Decision aids on breast conserving surgery for early stage breast cancer patients: a systematic review

BMC Medical Informatics and Decision Making

Dan Xing¹  Caiping Chen¹  Xiang Lu¹  Li Xue¹  Jing Si¹  Chao Han¹  Rong Guo² 

[1] Department of Breast Disease, The First Hospital of Jiaxing and The First Affiliated Hospital of Jiaxing University, No. 1882, South Zhonghuan Rd., 314000, Jiaxing, China;Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270, Dongan Rd., 200032, Shanghai, China;

关键词: Breast cancer;    Decision aids;    Decision making;    Decision support;    Breast conserving surgery;    Breast conserving therapy;   

DOI  :  10.1186/s12911-020-01295-8

来源: Springer

【 摘 要 】

BackgroundBreast cancer is a worldwide health concern. For early stage breast cancer patients, choosing the surgical method after diagnosis is always a dilemma. Decision aids designed for use by patients are tools which may help with surgical decision making for these patients.MethodsWe screened through MEDLINE, EMBASE, PubMed and Web of Science using the inclusion criteria which included (1) newly diagnosed patients with early stage breast cancer, (2) outcomes/results involving surgical options including breast conserving surgery. The search strategy used these key words or the combination of these words: “breast cancer”, “decision aid”, “decision making”, “decision support”, “breast conserving surgery”, “breast conserving therapy”.ResultsA total of 621 studies were identified, but only seven studies were included. Results were synthesized into narrative format. Various patterns of decision aids designed for use by patients were implemented. Mostly were educational materials via booklet, video or CDROM with or without assistance from surgeons. After decision aids, four studies showed that patients were more likely to change their original choices into mastectomy or modified radical instead of sticking to breast conserving surgery. Other results such as knowledge of breast cancer and treatments, decisional conflict and satisfaction, psychological changes after surgery and quality of life were all showed with a better trend in patients with decision aids in most studies.ConclusionDecision aids on breast conserving surgery made it easier for patient involvement in surgical decision making and improved decision-related outcomes in most early stage breast cancer patients. With more attention, improving procedures, and better interdisciplinary cooperation, more research is necessary for the improvement of decision aids. And we believe decision aids with agreed objective information are needed.

【 授权许可】

CC BY