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Clinical Trial
. 2022 Sep;195(2):141-152.
doi: 10.1007/s10549-022-06676-3. Epub 2022 Jul 30.

Acceptability of a companion patient guide to support expert consensus guidelines on surveillance mammography in older breast cancer survivors

Rachel A Freedman  1 , Anna C Revette  2 , Haley Gagnon  3 , Adriana Perilla-Glen  3 , Molly Kokoski  3 , Saida O Hussein  3 , Erin Leone  3 , Nicole Hixon  3 , Rebeka Lovato  3 , Wendy Loeser  3 , Nancy U Lin  3 , Christina A Minami  4 , Beverly Canin  5 , Barbara LeStage  6   7 , Meredith Faggen  3 , Philip D Poorvu  3 , Jennifer McKenna  3 , Kathryn J Ruddy  8 , Nancy L Keating  9   10 , Mara A Schonberg  11
Affiliations
Clinical Trial

Acceptability of a companion patient guide to support expert consensus guidelines on surveillance mammography in older breast cancer survivors

Rachel A Freedman et al. Breast Cancer Res Treat. 2022 Sep.

Abstract

Purpose: To support shared decision-making, patient-facing resources are needed to complement recently published guidelines on approaches for surveillance mammography in breast cancer survivors aged ≥ 75 or with < 10-year life expectancy. We created a patient guide to facilitate discussions about surveillance mammography in older breast cancer survivors.

Methods: The "Are Mammograms Still Right for Me?" guide estimates future ipsilateral and contralateral breast (in-breast) cancer risks, general health, and the potential benefits/harms of mammography, with prompts for discussion. We conducted in-clinic acceptability testing of the guide by survivors and their clinicians at a National Cancer Institute-designated comprehensive cancer center, including two community practices. Patients and clinicians received the guide ahead of a clinic visit and surveyed patients (pre-/post-visit) and clinicians (post-visit). Acceptability was defined as ≥ 75% of patients and clinicians reporting that the guide (a) should be recommended to others, (b) is clear, (c) is helpful, and (d) contains a suitable amount of information. We also elicited feedback on usability and mammography intentions.

Results: We enrolled 45 patients and their 21 clinicians. Among those responding in post-visit surveys, 33/37 (89%) patients and 15/16 (94%) clinicians would recommend the guide to others; 33/37 (89%) patients and 15/16 (94%) clinicians felt everything/most things were clear. All other pre-specified acceptability criteria were met. Most patients reported strong intentions for mammography (100% pre-visit, 98% post-visit).

Conclusion: Oncology clinicians and older breast cancer survivors found a guide to inform mammography decision-making acceptable and clear. A multisite clinical trial is needed to assess the guide's impact mammography utilization.

Trial registration: ClinicalTrials.gov-NCT03865654, posted March 7, 2019.

Keywords: Decision-making; Guide; Mammogram; Mammography; Older breast cancer survivors.

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Conflict of interest statement

Nancy U. Lin reports institutional research funding from Genentech, Merck, Pfizer, Seattle Genetics, AstraZeneca, Zion Pharmaceuticals, and Olema Pharmaceuticals; consultant/advisory board work for Pfizer, Puma, Seattle Genetics, Daiichi Sankyo, AstraZeneca, Prelude Therapeutics, Denali Therapeutics, Olema Pharmaceuticals, Aleta BioPharma, Affinia Therapeutics, Voyager Therapeutics, and Artera, Inc.; royalties from UpToDate; and stock or other ownership interests in Artera Inc. (a startup with no current value, but options only valued at < 5% and < $50,000 will be provided at a later date). The remaining authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Responses for acceptability of the patient guide by clinician (n = 19)
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