Aiding Breast Cancer Patients to Make Informed Decisions

The quality of life for women with breast cancer can be improved through careful and transparent communication and proper information exchange to enable informed and effective decision making. Bocconi's research center CERGAS led a project, coordinated by Oriana Ciani with Vittoria Ardito and Natalia Oprea, which included a group of partner institutions investigating communication approaches and shared decision-making practices across Europe to improve the quality of care of breast cancer patients. This project, called ShareView, ran for over a year until December 2022 and was sponsored by Pfizer Global Medical Grants together with Sharing Progress in Cancer Care, a non-profit organization.

"Breast cancer has recently overtaken lung cancer as the most common cancer type worldwide. Since for some patients there might not be a single best approach for the treatment, a shared decision-making process, including effective communication of the diagnosis and treatment options to patients, is crucial to ensure better treatment acceptance and compliance," Oriana Ciani explains.

The project, highlighted in the first video of the Planet CERGAS series, started with a literature review and a cross-country survey of 198 breast cancer specialists. The results of the survey showed a good attitude towards a participatory communication approach. Most respondents reported that decision aid tools were available, and in fact used, in their organization, although this mainly refers to paper tools. Interestingly, statistically significant gender differences were observed: female professionals appear more prone to receiving information from patients on what they value the most. They are also more likely to engage with family members and caregivers, and to use decision support tools to facilitate patients with the decision process.

Following this survey, the next stage of the project was the development of the prototype of a web-based tool aiming at supporting patients towards a better understanding of therapeutic information in order to make momentous treatment decisions. The tool allows patients to elicit their preferences with respect to relevant outcomes, such as efficacy, toxicity, and quality of life, and to base their treatment decision on such data. The tool was pilot-tested via focus groups in two breast cancer centers in Portugal and Italy. Both clinicians and patient representatives expressed high interest and willingness to have this kind of support when making breast cancer-related decisions.

After further improvements, the tool will ideally be considered for use across various clinical settings to clarify, among other things, potential areas of intervention in clinical practice.

The other partners in ShareView, which stands for "Supporting shared decision-making and communication in metastatic breast cancer", were the Belgian-based International Drug Development Institute (IDDI), Fundação Champalimaud of Lisbon, the association Europa Donna Italia and a university hospital in Northeastern Italy, Azienda sanitaria universitaria Friuli Centrale.