Survey Reveals Communication Gaps Between Oncologists and Patients With Advanced Breast Cancer Interview with:

Adam Brufsky, MD, PhD, FACP Medical Director of the Women's Cancer Center University of Pittsburgh Medical Center

Dr. Adam Brufsky

Adam Brufsky, MD, PhD, FACP
Medical Director of the Women’s Cancer Center
University of Pittsburgh Medical Center What is the background for this study? What are the main findings?

  • The Make Your Dialogue Count survey was conducted by Harris Poll on behalf of Novartis between June 20 and August 22, 2014. A total of 359 surveys were collected among women 21 years+ living with advanced breast cancer in addition to 234 caregivers of women with advanced breast cancer and 252 licensed oncologists who treat at least five advanced breast cancer patients per month within the United States. Novartis conducted the survey with guidance from oncologists, patient advocacy experts and a psychologist to better understand the dialogue around treatment goals and decisions that takes place among advanced breast cancer patients, caregivers and oncologists.
  • Main survey findings show communication gaps exist in discussions between patients and oncologists, particularly around treatment plans and goals.
  • 89% of patients and 76% of oncologists said that it’s important or very important to discuss long-term treatment plans beyond the current recommended treatment at their initial advanced breast cancer diagnosis. Yet, 43% of patients reported that this did not take place.
  • 70% of patients and 65% of oncologists said that it’s important or very important to refer patients to support services at their initial advanced breast cancer diagnosis. Yet, only 36% of patients reported that this was something their doctor did.
  • 23% of oncologists said that at times their emotions have kept them from sharing certain information with their advanced breast cancer patients, and 27% of oncologists said that, in certain situations, they do not discuss with patients the fact that advanced breast cancer is incurable.
What is the difference between advanced and early stage breast cancer?

Response: The stage of breast cancer is based on the size of the tumor and whether thecancer has spread. Early-stage breast cancer (stage I or II) is the most common invasive breast cancer in the United States. Advanced breast cancer comprises metastatic breast cancer (stage IV) and locally advanced breast cancer (stage III). Metastatic breast cancer is the most serious form of the disease and occurs when the cancer has spread to other parts of the body, such as the brain, bones or liver. Locally advanced breast cancer occurs when the cancer has spread to lymph nodes and/or other tissue in the area of the breast but not to distant sites in the body. Why are there such communication gaps between these groups?

Response: The average doctor’s appointment lasts approximately 15 minutes. This does not leave a lot of time for discussion around the treatment of advanced or metastatic breast cancer, which is a complex disease that requires many individual treatment considerations. Because of this, there can be unintended miscommunication between physicians and patients and/or patients’ family or friend caregivers. It’s also possible that the emotions of both the patient and doctor may get in the way of open and honest treatment decisions. What should readers take away from your report?

Response: My hope is that these survey findings will empower advanced breast cancer patients and caregivers to play an active role in treatment conversations and decisions. Separately, I hope that this report reinforces the importance of patients having access to other specialists, including a nurse, social worker, psychologist, financial advisor, etc. in addition to their oncologist for the most comprehensive care. What do the survey results mean for the advanced breast cancer community?

Response: The survey results show that there is ample room for improvement in communication between doctors and advanced breast cancer patients. The results shed light on the importance for doctors to have a continual and open dialogue with patients about their specific concerns and preferences so they can tailor treatment plans and improve quality of life for each individual patient. What can advanced breast cancer patients do to improve communication with their doctors?

Response: As a result of the findings, Novartis developed the first-of-its-kind Make Your Dialogue Count tool, available at, to help those living with the disease improve discussions with their doctors and make the most out of their doctor visits. After answering key questions relevant to their unique experience with advanced breast cancer, patients receive a personalized discussion guide that addresses their concerns, along with tips for initiating a dialogue with their doctor and questions to ask at their next appointment. With any change in treatment or status, patients can retake the questionnaire and generate a new discussion guide that addresses the topics that matter most to them. What recommendations do you have for future research as a result of this study?

Response: In terms of future research, I recommend conducting more practice-level studies to ensure patients living with advanced breast cancer are satisfied with their care and are getting what they need from their full healthcare team. Thank you for your contribution to the community.


Make Your Dialogue Count Personalized Discussion Guide

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on

[wysija_form id=”5″]