Patients with breast cancer prioritized affordability or maintaining functional independence when making treatment decisions. Because of this variability, preference evaluation during treatment decision-making could optimize patients’ treatment experiences.
This cross-sectional study used survey data from a nationwide sample of women with breast cancer who received assistance from Patient Advocate Foundation (PAF). Choice-based conjoint analysis elicited patient preferences and trade-offs. Latent class analysis segmented respondents into distinct preference groups. The Comprehensive Score for Financial Toxicity (COST) tool captured financial toxicity. Of 220 respondents, median age was 58 years, with 41% diagnosed within the past 2 years; 38% had recurred. Almost two-thirds were on active treatment. Treatment choice was most affected by preferences related to affordability and impact on activities of daily living (ADLs). Two distinct treatment preference archetypes emerged. The “Cost-Prioritizing Group” was most concerned about affordability, impact on ADLs, and burdening care partners. The “Functional Independence-Prioritizing Group” was most concerned about ability to work, physical side effects, and interference with important life events. Cost- versus functional independence-prioritizing respondents were more often diagnosed with an early stage cancer, white, or privately insured. Functional independence- versus cost-prioritizing respondents more often had household incomes less than $40,000, identified as Hispanic/Latino, or had Medicaid. COST scores were similar between archetypes in adjusted models.