Zdenkowski N, et al. - Researchers aimed to develop and evaluate a decision aid (DA) for women with large operable or highly proliferative breast cancer. They developed DA booklet according to international standards, including information about adjuvant and neoadjuvant treatment, outcome probabilities, and a values clarification exercise. The DA was identified to be feasible and acceptable to patients and clinicians. They noted improvement in decision-related outcomes when it was used in combination with clinical consultations. For women considering neoadjuvant systemic therapy (NAST) for operable breast cancer, this DA could safely be implemented into routine practice.

Methods

• In a multi-institutional, single-arm, longitudinal study, eligible women, considered by investigators as candidates for NAST, were enrolled.
• Completion of patient-reported outcome measure questionnaires was performed pre- and post-DA, between chemotherapy and surgery, and at 12 months.
• For this study, outcomes included feasibility (percentage of eligible patients accessing the DA); acceptability to patients (percentage who would recommend it to others) and clinicians (percentage who would use the DA in routine practice); and decision-related outcomes.

Results

• Seventy-seven eligible women were identified; of these, 59 were enrolled, of whom 47 (79.7%; 95% CI, 69.4–89.9) reported having read the DA; 51 completed the first post-DA questionnaire.
• For the decision regarding NAST, 41/51 participants (80.4%; 95% CI, 69.5–91.3) found the DA as useful.
• Of 18 responding investigators, 16 (88.9%; 95% CI, 74.4–103.4) indicated they would continue to use the DA in routine practice.
• Observations suggest that post-DA, decisional conflict reduced markedly (P<.01); anxiety and distress decreased significantly; and 86.3% (95% CI, 73.7–94.3) achieved at least as much decisional control as they desired.