Trial reportThe British journal of surgery2021
Bridging the age gap in breast cancer: cluster randomized trial of two decision support interventions for older women with operable breast cancer on quality of life, survival, decision quality, and treatment choices.
Trial report in The British journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 6 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- A mixed methods systematic review of cancer treatment decision-making in vulnerable populations.Patient education and counseling · 2026Pooled it
- Effects of patient decision aids used pre-consult or in-consult on patient-clinician communication - secondary analysis of a systematic review with meta-analysis.BMC medical informatics and decision making · 2025Pooled it
- Treatment decision-making and quality of life versus length of life preferences of older patients with early stage cancer: A systematic review.Journal of geriatric oncology · 2025Pooled it
- Frequency of use and characterization of frailty assessments in observational studies on older women with breast cancer: a systematic review.BMC geriatrics · 2024Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- Analysing cluster randomised controlled trials using GLMM, GEE1, GEE2, and QIF: results from four case studies.BMC medical research methodology · 2023Pooled it
- Effectiveness of a patient decision aid for women considering post-mastectomy breast reconstruction: randomized controlled trial.The British journal of surgery · 2025Trial
- Trial
- Evaluation of Surgeon Attitudes Toward Frailty Screening in Breast Oncology Patients.Annals of surgical oncology · 2026Article
- Use of ctDNA in Older Women with ER+ Breast Cancer to Facilitate Surgical De-escalation: A Prospective, Hybrid-Decentralized Trial with Correlative Studies.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Effectiveness of decision aids on decisional conflict and treatment or disease knowledge among women diagnosed with breast cancer: a systematic review and meta-analysis.Journal of cancer survivorship : research and practice · 2026Review
- Surgery in Older Cancer Patients.Current oncology reports · 2026Review
- Survivorship Issues in Older Adults with Breast Cancer.Current breast cancer reports · 2025Article
- A scoping review of web-based, interactive, personalized decision-making tools available to support breast cancer treatment and survivorship care.Journal of cancer survivorship : research and practice · 2025Article
- The Implementation of Shared Decision-Making Using Patient Decision Aid Tools to Select Breast Cancer Treatment Options: A Systematic Review in the Time of Minimum Quality Standards.Healthcare (Basel, Switzerland) · 2025Review
- Breast cancer care for the aging population: a focus on age-related disparities in breast cancer treatment.BMC cancer · 2025Article
- Research and practice priorities in pilonidal sinus disease: a consensus from the PITSTOP study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- Characterizing informational needs and information seeking behavior of patients with breast cancer.American journal of surgery · 2024Article
- Adjuvant Chemotherapy for Breast Cancer in Older Adult Patients.Clinical interventions in aging · 2024Review
- Differences in treatment and survival of older patients with operable breast cancer between the United Kingdom and the Netherlands - A comparison of two national prospective longitudinal multi-centre cohort studies.European journal of cancer (Oxford, England : 1990) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
41 authors at 15 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRates of surgery and adjuvant therapy for breast cancer vary widely between breast units. This may contribute to differences in survival. This cluster RCT evaluated the impact of decision support interventions (DESIs) for older women with breast cancer, to ascertain whether DESIs influenced quality of life, survival, decision quality, and treatment choice.
methodsA multicentre cluster RCT compared the use of two DESIs against usual care in treatment decision-making in older women (aged at least ≥70 years) with breast cancer. Each DESI comprised an online algorithm, booklet, and brief decision aid to inform choices between surgery plus adjuvant endocrine therapy versus primary endocrine therapy, and adjuvant chemotherapy versus no chemotherapy. The primary outcome was quality of life. Secondary outcomes included decision quality measures, survival, and treatment choice.
resultsA total of 46 breast units were randomized (21 intervention, 25 usual care), recruiting 1339 women (670 intervention, 669 usual care). There was no significant difference in global quality of life at 6 months after the baseline assessment on intention-to-treat analysis (difference -0.20, 95 per cent confidence interval (C.I.) -2.69 to 2.29; P = 0.900). In women offered a choice of primary endocrine therapy versus surgery plus endocrine therapy, knowledge about treatments was greater in the intervention arm (94 versus 74 per cent; P = 0.003). Treatment choice was altered, with a primary endocrine therapy rate among women with oestrogen receptor-positive disease of 21.0 per cent in the intervention versus 15.4 per cent in usual-care sites (difference 5.5 (95 per cent C.I. 1.1 to 10.0) per cent; P = 0.029). The chemotherapy rate was 10.3 per cent at intervention versus 14.8 per cent at usual-care sites (difference -4.5 (C.I. -8.0 to 0) per cent; P = 0.013). Survival was similar in both arms.
conclusionThe use of DESIs in older women increases knowledge of breast cancer treatment options, facilitates shared decision-making, and alters treatment selection. Trial registration numbers: EudraCT 2015-004220-61 (https://eudract.ema.europa.eu/), ISRCTN46099296 (http://www.controlled-trials.com).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.