Support Care Cancer. 2026 May 14;34(6):537. doi: 10.1007/s00520-026-10726-7.
ABSTRACT
PURPOSE: We conducted Alliance clinical trial A231701CD that provided breast cancer patients a decision aid (DA) before their surgical consultation with the goal of improving engagement in decision-making. We report a mixed-methods analysis from patients who received the DA to understand patients’ experiences in preparing for their consultation.
METHODS: Patients were included in this analysis if they were randomized to the DA arm (n = 331) and agreed to receive the DA (n = 195). Data collection included surveys before and after the consultation that assessed whether patients reviewed the DA and found it helpful, and reasons for non-review. We interviewed a subset of patients who had low engagement and experienced a preparatory barrier. We used descriptive statistics to summarize survey responses and content analysis to analyze interview data.
RESULTS: Seventy-three percent (n = 143) reviewed the DA before the consultation. The majority (93%) said they would recommend receiving information via email. The most common reasons for non-review were logistical. Additional barriers included wanting to hear information directly from the surgeon, feeling they were already informed, wanting to stay in denial about their cancer, and perceiving information would be scary. Interviewees shared suggestions for clinics to optimize patients’ review of information, such as explaining how preparing benefits patients and acknowledging emotion around cancer diagnoses.
CONCLUSION: Our study highlights that breast cancer patients want information prior to the consultation, but patient-centered challenges can lead to non-review. When sharing pre-consult information, clinics should communicate how reviewing information can help patients feel less overwhelmed and improve their discussion with the surgeon.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03766009 (12/4/2018).
PMID:42128956 | DOI:10.1007/s00520-026-10726-7
