Exploring women's experiences with a decision aid for neoadjuvant systemic therapy for operable breast cancer.

backgroundSome women with operable breast cancer have a choice between receiving upfront surgery followed by chemotherapy or neoadjuvant systemic therapy (NAST) prior to receiving surgery. While survival outcomes are equivalent for both options, the decision about treatment sequence can be difficult due to its complexity and perceived urgency. A decision aid has been developed to help patients decide on whether to receive NAST.

aimsTo explore, qualitatively, women's use and perceived benefit of a decision aid to help with their decision on NAST.

methodsA framework analysis process was conducted on a purposeful sample of 20, one-on-one, semistructured phone interviews with early-stage breast cancer patients eligible for NAST. Participants had recently decided on whether or not to have NAST.

resultsPatients perceived the decision aid as useful to becoming more informed and involved in making a decision as to whether they receive NAST. They described the information provided in the decision aid as reliable, relevant, sufficient in terms of amount, and tailored to their needs. Reading and rereading the decision aid at home in-between the consultations with their surgeon and their medical oncologist allowed women to better understand their treatment options and easily integrate the decision aid into their care. The decision aid seemed to confirm but not change women's decisions on NAST.

conclusionThe decision aid appears to help breast cancer patients support their decision about whether to receive NAST. Patients' ability to review the decision aid in-between two consultations seems to be an acceptable and feasible way of integrating the decision aid into patients' care.