Abstract
Purpose
To determine the feasibility and acceptability of using a patient decision aid (DA) for women with elevated breast cancer risk who are considering MRI screening.
Methods
This pilot study employed a mixed methods design to develop, modify, and test an interactive DA. The DA was administered among a consecutive patient sample with an estimated Tyrer-Cuzick v.8 lifetime breast cancer risk of 20% or greater and without a pathologic genetic mutation. The decisional conflict scale was used to measure decisional conflict. Post-intervention provider and patient feedback evaluated shared decision-making, feasibility, and acceptability.
Results
Twenty-four patients participated, with a median age of 44 years. Prior to DA use, sixteen patients (67%) were unsure whether to add MRI to their screening, six patients elected MRI (25%), and two patients declined MRI (8%). Following DA use, thirteen of sixteen of the initially undecided participants (81%) established a preference, with eleven electing to add MRI screening. Of participants with an initial preference, all maintained the same decision following use of the DA. Prior to the DA, the median decisional conflict score among participants was 25% (range 0–60%) compared with 0% (range 0–25%) after the DA. Healthcare providers reported that the DA was useful and easily incorporated into clinical workflow.
Conclusions
This pilot study shows that there may be a benefit to DA utilization in the high-risk breast cancer clinic to guide shared decision-making in establishing a screening preference. The findings warrant further research to test the use of the DA in a larger, multi-site trial.
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Acknowledgment
Financial support for this study was provided entirely by a Grant from the University of Virginia, Internal Department of Surgery Grant.
Funding
Research supported by a Pilot Project Grant from the University of Virginia, Internal Department of Surgery Grant. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
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Chu, C., Smith, C.E., Gorski, J. et al. Implementation of a Novel Patient Decision Aid for Women with Elevated Breast Cancer Risk Who Are Considering MRI Screening: A Pilot Study. Ann Surg Oncol 30, 6152–6158 (2023). https://doi.org/10.1245/s10434-023-13901-w
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DOI: https://doi.org/10.1245/s10434-023-13901-w