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Open Access 01-04-2018 | Review

Interventions are needed to support patient–provider decision-making for DCIS: a scoping review

Authors: Claire Kim, Laurel Liang, Frances C. Wright, Nicole J. Look Hong, Gary Groot, Lucy Helyer, Pamela Meiers, May Lynn Quan, Robin Urquhart, Rebecca Warburton, Anna R. Gagliardi

Published in: Breast Cancer Research and Treatment | Issue 3/2018

Abstract

Purpose

Prognostic and treatment uncertainty make ductal carcinoma in situ (DCIS) complex to manage. The purpose of this study was to describe research that evaluated DCIS communication experiences, needs and interventions among DCIS patients or physicians.

Methods

MEDLINE, EMBASE, CINAHL and The Cochrane Library were searched from inception to February 2017. English language studies that evaluated patient or physician DCIS needs, experiences or behavioural interventions were eligible. Screening and data extraction were done in duplicate. Summary statistics were used to describe study characteristics and findings.

Results

A total of 51 studies published from 1997 to 2016 were eligible for review, with a peak of 8 articles in year 2010. Women with DCIS lacked knowledge about the condition and its prognosis, although care partners were more informed, desired more information and experienced decisional conflict. Many chose mastectomy or prophylactic mastectomy, often based on physician’s recommendation. Following treatment, women had anxiety and depression, often at levels similar to those with invasive breast cancer. Disparities were identified by education level, socioeconomic status, ethnicity and literacy. Physicians said that they had difficulty explaining DCIS and many referred to DCIS as cancer. Despite the challenges reported by patients and physicians, only two studies developed interventions designed to improve patient–physician discussion and decision-making.

Conclusions

As most women with DCIS undergo extensive treatment, and many experience treatment-related complications, the paucity of research on PE to improve and support informed decision-making for DCIS is profound. Research is needed to improve patient and provider discussions and decision-making for DCIS management.

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Title: Interventions are needed to support patient–provider decision-making for DCIS: a scoping review
Authors: Claire Kim
Laurel Liang
Frances C. Wright
Nicole J. Look Hong
Gary Groot
Lucy Helyer
Pamela Meiers
May Lynn Quan
Robin Urquhart
Rebecca Warburton
Anna R. Gagliardi
Publication date: 01-04-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4613-x

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