Decision Aids on Breast Conserving Surgery for Early Stage Breast Cancer Patients: a Systematic Review

Overview

Journal BMC Med Inform Decis Mak

Publisher Biomed Central

Specialty Medical Informatics

Date 2020 Oct 23

PMID 33092602

Citations 8

Authors

Jing Si

Rong Guo

Xiang Lu

Chao Han

Li Xue

Dan Xing

Caiping Chen

Affiliations

Soon will be listed here.

Abstract

Background: Breast cancer is a worldwide health concern. For early stage breast cancer patients, choosing the surgical method after diagnosis is always a dilemma. Decision aids designed for use by patients are tools which may help with surgical decision making for these patients.

Methods: We screened through MEDLINE, EMBASE, PubMed and Web of Science using the inclusion criteria which included (1) newly diagnosed patients with early stage breast cancer, (2) outcomes/results involving surgical options including breast conserving surgery. The search strategy used these key words or the combination of these words: "breast cancer", "decision aid", "decision making", "decision support", "breast conserving surgery", "breast conserving therapy".

Results: A total of 621 studies were identified, but only seven studies were included. Results were synthesized into narrative format. Various patterns of decision aids designed for use by patients were implemented. Mostly were educational materials via booklet, video or CDROM with or without assistance from surgeons. After decision aids, four studies showed that patients were more likely to change their original choices into mastectomy or modified radical instead of sticking to breast conserving surgery. Other results such as knowledge of breast cancer and treatments, decisional conflict and satisfaction, psychological changes after surgery and quality of life were all showed with a better trend in patients with decision aids in most studies.

Conclusion: Decision aids on breast conserving surgery made it easier for patient involvement in surgical decision making and improved decision-related outcomes in most early stage breast cancer patients. With more attention, improving procedures, and better interdisciplinary cooperation, more research is necessary for the improvement of decision aids. And we believe decision aids with agreed objective information are needed.

Citing Articles

A bibliometric worldview of breast-conserving surgery for breast cancer from 2013 to 2023.

Cao S, Wei Y, Huang J, Yue Y, Deng A, Zeng H Front Oncol. 2024; 14:1405351.

PMID: 39099692 PMC: 11294094. DOI: 10.3389/fonc.2024.1405351.

Behaviour, barriers and facilitators of shared decision making in breast cancer surgical treatment: A qualitative systematic review using a 'Best Fit' framework approach.

Zheng H, Yang L, Hu J, Yang Y Health Expect. 2024; 27(2):e14019.

PMID: 38558230 PMC: 10982676. DOI: 10.1111/hex.14019.

Intraoperative radiotherapy in breast cancer: Alterations to the tumor microenvironment and subsequent biological outcomes (Review).

Yang Y, Hou X, Kong S, Zha Z, Huang M, Li C Mol Med Rep. 2023; 28(6).

PMID: 37888611 PMC: 10636769. DOI: 10.3892/mmr.2023.13118.

Effectiveness of a Decision Aid Plus Standard Care in Surgical Management Among Patients With Early Breast Cancer: A Randomized Clinical Trial.

Joshi S, Ramarajan L, Ramarajan N, Lee S, Deshpande O, Fernandes E JAMA Netw Open. 2023; 6(10):e2335941.

PMID: 37782500 PMC: 10546236. DOI: 10.1001/jamanetworkopen.2023.35941.

Factors influencing the decision-making process for breast surgery in women likely to face breast cancer: a cross-sectional study.

Naccour J, El-Helou E Ann Med Surg (Lond). 2023; 85(5):1648-1654.

PMID: 37229100 PMC: 10205190. DOI: 10.1097/MS9.0000000000000577.

