Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States of America.
J Geriatr Oncol. 2021 Jun;12(5):724-730. doi: 10.1016/j.jgo.2021.02.028. Epub 2021 Mar 5.
A comprehensive decision aid (DA) for women ≥70 years with Stage I ER+/HER2-negative breast cancer was developed to support locoregional and systemic treatment decision-making. We aimed to test the acceptability of this novel DA in women newly-diagnosed with breast cancer.
Women ≥70 diagnosed with Stage I, ER+/HER2- breast cancer were recruited from three Boston-area hospitals. They underwent baseline interviews after initial surgical consultation, reviewed the DA, and were surveyed <2 weeks later to determine DA acceptability (e.g., was it helpful?), changes in decisional conflict, stage of decision-making, and knowledge. Participants could optionally complete a three-month follow-up. Paired t-tests and McNemar's tests were used for statistical comparisons, and thematic analyses were conducted to identify themes in participants' open-ended comments.
Thirty-three of 56 eligible patients approached completed the baseline and acceptability surveys, and 25 completed the three-month follow-up. Participants' mean age was 74.7 years (±3.8). Nearly all participants (n = 31, 94%) strongly agreed that the DA was helpful and felt that the DA prepared them for treatment decision-making, with a mean decision preparation score of 4.1 (out of 5.0); 6% (n = 2) found it very anxiety provoking. Knowledge improved with a mean of 9.0 out of 14 questions correct at baseline to 10.6 correct on the acceptability survey (p < 0.0001).
A DA tailored to women ≥70 with Stage I, ER+, HER2- breast cancer increased knowledge and was perceived to be helpful by older women. A randomized controlled trial is needed to evaluate its efficacy.
为支持局部和全身治疗决策，为≥70 岁患有 I 期 ER+/HER2-阴性乳腺癌的女性开发了综合决策辅助工具 (DA)。我们旨在测试该新型 DA 在新诊断为乳腺癌的女性中的可接受性。
从波士顿地区的三家医院招募了≥70 岁、患有 I 期、ER+/HER2-乳腺癌的女性。她们在初始手术咨询后接受基线访谈，查看 DA，并在不到 2 周后进行调查以确定 DA 的可接受性（例如，是否有帮助？）、决策冲突、决策阶段的变化，以及知识。参与者可以选择完成三个月的随访。使用配对 t 检验和 McNemar 检验进行统计比较，并进行主题分析以确定参与者开放式评论中的主题。
在 56 名符合条件的患者中，有 33 名完成了基线和可接受性调查，有 25 名完成了三个月的随访。参与者的平均年龄为 74.7 岁（±3.8）。几乎所有参与者（n=31，94%）强烈认为 DA 很有帮助，并认为 DA 使他们为治疗决策做好了准备，平均决策准备得分为 4.1（满分 5.0）；6%（n=2）认为它非常令人焦虑。知识得到了提高，基线时 14 个问题的平均正确数为 9.0，在可接受性调查中正确数为 10.6（p<0.0001）。
为患有 I 期、ER+、HER2-乳腺癌的≥70 岁女性量身定制的 DA 提高了知识水平，并被老年女性认为是有帮助的。需要进行随机对照试验来评估其疗效。
