Health care professionals' perspectives on shared decision making supported by personalised-risk-for-recurrences-calculations regarding surveillance after breast cancer

the Santeon VBHC Breast Cancer Group

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Abstract

Objective: Breast cancer patients for whom less intensive surveillance is sufficient can be identified based on the risk for locoregional recurrences (LRRs). This study explores health care professionals' (HCPs) perspectives on less intensive surveillance, preferences for shared decision-making (SDM) about surveillance and perspectives on the use of patients' estimated personal risk for LRRs in decision-making about surveillance. Methods: We conducted semi-structured interviews with 21 HCPs providing follow-up care for breast cancer patients in seven Dutch teaching hospitals (Santeon hospitals). Results: HCPs were predominantly positive about less intensive surveillance for women with a low risk for recurrences. They mentioned important prerequisites such as clearly defined surveillance schedules based on risk categories, information provision and communication support for patients and HCPs. Most HCPs supported SDM about surveillance and were positive about using patients' estimated personal risk for LRRs. HCPs specified prerequisites such as clear visualisation and explanation of risk information, attention for fear of cancer recurrence (FCR) and defined surveillance schedules for specific risk groups. Conclusion: Mentioned prerequisites for less intensive surveillance need to be accounted for. Information needs and existing misconceptions need to be addressed. Outcome information regarding risks for LRRs and FCR can enrich the SDM process about surveillance.

Original languageEnglish
Article numbere13623
JournalEuropean journal of cancer care
Volume31
Issue number5
Early online date1 Jun 2022
DOIs
Publication statusPublished - 1 Sept 2022

Keywords

  • breast cancer
  • follow-up
  • personalised
  • risk information
  • shared decision-making
  • surveillance

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