Decision Aid Interventions for Contralateral Prophylactic Mastectomy in Women of Average Risk: An Integrative Review

Problem Identification: The use of a decision aid (DA) for women facing the decision of contralateral prophylactic mastectomy (CPM) is limited. This article aimed to examine the literature for studies testing a DA for patients diagnosed with unilateral breast cancer considering CPM.

Literature Search: A comprehensive search was conducted in CINAHL®, Ovid MEDLINE®, PubMed®, Web of Science, PsycINFO®, and Cochrane Library databases from 2017 to 2024.

Data Evaluation: The studies were assessed for relevance in testing a patient DA for CPM in patients diagnosed with unilateral breast cancer. Studies were evaluated using the Mixed Methods Appraisal Tool, version 2018.

Synthesis: Five studies met inclusion criteria. These studies included one pre-/postassessment cohort pilot study, one randomized controlled trial, two mixed-methods studies, and one qualitative study. Studies included 370 patients and 50 clinicians in the breast oncology setting.

Implications For Practice: Oncology nurses can play a key role in advocating for shared decision-making for patients considering CPM. Additional testing of a DA for patients diagnosed with unilateral breast cancer considering CPM should be considered.