Oral Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Development of a patient decision aid for women with early stage breast cancer considering contralateral prophylactic mastectomy (#125)

Brittany Ager 1
  1. University of Sydney, University Of Sydney, NSW, Australia

Aims: The surgical removal of the unaffected breast in women with early stage breast cancer (contralateral prophylactic mastectomy; CPM) has increased dramatically in recent years. Although CPM reduces risk of developing a second primary cancer (contralateral breast cancer) by 95%, CPM has not been associated with increased survival in this subset of women. We developed a decision aid for women with early-stage unilateral breast cancer considering CPM. This study aims to elicit feedback from women about the decision aid as part of the development process, in order to form the basis for a future randomised controlled trial.


Methods: The content of the decision aid was based on the International Patient Decision Aids Standards (IPDAS), results from a previous patient-preference study and a systematic review on patient reported reasons for CPM. The development process involved an expert advisory group of medical oncologists, breast cancer surgeons, psycho-oncologists and researchers with expertise in medical decision-making. In order to obtain consumer feedback, we plan to recruit 20 women diagnosed with stage I or II unilateral breast cancer between 40-75 years who have finished active breast cancer treatment. Eligible women may or may not have had CPM. Women will be recruited through a breast cancer research network. Consenting participants will be asked to attend an interview in person or over the phone to review the decision aid. The ‘think aloud’ method will be used to assess patients’ thoughts on the decision aid. Interviews will be recorded, transcribed and coded to highlight main areas of feedback.


Results: The decision aid was finalised in June, 2016. We plan to present consumer feedback at COSA.


Conclusion:  Limited information resources are currently available for women considering CPM. This project includes a novel decision aid to assist women in making this difficult decision.