- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02823262
A Breast Cancer Treatment Decision Aid for Women Aged 70 and Older
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The investigators aim to use this information to further refine and evaluate a decision aid to help newly-diagnosed women aged 70 and older with breast cancer understand the risks and benefits of different types of breast cancer treatment. The Decision Aid (DA) was created for women 70 years or older diagnosed with ER+, HER2-, clinically LN-, 3cm or less breast cancers deciding on breast cancer treatment. The DA was designed considering the health literary, cognitive abilities, treatment outcomes, and competing health issues of older women.
Phase I :
- The investigators will obtain and incorporate additional feedback on the DA from women 70 years or older who were diagnosed with breast cancer > 6 months ago, their family members, and clinicians, so that the DA can be refined and evaluated by women who were recently treated for breast cancer but not newly diagnosed with breast cancer.
Phase II
- The investigators plan to test the efficacy of the revised DA in a randomized control trial (RCT) of 230 diverse women 70 years or older newly diagnosed with ER+, LN-, HER2-, 3 cm or less breast cancer.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Dana Farber Cancer Institute
-
Boston, Massachusetts, United States, 02115
- Beth Israel Deaconess Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Phase I
- Patient age ≥ 70 yrs
- Female patient diagnosed with a first primary ER+, HER2-, LN-, 3cm or less breast cancer >6 months ago but <2 years ago
- Caregiver age >21 years
- English speaking
Phase II
- Female patient age ≥ 70 yrs newly diagnosed with a first primary ER+, HER2-, LN-, 3cm or less breast cancer
- Women newly diagnosed with breast cancer on the day of surgical consult
Exclusion Criteria:
Phase I
- Patient Age < 70 years
- Women diagnosed with Paget's disease, inflammatory breast cancer or a phyllodes tumor
- Signs of Dementia
- Score >10 on the Orientation-Memory-Concentration (OMC) test
- Non-English Speaking;
- Caregiver age < 21 years
- Women who do not have capacity to participate. --- Before enrolling women in this study, possible participants will be asked 7 questions about the benefits and risks of the study. Women that answer 3 or more of these questions incorrectly will be excluded.
Phase II
- Women with a history of breast cancer (invasive and non-invasive)
- Diagnosed with Paget's disease, inflammatory breast cancer or a phyllodes tumor
- Signs of Dementia
- Score >10 on the OMC test (indicative of dementia).
- Women who do not have capacity to participate. --- Before enrolling women in this study, possible participants will be asked 7 questions about the benefits and risks of the study. Women that answer 3 or more of these questions incorrectly will be excluded.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Decision Aid
Post Initial Surgical Consultation
|
We developed a decision aid on breast cancer treatment for women 70 years or older newly diagnosed with estrogen receptor positive (ER+), clinically lymph node negative (LN-), HER2 negative (HER2-), breast cancers that are 3 centimeters or less.
The DA was written using low literacy principles and provides information on the benefits and risks of mastectomy vs. breast conserving surgery (BCS), radiotherapy after BCS, and of hormonal therapies (e.g., anastrozole).
It also considers the impact of competing health issues on older women's treatment choices.
|
Active Comparator: No Decision Aid
Post Initial Surgical Consultation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Decisional Conflict Scale at 1 week
Time Frame: Baseline, 1 week
|
Scores on the decisional conflict scale (DCS, range from 0 [none] to 100 [extremely high decisional conflict]
|
Baseline, 1 week
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Knowledge score using our knowledge test
Time Frame: One week, 5 Months
|
mean of Correct Response at each time point
|
One week, 5 Months
|
Change in Stage of Decision-Making at one week using one-item tool
Time Frame: Baseline, One week
|
One item (responses vary from "haven't begun to think about the choices to "considering the options", to "have already made a decision.")
This tool is used to differentiate women who are at earlier stages of decision-making compared to women who are in later stages.
|
Baseline, One week
|
Self-Efficacy using 11-item scale
Time Frame: One week
|
11 item scale (each 5 points), measures self-confidence in making an informed treatment choice.
(e.g., I feel confident that I can get the facts about the treatment choices available to me, ask questions without feeling dumb)
|
One week
|
Values using importance scale 1-10
Time Frame: One week
|
How important is it to you to (0-10): 1) keep your breast, 2) minimize chance of cancer coming back in breast, 3) avoid radiation, 4) do everything possible to treat my breast cancer, 5) minimize length of treatment, 6) do what doctor thinks is best, 7) avoid side effects of treatment
|
One week
|
Treatment preferences using two-item tool
Time Frame: One week
|
Which surgery do you want to treat your early stage breast cancer?
