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

Rachel A. Freedman; Anna C. Revette; Haley Gagnon; Adriana Perilla-Glen; Molly Kokoski; Saida O. Hussein; Erin Leone; Nicole Hixon; Rebeka Lovato; Wendy Loeser; Nancy U. Lin; Christina A. Minami; Beverly Canin; Barbara LeStage; Meredith Faggen; Philip D. Poorvu; Jennifer McKenna; Kathryn J. Ruddy; Nancy L. Keating; Mara A. Schonberg

doi:10.1007/s10549-022-06676-3

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

Rachel A. Freedman, Anna C. Revette, Haley Gagnon, Adriana Perilla-Glen, Molly Kokoski, Saida O. Hussein, Erin Leone, Nicole Hixon, Rebeka Lovato, Wendy Loeser, Nancy U. Lin, Christina A. Minami, Beverly Canin, Barbara LeStage, Meredith Faggen, Philip D. Poorvu, Jennifer McKenna, Kathryn J. Ruddy, Nancy L. Keating, Mara A. Schonberg

Medical Oncology

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Pages (from-to)	141-152
Number of pages	12
Journal	Breast Cancer Research and Treatment
Volume	195
Issue number	2
DOIs	https://doi.org/10.1007/s10549-022-06676-3
State	Published - Sep 2022

Keywords

Decision-making
Guide
Mammogram
Mammography
Older breast cancer survivors

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1007/s10549-022-06676-3

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Freedman, R. A., Revette, A. C., Gagnon, H., Perilla-Glen, A., Kokoski, M., Hussein, S. O., Leone, E., Hixon, N., Lovato, R., Loeser, W., Lin, N. U., Minami, C. A., Canin, B., LeStage, B., Faggen, M., Poorvu, P. D., McKenna, J., Ruddy, K. J., Keating, N. L., & Schonberg, M. A. (2022). Acceptability of a companion patient guide to support expert consensus guidelines on surveillance mammography in older breast cancer survivors. Breast Cancer Research and Treatment, 195(2), 141-152. https://doi.org/10.1007/s10549-022-06676-3

Freedman, RA, Revette, AC, Gagnon, H, Perilla-Glen, A, Kokoski, M, Hussein, SO, Leone, E, Hixon, N, Lovato, R, Loeser, W, Lin, NU, Minami, CA, Canin, B, LeStage, B, Faggen, M, Poorvu, PD, McKenna, J, Ruddy, KJ, Keating, NL & Schonberg, MA 2022, 'Acceptability of a companion patient guide to support expert consensus guidelines on surveillance mammography in older breast cancer survivors', Breast Cancer Research and Treatment, vol. 195, no. 2, pp. 141-152. https://doi.org/10.1007/s10549-022-06676-3

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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{\textquoteright}s impact mammography utilization. Trial registration: ClinicalTrials.gov-NCT03865654, posted March 7, 2019.",

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author = "Freedman, {Rachel A.} and Revette, {Anna C.} and Haley Gagnon and Adriana Perilla-Glen and Molly Kokoski and Hussein, {Saida O.} and Erin Leone and Nicole Hixon and Rebeka Lovato and Wendy Loeser and Lin, {Nancy U.} and Minami, {Christina A.} and Beverly Canin and Barbara LeStage and Meredith Faggen and Poorvu, {Philip D.} and Jennifer McKenna and Ruddy, {Kathryn J.} and Keating, {Nancy L.} and Schonberg, {Mara A.}",

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doi = "10.1007/s10549-022-06676-3",

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AU - Freedman, Rachel A.

AU - Revette, Anna C.

AU - Gagnon, Haley

AU - Perilla-Glen, Adriana

AU - Kokoski, Molly

AU - Hussein, Saida O.

AU - Leone, Erin

AU - Hixon, Nicole

AU - Lovato, Rebeka

AU - Loeser, Wendy

AU - Lin, Nancy U.

AU - Minami, Christina A.

AU - Canin, Beverly

AU - LeStage, Barbara

AU - Faggen, Meredith

AU - Poorvu, Philip D.

AU - McKenna, Jennifer

AU - Ruddy, Kathryn J.

AU - Keating, Nancy L.

AU - Schonberg, Mara A.

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AB - 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.

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

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