References

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

Litiere S, Werutsky G, Fentiman I, Rutgers E, Christiaens M, Van Limbergen E . Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol. 2012; 13(4):412-9. DOI: 10.1016/S1470-2045(12)70042-6. View

Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M . Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer. 2018; 103:356-387. DOI: 10.1016/j.ejca.2018.07.005. View

Fisher B, Anderson S, Bryant J, Margolese R, Deutsch M, Fisher E . Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002; 347(16):1233-41. DOI: 10.1056/NEJMoa022152. View

DeSantis C, Ma J, Gaudet M, Newman L, Miller K, Sauer A . Breast cancer statistics, 2019. CA Cancer J Clin. 2019; 69(6):438-451. DOI: 10.3322/caac.21583. View

Mac Bride M, Neal L, Dilaveri C, Sandhu N, Hieken T, Ghosh K . Factors associated with surgical decision making in women with early-stage breast cancer: a literature review. J Womens Health (Larchmt). 2013; 22(3):236-42. DOI: 10.1089/jwh.2012.3969. View

Chen W, Zheng R, Baade P, Zhang S, Zeng H, Bray F . Cancer statistics in China, 2015. CA Cancer J Clin. 2016; 66(2):115-32. DOI: 10.3322/caac.21338. View

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4:1. PMC: 4320440. DOI: 10.1186/2046-4053-4-1. View

Au A, Lam W, Chan M, Or A, Kwong A, Suen D . Development and pilot-testing of a Decision Aid for use among Chinese women facing breast cancer surgery. Health Expect. 2011; 14(4):405-16. PMC: 5060593. DOI: 10.1111/j.1369-7625.2010.00655.x. View

10.

Molenaar S, Sprangers M, Rutgers E, Luiten E, Mulder J, Bossuyt P . Decision support for patients with early-stage breast cancer: effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life. J Clin Oncol. 2001; 19(6):1676-87. DOI: 10.1200/JCO.2001.19.6.1676. View

11.

Jibaja-Weiss M, Volk R, Granchi T, Neff N, Robinson E, Spann S . Entertainment education for breast cancer surgery decisions: a randomized trial among patients with low health literacy. Patient Educ Couns. 2010; 84(1):41-8. DOI: 10.1016/j.pec.2010.06.009. View

12.

Goel V, Sawka C, Thiel E, Gort E, OConnor A . Randomized trial of a patient decision aid for choice of surgical treatment for breast cancer. Med Decis Making. 2001; 21(1):1-6. DOI: 10.1177/0272989X0102100101. View

13.

Whelan T, Levine M, Gafni A, Sanders K, Willan A, Mirsky D . Mastectomy or lumpectomy? Helping women make informed choices. J Clin Oncol. 1999; 17(6):1727-35. DOI: 10.1200/JCO.1999.17.6.1727. View

14.

Belkora J, Miller M, Dougherty K, Gayer C, Golant M, Buzaglo J . The need for decision and communication aids: a survey of breast cancer survivors. J Community Support Oncol. 2015; 13(3):104-12. DOI: 10.12788/jcso.0116. View

15.

Lam W, Chan M, Or A, Kwong A, Suen D, Fielding R . Reducing treatment decision conflict difficulties in breast cancer surgery: a randomized controlled trial. J Clin Oncol. 2013; 31(23):2879-85. DOI: 10.1200/JCO.2012.45.1856. View

16.

Durand M, Alam S, Grande S, Elwyn G . 'Much clearer with pictures': using community-based participatory research to design and test a Picture Option Grid for underserved patients with breast cancer. BMJ Open. 2016; 6(2):e010008. PMC: 4746463. DOI: 10.1136/bmjopen-2015-010008. View

17.

Molenaar S, Oort F, Sprangers M, Rutgers E, Luiten E, Mulder J . Predictors of patients' choices for breast-conserving therapy or mastectomy: a prospective study. Br J Cancer. 2004; 90(11):2123-30. PMC: 2409497. DOI: 10.1038/sj.bjc.6601835. View

18.

Kummerow K, Du L, Penson D, Shyr Y, Hooks M . Nationwide trends in mastectomy for early-stage breast cancer. JAMA Surg. 2014; 150(1):9-16. DOI: 10.1001/jamasurg.2014.2895. View

19.

Elwyn G, OConnor A, Stacey D, Volk R, Edwards A, Coulter A . Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006; 333(7565):417. PMC: 1553508. DOI: 10.1136/bmj.38926.629329.AE. View

20.

Wilkins E, Lowery J, Copeland L, Goldfarb S, Wren P, Janz N . Impact of an educational video on patient decision making in early breast cancer treatment. Med Decis Making. 2006; 26(6):589-98. DOI: 10.1177/0272989X06295355. View