Dataset Information

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

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.

SUBMITTER: Freedman RA

PROVIDER: S-EPMC9362353 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

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

Freedman Rachel A RA Revette Anna C AC Gagnon Haley H Perilla-Glen Adriana A Kokoski Molly M Hussein Saida O SO Leone Erin E Hixon Nicole N Lovato Rebeka R Loeser Wendy W Lin Nancy U NU Minami Christina A CA Canin Beverly B LeStage Barbara B Faggen Meredith M Poorvu Philip D PD McKenna Jennifer J Ruddy Kathryn J KJ Keating Nancy L NL Schonberg Mara A MA

Breast cancer research and treatment 20220730 2

<h4>Purpose</h4>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.<h4>Methods</h4>The "Are Mammograms Still Right for Me?" guide estimates future ipsilateral and contralateral breast (in-breast) cancer r ...[more]

PMID: 35908120

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Project description:ImportanceThere is currently no guidance on how to approach surveillance mammography for older breast cancer survivors, particularly when life expectancy is limited.ObjectiveTo develop expert consensus guidelines that facilitate tailored decision-making for routine surveillance mammography for breast cancer survivors 75 years or older.EvidenceAfter a literature review of the risk of ipsilateral and contralateral breast cancer events among breast cancer survivors and the harms and benefits associated with mammography, a multidisciplinary expert panel was convened to develop consensus guidelines on surveillance mammography for breast cancer survivors 75 years or older. Using an iterative consensus-based approach, input from clinician focus groups, and critical review by the International Society for Geriatric Oncology, the guidelines were refined and finalized.FindingsThe literature review established a low risk for ipsilateral and contralateral breast cancer events in most older breast cancer survivors and summarized the benefits and harms associated with mammography. Draft mammography guidelines were iteratively evaluated by the expert panel and clinician focus groups, emphasizing a patient's risk for in-breast cancer events, age, life expectancy, and personal preferences. The final consensus guidelines recommend discontinuation of routine mammography for all breast cancer survivors when life expectancy is less than 5 years, including those with a history of high-risk cancers; consideration to discontinue mammography when life expectancy is 5 to 10 years; and continuation of mammography when life expectancy is more than 10 years. Individualized, shared decision-making is encouraged to optimally tailor recommendations after weighing the benefits and harms associated with surveillance mammography and patient preferences. The panel also recommends ongoing clinical breast examinations and diagnostic mammography to evaluate clinical findings and symptoms, with reassurance for patients that these practices will continue.Conclusions and relevanceIt is anticipated that these expert guidelines will enhance clinical practice by providing a framework for individualized discussions, facilitating shared decision-making regarding surveillance mammography for breast cancer survivors 75 years or older.

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Project description:The International Paralympic Committee requires their member sports to develop a classification system that is sport-specific, meaning that the specific 'class' in which an athlete competes should be suitable for the degree to which the athlete's impairment affects performance in that particular sport. However, swimmers with vision impairment (VI) currently compete in classes that were developed on the basis of legal definitions of blindness, failing to consider how vision impacts swimming performance. The aim of this study was to establish expert guidance on the specific requirements for a sport-specific system of classification for VI swimming. A three-round Delphi review was conducted with a panel of 16 people with expertise in VI swimming either as an athlete, coach, administrator, or scientist. There was clear consensus (86%) among the panel that the current classification system used for VI swimming fails to fulfill the aim of minimizing the impact of VI on the outcome of competition. Particularly, the panel agreed that there are a range of aspects of visual function (e.g., depth perception and contrast sensitivity) that are important for optimal swimming performance, yet are not assessed using the current classification system. The panel also identified nine performance components of a swimming race that are mostly likely to be affected by VI. Interestingly, these were spread across all four major segments (start, clean swim, turn, and finish), and weren't necessarily those performance determinants generally used by performance analysts and coaches. There was also strong agreement that the age at which VI is acquired will substantially impact the ability of a swimmer to reach their full potential in the pool. The main implication is that changes are required to the way that swimmers with VI are classified for para-sport competition. Clear guidance has been provided for how to further the development of an evidence-based classification system.

Dataset Information

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

Purpose

Methods

Results

Conclusion

Trial registration

Publications

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

Similar Datasets

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