Interactive tool improves patient knowledge of breast cancer treatment options

January 30, 2018 by Nicole Fawcett, University of Michigan
Interactive tool improves patient knowledge of breast cancer treatment options
Visual abstract. Credit: Michigan Medicine

Breast cancer patients face complex decisions about their treatment.

"Knowledge is a key component of , and yet it's consistently low even among who have received . We need better tools to make these decisions more informed," says Sarah T. Hawley, Ph.D., MPH, professor of internal medicine at Michigan Medicine.

Hawley and colleagues from the Cancer Surveillance and Outcomes Research Team at the University of Michigan Comprehensive Cancer Center developed an interactive online to help patients understand their treatment options.

Compared to a static informational website, patients using the interactive tool had higher knowledge and felt more prepared to make a , according to a new study published in the Journal of Clinical Oncology.

Researchers enrolled 537 patients with newly diagnosed early stage breast cancer from multiple practices spread throughout four states. Patients were randomized to view a tailored, interactive decision tool called iCanDecide or to view similar information on a static website. They were then surveyed about five weeks later, after making their treatment decision; 496 completed the survey.

Overall, 61 percent of patients who used the interactive tool had a high knowledge of , compared to 42 percent of patients who viewed the static material. Patients who used the were also more likely to say they felt prepared to make a treatment decision, 50 percent, compared to 33 percent of patients viewing static material.

The interactive site was designed to walk people systemically through key facts about breast cancer surgery, such as how often cancer recurs and the likelihood of needing additional surgery. A second module on the website helped patients understand options about systemic treatment, such as chemotherapy. The paper assesses only the surgery module.

"Instead of throwing the information on the website and hoping patients would figure it out, we gave them the bullet point fact, asked a question to see if they understood, and then allowed them to drill down and look at more detailed information. They couldn't just bounce around. They had to go through it in a linear fashion," Hawley says.

The tool also assessed patients' values, taking them through a series of hypothetical scenarios. In the end, each patient had a customized bar graphic that showed how their preferences matched to treatments. For example, if they valued keeping their natural breast, the lumpectomy bar would be higher. Patients could interact with the figure to learn more.

A similar number of patients from both groups reported making a choice in line with their values. Hawley stresses that assessing a patient's values is key.

"The values clarification is important. If you don't combine the knowledge and the values, you get people making values-based choices that may not be fully informed," Hawley says.

Researchers plan to further refine the timing of when to deliver tools and assess patient values.

Explore further: How decision-making habits influence the breast cancer treatments women consider

More information: Sarah T. Hawley et al, Improving Breast Cancer Surgical Treatment Decision Making: The iCanDecide Randomized Clinical Trial, Journal of Clinical Oncology (2018). DOI: 10.1200/JCO.2017.74.8442

Related Stories

How decision-making habits influence the breast cancer treatments women consider

August 15, 2017
A new study finds that more than half of women with early stage breast cancer considered an aggressive type of surgery to remove both breasts. The way women generally approach big decisions, combined with their values, impacts ...

Many women report not feeling completely informed about breast cancer treatment options

December 15, 2017
Breast cancer is the second most common cancer among women in the United States, with more than 230,000 women diagnosed annually. (Skin cancer remains the most common.) Patients often describe the process of making a treatment ...

Team aims to help patients with cancer make complex care decisions

November 22, 2017
Researchers at the University of Virginia Cancer Center are developing a tool to help patients with prostate cancer better understand the potential risks and rewards of their treatment options. And that tool could ultimately ...

Most women who have double mastectomy don't need it, study finds

November 27, 2012
About 70 percent of women who have both breasts removed following a breast cancer diagnosis do so despite a very low risk of facing cancer in the healthy breast, new research from the University of Michigan Comprehensive ...

70-gene signature impacts treatment decisions in breast CA

October 29, 2017
(HealthDay)—The 70-gene signature (GS) assay affects treatment decisions among physicians treating patients identified as being at intermediate risk with the 21-gene assay (21-GA), according to a study published online ...

Recommended for you

Two ways cancer resists treatment are actually connected, with one activating the other

December 18, 2018
Drugs that target BRAF and MEK in cancer have shown promise in treating a subset of melanoma that carries a mutation in the BRAF gene, but drug resistance usually emerges, reversing the benefit of these drugs and limiting ...

HPV discovery raises hope for new cervical cancer treatments

December 18, 2018
Researchers at the University of Virginia School of Medicine have made a discovery about human papillomavirus (HPV) that could lead to new treatments for cervical cancer and other cancers caused by the virus.

Vaccine, checkpoint drugs combination shows promise for pancreatic cancers

December 18, 2018
Researchers at the Johns Hopkins Kimmel Cancer Center discovered a combination of a cancer vaccine with two checkpoint drugs reduced pancreatic cancer tumors in mice, demonstrating a possible pathway for treatment of people ...

Researchers identify ways breast cancer avoids immune system detection

December 18, 2018
Recent breakthroughs in immunotherapy are making a huge difference in treating some forms of cancer, especially metastatic cancer. But breast cancer has proven a tricky foe for this new therapy, and an interdisciplinary team ...

Metal chemotherapy drugs boost the impact of immunotherapy in cancer

December 18, 2018
Due to their powerful tumour-killing effect, metal-based chemotherapies are frequently used in cancer treatment. However, it was hitherto assumed that they damaged the immune system, because of their cytotoxic (cell-damaging) ...

10-year follow-up after negative colonoscopies linked to lower colorectal cancer risk

December 17, 2018
Ten years after a negative colonoscopy, Kaiser Permanente members had 46 percent lower risk of being diagnosed with and were 88 percent less likely to die from colorectal cancer compared with those who did not undergo colorectal ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.