Working Toward a Decision: The Development and First Impressions of a Decision Aid for Older Women with Early-stage Breast Cancer.

Background: The use of decision aids (DAs) have been advocated in cancer decisions to help patients understand treatment options and to promote patient involvement in the treatment decision. Although the challenges of involving older patients in treatment decision making have been highlighted, decisional support for older early-stage breast cancer patients has not been established yet. This study reports on the development of a DA prototype and the initial assessment of it.

Objective: To conduct a preliminary testing of the DA prototype to ensure that the format and information presented is clear and acceptable to patients.

Methods: Twelve one-on-one interviews were conducted with women over the age of 70 diagnosed with Stage I breast cancer after radiation therapy from an academic cancer centre.

Results: The overall impression of the DA prototype was favorable with all participants rating the tool as extremely acceptable. All participants felt that this tool would be helpful for older women with early-stage breast cancer making decisions about treatments and would recommend its use in clinical practice.

Conclusions: Similar to previous literature, we found that older breast cancer patients experienced difficulties expressing their concerns and found it challenging to participate in treatment decisions. These findings led to the next steps in the development of a DA for older early-stage breast cancer patients.