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

Research output: Contribution to journalArticleResearchpeer-review

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.

LanguageEnglish
Pages79-85
Number of pages7
JournalBreast
Volume36
DOIs
Publication statusPublished - 1 Dec 2017

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Decision Support Techniques
Mammaplasty
Genetic Testing
Decision Making
Randomized Controlled Trials
Breast Neoplasms
Mastectomy
Neoplasms
Breast
Conflict (Psychology)

Keywords

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

Cite this

@article{6c85b371277d40d09b2b9150716738ae,
title = "Facilitating decision-making in women undergoing genetic testing for hereditary breast cancer: BRECONDA randomized controlled trial results",
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.",
keywords = "Breast cancer, Decision aid, Decision-making, Decisional conflict, Hereditary risk, Randomized controlled trial",
author = "Sherman, {Kerry A.} and Kilby, {Christopher J.} and Shaw, {Laura Kate} and Caleb Winch and Judy Kirk and Kathy Tucker and Elisabeth Elder",
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Facilitating decision-making in women undergoing genetic testing for hereditary breast cancer : BRECONDA randomized controlled trial results. / Sherman, Kerry A.; Kilby, Christopher J.; Shaw, Laura Kate; Winch, Caleb; Kirk, Judy; Tucker, Kathy; Elder, Elisabeth.

In: Breast, Vol. 36, 01.12.2017, p. 79-85.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Facilitating decision-making in women undergoing genetic testing for hereditary breast cancer

T2 - Breast

AU - Sherman, Kerry A.

AU - Kilby, Christopher J.

AU - Shaw, Laura Kate

AU - Winch, Caleb

AU - Kirk, Judy

AU - Tucker, Kathy

AU - Elder, Elisabeth

PY - 2017/12/1

Y1 - 2017/12/1

N2 - 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.

AB - 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.

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KW - Decision aid

KW - Decision-making

KW - Decisional conflict

KW - Hereditary risk

KW - Randomized controlled trial

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U2 - 10.1016/j.breast.2017.10.001

DO - 10.1016/j.breast.2017.10.001

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