Oral Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Development and testing of a decision aid for women contemplating neoadjuvant systemic therapy for operable breast cancer (#126)

Nicholas Zdenkowski 1
  1. Calvary Mater Newcastle, Waratah, NSW, Australia

Background/Aim: The decision about whether to receive neoadjuvant systemic therapy or surgery as the first treatment modality for operable breast cancer is a preference sensitive decision. Some women value the opportunity to downstage, prognosticate and have extra time to consider surgical options, while others prefer to proceed with up-front surgery. This decision is made in the difficult context of a recent diagnosis of cancer, time pressure and complex treatment options, therefore a decision aid was considered worthwhile. Our study aims to develop and evaluate a decision aid for women with operable breast cancer who are considering neoadjuvant systemic therapy.

Methods: A decision aid, developed for this study according to internationally accepted criteria, literature review and stakeholder engagement. We are evaluating this decision aid in a prospective, single-arm, pre-post study. Participants have been diagnosed with breast cancer and have been offered neoadjuvant systemic therapy with curative intent. The primary endpoints are patient and provider acceptability and feasibility; secondary endpoints include several validated decision-related outcome questionnaires such as decisional conflict, information and involvement preferences and decisional regret. Assessments occur at baseline, after use of the decision aid, between chemotherapy and surgery, and at 12 months. Participants are offered an optional interview about their experience with the decision aid, which will undergo qualitative analysis.

Results: Recruitment is underway, with 38 out of 50 planned participants enrolled. Initial interview results (n=16) indicate that the decision aid is informative, accessible and can be integrated into routine medical care. It did not tend to change the treatment schedule that patients would have received.

Conclusion: Preliminary results suggest that this decision aid is acceptable to patients. Quantitative questionnaire results will be presented at the meeting.

Disclosures: None to declare.