cancer: A qualitative analysis
Authors: Tomczik Katherine , Coombs Lorinda 
Published: May 2024

Abstract
Background: Many treatment options exist for metastatic breast cancer and decisions may be based on pathology, oncology clinician preference, performance status, financial considerations, patient values, or a combination of these factors. Some studies have characterized the importance that family and a strong support system can have on treatment decisions, but few have explicitly examined the impact that children—and grandchildren—have on treatment decisions in metastatic breast cancer (mBC). This qualitative study examined how being a parent or grandparent influences treatment decisions for women with metastatic breast cancer. Methods: A qualitative sub-analysis was conducted with a purposive diverse sample of thirteen women with metastatic breast cancer in the Eastern United States. Women of color were specifically oversampled relative to the regional population. Semi-structured interviews were conducted to explore treatment decision making, clinician-patient communication, and patient values relevant to their treatment decisions. Interviews were recorded, professionally transcribed, and coded by three independent coders. Any coding discrepancies were resolved through discussion. Thematic analysis identified recurrent themes important to women diagnosed with mBC. Results: Nearly 50% of the participants were women of color and of the 13 participants, 12 had children. When asked about what factors were important to them when making treatment decisions, a list of more than 10 themes emerged. Five participants said that children and grandchildren impacted their treatment decisions and were a crucial part of their cancer care. Other significant themes that emerged were side effects (54% of participants) and quality of life (46% of participants). Women who expressed that children were their top priority were also concerned about “looking sick” in front of their children. For women who said their grandchildren were the most important factor, being able to watch their grandchildren grow up was the primary motivator for their treatment decisions. Among the women who identified that side effects and quality of life were important, children either provided supportive care, helped with activities of daily living, or were too young to provide support. Conclusions: The presence of children and the relationships women with mBC have with their children was primary in making treatment decisions for their cancer. Of the participants in our study, having children—and grandchildren—rivaled other important factors such as quality of life and side effects of treatment, indicating the need to explore the impact that children have on cancer care as it is currently a poorly understood phenomenon. However, it is important not to make assumptions about patient treatment preferences based on whether women with mBC have children, instead, shared decision-making conversations should determine what is most important when deciding on a treatment plan. Future tools should integrate questions about family and children, and how these considerations may impact treatment decisions.

Citation Format: Katherine Tomczik, Lorinda Coombs. 'Who’s gonna take care of my babies?' The Impact of Children on Treatment Decisions for Women with Metastatic Breast Cancer: A qualitative analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-11.