Pilot testing a patient decision aid as a strategy to reduce overtreatment for older women with early-stage breast cancer - 15/08/24
, Ruby J. Kazemi a, 1, Abigail Kappelman a, c, Jessica L. Thompson d, Chad Jobin e, Ton Wang f, Lesly A. Dossett g, hAbstract |
Background |
Despite national guidelines recommending omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy (RT) in older women with early-stage, hormone receptor-positive (HR+) breast cancer, these practices persist. This pilot study assesses whether a decision aid can target patient-level determinants of low-value treatments.
Methods |
We adapted and pilot-tested a decision aid in women ≥70 years old with early-stage HR + breast cancer. Primary outcomes included acceptability and appropriateness of the decision aid. Secondary outcomes included treatment choice and satisfaction with decision.
Results |
Twenty-three patients enrolled in the trial. 19 completed survey one; 16 completed survey two. Primary outcomes demonstrated that 84% of patients agreed or strongly agreed the aid was acceptable and appropriate. Secondary outcomes demonstrated that 19% of patients underwent SLNB (below pre-intervention baseline), and 85% received adjuvant RT (change not statistically significant).
Conclusions |
We demonstrate that a decision aid may effectively target patient-level factors contributing to overuse of low-value therapies.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Older women find a breast cancer decision aid highly acceptable and appropriate. |
• | Patients report increased satisfaction with their treatment choices. |
• | Patients endorse improved shared-decision making. |
• | The decision aid may reduce utilization of low-value cancer therapies. |
Keywords : Breast cancer, de-implementation, Radiotherapy, Sentinel lymph node biopsy, Older women
Plan
Vol 235
Article 115774- septembre 2024 Retour au numéro
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