Customized, Web-based Decision Guide Reduces Uncertainty over Breast Cancer Prevention
A customized web-based decision guide about prevention options can help women at high risk of breast cancer to make a choice about prevention and to feel comfortable with their choice.
When women viewed a web-based tool titled the Guide to Decide, they expressed significantly less uncertainty when deciding whether to take tamoxifen or raloxifene - two medical options to prevent breast cancer.
"Since the decision to use tamoxifen or raloxifene to prevent breast cancer is based on each woman's preferences, with no single right or wrong answer, the intervention enabled each woman to weigh the relative risks and benefits for herself and make a decision that aligned with her own values and preferences," said lead researcher Matthew (Mateo) P. Banegas, M.P.H., M.S., a doctoral candidate at the University of Washington.
Researchers created a web-based tool titled the Guide to Decide, which included general information about breast cancer and personalized information about an individual woman's five-year risk of breast cancer. The guide introduced two medical options to prevent breast cancer: tamoxifen and raloxifene. Information was tailored to each woman's age and race, and contained information on the benefits and risk of tamoxifen and raloxifene as well as how it would affect the woman's breast cancer risk.
The study looked at post-menopausal women ages 40-74 who were considered at high risk of breast cancer. Of the 1,012 women who participated, 690 were randomly assigned to read the decision guide. Participants were asked after reading the guide and again three months later about whether they wanted to receive preventive treatment and how they felt about that decision.
Subjects who read the guide reported significantly less uncertainty when deciding whether to take tamoxifen or raloxifene, and three months later they were more likely to have made a decision.
"Because the guide was web-based, women could access it in the comfort of their home or preferred setting, at their own pace, and with their family, friends or other support system around. In addition, tailoring the information meant it matched each woman's circumstances and was much more personal," says study senior author Angela Fagerlin, Ph.D., associate professor of internal medicine and co-director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan Medical School, and a research scientist at the VA Ann Arbor Center for Clinical Management Research.
Banegas will present the findings of the study April 14 at the Society of Behavioral Medicine annual meeting in New Orleans, La.