Shared Decision-Making and Patient Engagement in Breast Cancer Treatment Decisions

By: Chris Schimpf, BS
Posted: Tuesday, March 12, 2024

In-consultation shared decision-making practices between oncologists and patients with breast cancer may improve patient engagement in the treatment-planning process, according to a Danish study published in Radiotherapy & Oncology. In their cluster-randomized, controlled, multicenter trial, Stine Rauff Søndergaard, MD, of Vejle Hospital, Denmark, and colleagues found that the use of a standardized in-consultation patient decision aid significantly increased patients’ engagement in decisions regarding adjuvant whole-breast irradiation. In addition, the researchers reported that patients experienced less decisional conflict, without increased fear of cancer recurrence or decision regret.

“Based on the findings of this trial and recent findings on the benefit of shared decision-making…, the Danish Breast Cancer Group Radiotherapy Committee now recommends shared decision-making and use of [our in-consultation patient decision aid] as standard care in the national clinical guideline on adjuvant whole-breast irradiation,” the investigators noted.

A total of 674 patients who had undergone breast-conserving surgery for node-negative breast cancer and were eligible for adjuvant whole-breast irradiation were enrolled in the study between March 2020 and December 2022. Oncologists at four radiotherapy units were randomly assigned to either practice shared decision-making using the study’s standardized patient decision aid or to continue their usual practice. Participants were randomly assigned into the two groups.

Among the participants, 635 patients (94%) completed the Shared Decision Making Questionnaire (SDM-Q-9). On a scale of 0 to 100, the investigators observed that patients in the intervention group reported higher levels of engagement (median = 80; interquartile range [IQR] = 68.9–94.4) than the control group (median = 71.1; IQR = 55.6–82.2; P < .0001). Oncologist-reported patient engagement was also higher in the invention group (median = 93.3; IQR = 82.2–100) compared with the control group (median = 73.3; IQR = 60.0–84.4; P < .0001).

Disclosure: The study authors reported no conflicts of interest.

Radiotherapy & Oncology

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