This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
About one in eight women will develop breast cancer at some point in their lives. Women with breast cancer have to make decisions about treatment, such as whether to have surgery to remove all or part of their breast. These decisions are complex. They can change women’s lives and change how they feel about themselves. Women with low incomes or little education may not be familiar with the healthcare system and may not understand their treatment choices. They may not ask their doctors questions that could help them make decisions. As a result, women with low incomes or little education often do not get the treatment they would prefer.
Decision aids help people choose between two or more healthcare options based on what is most important to them. However, people who find it hard to understand information about health, the healthcare system, or treatment options may also have trouble using some decision aids for breast cancer. Decision aids that are brief and use pictures and everyday terms may work better.
In this study, the research team is comparing three ways of helping women decide between two early-stage breast cancer treatment options. The first treatment option is surgery to remove one or both breasts. The second option is surgery that saves as much of the breasts as possible, followed by radiation. The team is comparing two types of decisions aids with usual care. The research team wants to see whether one approach works better to help women with low incomes or limited education learn more about breast cancer treatment options. The team also wants to see if one approach works better to help these women make treatment decisions that reflect what matters most to them.
Who can this research help?
Findings from this study may help leaders of cancer centers decide whether to offer decision aids to help patients choose between early-stage breast cancer treatment options. Findings may also help cancer center leaders decide which decision aids to offer.
What is the research team doing?
The research team is conducting the study at eight hospitals in Hanover, New Hampshire; New York City; and St. Louis, Missouri. The team is recruiting 1,100 women diagnosed with early-stage breast cancer who are seeing a clinician at one of the eight study hospitals. Half of the women have low incomes or little education and the other half do not.
The team is assigning participating clinicians by chance to use one of three ways of helping women decide among breast cancer treatment options:
- Using a decision aid that gives a written description of women’s options
- Using a decision aid that uses simple words and pictures
- Providing usual information and resources on breast cancer treatment (usual care)
The research team wants to know which of these ways help women
- Know more about treatment options
- Make treatment decisions with their doctors
- Have fewer regrets about their treatment decisions
- Feel less anxious
- Have better quality of life
The team wants to know if one of the three approaches works better than the others for women with low incomes or little education.
Patients, caregivers, doctors, and breast cancer experts helped design the study, choose what to measure, recruit study participants, and monitor study progress.
Research methods at a glance
- Linda Walling
- Ann Bradley
- Eloise Crayton
- Sherrill Jackson
Other Stakeholder Partners
- Kari Rosenkranz
- Dale C. Vidal
- Sanja Percac-Lima
- Julie Margenthaler
- Shubhada Dhage
- Katie Weichman
^Marie-Anne Durand, MSc, MPhil, PhD was this project's principal investigator when it was awarded.