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Patient Preferences for Breast Cancer Treatment Interventions: A Systematic Review of Discrete Choice Experiments

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Abstract

Introduction

Understanding how patients value different characteristics of an intervention and make trade-offs in a therapy choice context with potential benefit and possible harm may result in decisions for which a better reflected value is delivered. This systematic review summarizes patient preferences for breast cancer treatments elicited by discrete choice experiments (DCE).

Methodology

The electronic databases MEDLINE (PubMed), Scopus, PsycINFO, CINAHL, LILACS, and Web of Science were last searched on May 9, 2019 without restrictions regarding language and time of publication. Original studies reporting patient preferences related to breast cancer treatment (surgery, radiotherapy, endocrine therapy, chemotherapy or palliative care) elicited by DCE were eligible. A narrative synthesis of the relative importance and trade-offs of the treatment attributes of each study was reported.

Results

Five studies conducted in Japan, Thailand, USA and the Netherlands with 146–298 participants evaluated preferences regarding chemotherapy regimens for advanced/metastatic disease, and breast reconstruction after mastectomy. The attributes with major relative effects on preferences were greater survival, better aesthetic result of the surgery, and lower side effects and complication rates. Patients would trade a better aesthetic result to minimize complication rates, and, in advanced disease, the willingness to pay was greater for gains in survival and to avoid some severe adverse events.

Conclusion

Despite the relative lack of evidence in this specific context, our review shows that breast cancer patients naturally value greater benefit and, in scenarios of advanced and metastatic disease, are willing to face risks of some side effects for gains in survival.

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Data availability

Data are available on request to the authors.

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Authors and Affiliations

  1. Health Technology Assessment Unit of the Brazilian National Institute of Cancer, Rua Marquês de Pombal 125, 7º andar, Centro, Rio de Janeiro, RJ, CEP: 20.230-240, Brazil

    Renata Leborato Guerra, Luciana Castaneda, Rita de Cássia Ribeiro de Albuquerque, Flávia de Miranda Corrêa & Ricardo Ribeiro Alves Fernandes

  2. Integrated Library System, Teaching Coordination of the Brazilian National Cancer Institute, Rio de Janeiro, Brazil

    Camila Belo Tavares Ferreira

  3. Populational Research Division of the Brazilian National Institute of Cancer, Rio de Janeiro, Brazil

    Liz Maria de Almeida

Authors
  1. Renata Leborato Guerra
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  2. Luciana Castaneda
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  3. Rita de Cássia Ribeiro de Albuquerque
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  4. Camila Belo Tavares Ferreira
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  5. Flávia de Miranda Corrêa
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  6. Ricardo Ribeiro Alves Fernandes
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  7. Liz Maria de Almeida
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Contributions

RLG contributed to the conception and design of the work, data collection, data analysis and interpretation, and drafted the article; LC and RCRA contributed to data collection, data analysis and interpretation, and manuscript writing; CBTF contributed to data collection and critical revision of the manuscript; FMC, RRAF and LMA contributed to the conception and design of the work and critical revision of the manuscript. All authors approved the final version of the article.

Corresponding author

Correspondence to Renata Leborato Guerra.

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Conflict of interest

The authors Renata Leborato Guerra, Luciana Castaneda, Rita de Cássia Ribeiro de Albuquerque, Camila Belo Tavares Ferreira, Flávia de Miranda Corrêa, Ricardo Ribeiro Alves Fernandes and Liz Maria de Almeida declare that they have no conflict of interest.

Funding

This study was supported by the 54° technical cooperation term between the Brazilian National Institute of Cancer/Ministry of Health and the Pan-American Health Organization/World Health Organization.

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Guerra, R.L., Castaneda, L., de Albuquerque, R.d.C.R. et al. Patient Preferences for Breast Cancer Treatment Interventions: A Systematic Review of Discrete Choice Experiments. Patient 12, 559–569 (2019). https://doi.org/10.1007/s40271-019-00375-w

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