Pilot testing a patient decision aid as a strategy to reduce overtreatment for older women with early-stage breast cancer.

Document Type

Article

Publication Date

9-2024

Publication Title

American journal of surgery

Abstract

BACKGROUND: Despite national guidelines recommending omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy (RT) in older women with early-stage, hormone receptor-positive (HR+) breast cancer, these practices persist. This pilot study assesses whether a decision aid can target patient-level determinants of low-value treatments.

METHODS: We adapted and pilot-tested a decision aid in women ≥70 years old with early-stage HR + breast cancer. Primary outcomes included acceptability and appropriateness of the decision aid. Secondary outcomes included treatment choice and satisfaction with decision.

RESULTS: Twenty-three patients enrolled in the trial. 19 completed survey one; 16 completed survey two. Primary outcomes demonstrated that 84% of patients agreed or strongly agreed the aid was acceptable and appropriate. Secondary outcomes demonstrated that 19% of patients underwent SLNB (below pre-intervention baseline), and 85% received adjuvant RT (change not statistically significant).

CONCLUSIONS: We demonstrate that a decision aid may effectively target patient-level factors contributing to overuse of low-value therapies.

Volume

235

First Page

115774

DOI

10.1016/j.amjsurg.2024.115774

ISSN

1879-1883

PubMed ID

38834420

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