Facilitating decision-making in women undergoing genetic testing for hereditary breast cancer

BRECONDA randomized controlled trial results

Kerry A. Sherman*, Christopher J. Kilby, Laura Kate Shaw, Caleb Winch, Judy Kirk, Kathy Tucker, Elisabeth Elder

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: Decision-making concerning risk-reducing mastectomy for women at hereditary risk of breast cancer entails complex personal choices. Deciding whether and how to restore breast shape after risk-reducing mastectomy is a key part of this process. We developed a web-based decision aid, BRECONDA (Breast Reconstruction Decision Aid), to assist women in decision-making regarding breast reconstruction.

METHOD: This study assessed the efficacy of BRECONDA to assist women at increased risk of breast cancer in making decisions regarding risk-reducing mastectomy in terms of decisional conflict, knowledge, and satisfaction with information. Women at hereditary risk of breast cancer (N = 64) were recruited into this randomized controlled trial from four Australian hereditary cancer clinics. Participants initially provided online consent and completed baseline questionnaires assessing decisional conflict, knowledge, and satisfaction with information. They were then randomly assigned to either: 1) Intervention - unlimited access to BRECONDA, with usual care; or, 2) Control - usual care. At 2-months follow-up (N = 60) the outcomes were re-assessed. Intervention participants also completed user acceptability ratings for the intervention overall and specific key modules.

RESULTS: MANCOVA analyses indicated that Intervention participants reported lower decisional conflict (P = 0.027), and greater knowledge (P = 0.019) and satisfaction with information (P < 0.0005) at 2-months follow-up compared with Controls. Intervention participants reported high user acceptability and satisfaction with the intervention.

CONCLUSION: BRECONDA benefits women considering risk-reducing mastectomy by reducing decisional conflict, and improving knowledge and satisfaction with information. These benefits, coupled with high user acceptability, demonstrate the feasibility of implementing BRECONDA in the hereditary cancer risk context.

Original languageEnglish
Pages (from-to)79-85
Number of pages7
JournalBreast
Volume36
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • Breast cancer
  • Decision aid
  • Decision-making
  • Decisional conflict
  • Hereditary risk
  • Randomized controlled trial

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