Supporting women with breast cancer in making an informed decision about immediate breast reconstruction: the development and evaluation of a patient decision aid

Stege, J.A. ter (2024)

Doctoral Thesis

The decision for immediate breast reconstruction after mastectomy is a preference-sensitive decision. For preference-sensitive decisions, shared decision making is propagated, but not yet properly implemented. Furthermore, prior studies identified unmet decision support needs in women considering breast reconstruction. With this thesis we aimed to optimally support women in making an informed decision about breast reconstruction. For this purpose, we developed an online patient decision aid (pDA) for breast cancer patients considering immediate breast reconstruction after mastectomy. This thesis describes the development and evaluation of this pDA. In our multicenter randomized controlled trial including 250 participants, we found that women who used the pDA felt better prepared for decision making, than women who received usual care. Other outcomes did not differ between both groups.

• Shared decision making
• Decision aid
• Breast reconstruction
• Breast cancer
• Decisional conflict
• Mastectomy

• All authors: Stege, J.A. ter
• Supervisor: Bleiker, E.M.A.
• Co-supervisor: Oldenburg, H.S.A.; Woerdeman, L.A.E.
• Committee: Stiggelbout, A.M.; Liefers, G.J.; Siesling, S.; Mureau, M.A.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2024-05-28
• Sponsorship: Dutch Cancer Society