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Impact of an In-visit Decision Aid on Patient Knowledge about Contralateral Prophylactic Mastectomy: A Pilot Study

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

An Erratum to this article was published on 27 March 2017

Abstract

Background

Studies have reported that breast cancer patients have limited understanding about the oncologic outcomes following contralateral prophylactic mastectomy (CPM). We hypothesized that an in-visit decision aid (DA) would be associated with higher patient knowledge about the anticipated short and long term outcomes of CPM.

Methods

We piloted a DA which used the SCOPED: (Situation, Choices, Objectives, People, Evaluation and Decision) framework. Knowledge, dichotomized as “low” (≤3 correct) versus “high” (≥4 correct), was assessed immediately after the visit by a 5 item survey. There were 97 DA patients (response rate 62.2 %) and 114 usual care (UC) patients (response rate 71.3 %).

Results

Patient demographic factors were similar between the two groups. Twenty-one (21.7 %) patients in the DA group underwent CPM compared with 18 (15.8 %) in the UC group (p = 0.22). Mean and median knowledge levels were significantly higher in the DA group compared with the UC group for patients of all ages, tumor stage, race, family history, anxiety levels, worry about CBC, and surgery type. Eighty-six (78.9 %) of UC versus 35 (37.9 %) DA patients had low knowledge. Of patients who underwent CPM, 15 (83.3 %) in the UC cohort versus 5 (25.0 %) of DA patients had “low” knowledge.

Conclusions

Knowledge was higher in the DA group. The UC group had approximately three times the number of patients of the DA group who were at risk for making a poorly informed decision to have CPM. Future studies should assess the impact of increased knowledge on overall CPM rates.

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Authors and Affiliations

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

    Katharine Yao MD, Mark Sisco MD, Ermilo Barrera MD, Alexandra Kyrillios BS, Sarah Rabbitt RN, Catherine Pesce MD, Sandra Simovic BS & David J. Winchester MD

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

    Jeff Belkora PhD

  3. Department of Surgery, MD Anderson Cancer Center, Houston, TX, USA

    Isabelle Bedrosian MD

  4. Dana Farber Cancer Institute, Boston, MA, USA

    Shoshana Rosenberg PhD

  5. Mayo Clinic, Rochester, MN, USA

    Jon Tilburt MD

  6. Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, IL, USA

    Chihsiung Wang PhD

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

    Karen Sepucha PhD

Authors
  1. Katharine Yao MD
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  2. Jeff Belkora PhD
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Correspondence to Katharine Yao MD.

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Additional information

An erratum to this article is available at http://dx.doi.org/10.1245/s10434-017-5850-2.

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Yao, K., Belkora, J., Bedrosian, I. et al. Impact of an In-visit Decision Aid on Patient Knowledge about Contralateral Prophylactic Mastectomy: A Pilot Study. Ann Surg Oncol 24, 91–99 (2017). https://doi.org/10.1245/s10434-016-5556-x

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