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Implementation of Decision Support for Breast Reconstruction in the Healthy State Alliance
Rakhsha Khatri (BA), Sharlene Grisez (RN), Laura Katona (BA), Mita Patel (MD), Clara Lee (MD, MPP, FACS), Min-Jeong Cho, MD
The Ohio State University Wexner Medical Center, Division of Plastic and Reconstructive Surgery
2024-02-01
Presenter: Rakhsha Khatri
Affidavit:
The presenter has contributed to this project with the other authors and the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Amy Moore, MD, FACS
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Introduction: While breast reconstruction after mastectomy improves quality of life for many patients, it is preference-sensitive because the right choice depends on preferences about complication risk, appearance, and recovery. BREASTChoice is a decision aid that gives breast cancer patients information and helps them clarify their personal preferences. Given that implementation of BREASTChoice was effective in two academic centers, this study assessed feasibility, usability, and decisional conflict and evaluated approaches to implementing BREASTChoice at a community breast cancer practice.
Methods: In this implementation study, enrolled adult patients with a recent breast cancer diagnosis presenting Mercy Health were shown the BREASTChoice video and given the BREASTChoice brochure in conjunction with their already planned patient education materials. The primary outcomes were feasibility and usability (System Usability Scale) of BREASTChoice in a community breast cancer practice while secondary outcome included decisional conflict (SURE scale).
Results: Between 8/2023 and 1/2024, 21 patients were shown given BREASTChoice. Mean age was 57.8±12.2 years, and 80% were white. Patients' diagnoses included stage I (60%), III (10%), and 0 DCIS (10%). Among the four participants electing for breast reconstruction, three preferred delayed reconstruction and two indicated preferences for type: implant based. Implementation of BREASTChoice was feasible (95.2% feasibility). The mean score on the System Usability Scale was 67.4±17.6, indicating average usability. 80% of the participants did not experience clinically significant decisional conflict.
Conclusions: These findings highlight that BREASTChoice is feasible and showed moderate usability in a community practice. Future studies should examine its impact on treatment choice and outcomes.
