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An In-Visit Decision Aid for Surgeons to Address Decision Making for Bilateral Mastectomy for Newly Diagnosed Breast Cancer Patients

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Few decision aids for newly diagnosed breast cancer patients are used by surgeons during their consultations with patients.

Methods

From 2017 to 2019, an online interactive breast cancer in-visit decision aid (BIDA) was used on 63 patients and 57 patients underwent usual care (UC). We compared knowledge, decision involvement, anxiety and distress (HADS scale), quality of life (PROMIS), fear of recurrence, body image, and patient values between BIDA and UC before surgery. A knowledge score of ≥ 57% was considered “high knowledge.”

Results

A total of 188 patients were enrolled of which 120 (63.8%) completed all study procedures. Patient demographic characteristics and anxiety and quality of life (QOL) at baseline were similar between patients in BIDA and UC cohorts. After seeing the surgeon, patients in the BIDA group had higher composite knowledge scores compared with UC patients [n = 55 (87.3%) vs. n = 39 (68.4%) respectively, p = 0.012]. Patients in the BIDA cohort reported being asked more often their surgical preference (p = 0.013) and discussing bilateral mastectomy (BM) as an option (p = 0.048). There was a trend of less patients in the BIDA cohort undergoing BM then in the UC cohort [10 (15.9%) vs. 14 (24.6%), p = 0.49]. Anxiety and distress, QOL, fear of recurrence, and body image were not significantly different between BIDA and UC cohorts.

Conclusions

A decision aid used by surgeons during their consultation was associated with higher knowledge levels, patients reporting more discussion about BM, and a trend of lower BMs. A larger study with more patients is needed to confirm this finding.

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Acknowledgement

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA

    Katharine Yao MD, Catherine Pesce MD, Katherine Kopkash MD, Sarah Rabbitt RN, Ermilo Barrera MD & Sandra Simovic BS

  2. University of California San Francisco School of Medicine, San Francisco, CA, USA

    Jeff Belkora PhD

  3. Division of Plastic Surgery, Department of Surgery, Ohio State University Medical Center, Columbus, OH, USA

    Clara Lee MD

  4. Biostatistical Core, NorthShore University HealthSystem Research Institute, Evanston, IL, USA

    Kristine Kuchta MS

  5. Health Decision Sciences Center, Massachusetts General Hospital, Boston, MA, USA

    Karen Sepucha PhD

  6. Pritzker School of Medicine, University of Chicago, Evanston, IL, USA

    Katharine Yao MD, Catherine Pesce MD, Katherine Kopkash MD & Ermilo Barrera MD

Authors
  1. Katharine Yao MD
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  2. Jeff Belkora PhD
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  3. Clara Lee MD
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  4. Kristine Kuchta MS
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  9. Sandra Simovic BS
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  10. Karen Sepucha PhD
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Correspondence to Katharine Yao MD.

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Yao, K., Belkora, J., Lee, C. et al. An In-Visit Decision Aid for Surgeons to Address Decision Making for Bilateral Mastectomy for Newly Diagnosed Breast Cancer Patients. Ann Surg Oncol 26, 4372–4380 (2019). https://doi.org/10.1245/s10434-019-07912-9

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  • DOI: https://doi.org/10.1245/s10434-019-07912-9

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