Lumpectomy, lumpectomy and radiation, mastectomy, other surgery, I am not sure; Which medication do you want to treat your early stage breast cancer?
tamoxifen, aromatase inhibitor, neither, not sure.
|
One week
|
Desired role in decision-making using one-item tool
Time Frame: One week
|
Which best describes how you like to make treatment decisions: a) the doctor decides what should be done and does it; b) the doctor presents his or her recommendations to you to accept or reject; c) the doctor discusses alternatives with you and the two of you decide together how to proceed; or d) the doctor presents all available options and allows you to decide
|
One week
|
Anxiety using 6-item Spielberger State-Trait Anxiety Inventory short-form
Time Frame: One week, 5 months
|
Spielberger State-Trait Anxiety Inventory short-form; 6 items used widely in cancer studies.
|
One week, 5 months
|
Quality of Life using the SF-12 physical and mental component scores
Time Frame: One week, 5 months
|
Health related quality of life measured using the SF-12 physical and mental component at scores at both time points
|
One week, 5 months
|
Preparation for Decision-Making using 10 items (1-5 scale
Time Frame: One week, 5 months
|
Patient's perception of how useful the DA is in preparing to communicate with their clinician; 10 items (1-5 scale), Ex: Did this educational material help you organize your thoughts?
Assessed at both time points.
|
One week, 5 months
|
Actual role in decision-making using one-item tool
Time Frame: 5 months
|
Which best describes how treatment decisions with your surgeon (will also ask about decision with their radiation oncologist/oncologist) were made: a) the surgeon decided what should be done and did it; b) the surgeon presented his/her recommendation to you to accept or reject; c) the surgeon discussed alternatives with you and the two of you decided together how to proceed; d) the surgeon presented all available options and allowed you to decide.
|
5 months
|
Decision Regret using one-item tool
Time Frame: 5 months
|
If I had to do it over I would make a different decision about breast cancer treatment (strongly agree to strongly disagree); will ask specifically about surgery/radiation/endocrine therapy
|
5 months
|
Satisfaction with treatment decision using 4-item tool
Time Frame: 5 months
|
4 items (scores 4-20).
Higher scores> satisfaction; Subjects level of agreement with: a) I was adequately informed about the issues; b) the decision about which treatment I would receive was the best decision for me; c) treatment decisions were consistent with my personal values; d) I am satisfied with my treatment choice.
|
5 months
|
Satisfaction with the decision process using 4-item tool
Time Frame: 5 months
|
4 items (scores 4-20).
Higher scores > satisfaction (Cronbach's alpha =0.91).
Subjects level of agreement with: a) I wish I would have given more consideration to my options; b) I would have liked to had more information; c) I would have like to have been more active in the decision-making process; d) I did not have as much say as I would have liked.
|
5 months
|
Treatment received using chart abstraction
Time Frame: 5 months
|
Type of surgery, radiation, endocrine therapy, abstracted from medical records
|
5 months
|
Acceptability using 0-3 scale
Time Frame: 1 week
|
Length; amount of information; clarity (scale 0-3); balance (e.g. the information was slanted towards getting radiation); anxiety provoking (scale 0-3); helpful (scale 0-3); amount read
|
1 week
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Mara Schonberg, MD MPH, Beth Israel Deaconess Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-117
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Breast Cancer
-
Northwestern UniversityEisai Inc.UnknownMale Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Triple-negative Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast Cancer | Estrogen Receptor-negative Breast Cancer | Progesterone Receptor-negative Breast Cancer | HER2-negative...United States
-
Rutgers, The State University of New JerseyNational Cancer Institute (NCI); Rutgers Cancer Institute of New JerseyActive, not recruitingStage IIIA Breast Cancer | Stage IIIB Breast Cancer | Triple-negative Breast Cancer | Stage IIA Breast Cancer | Stage IIB Breast Cancer | Stage IIIC Breast Cancer | Estrogen Receptor-negative Breast Cancer | Progesterone Receptor-negative Breast Cancer | HER2-negative Breast CancerUnited States
-
University of Southern CaliforniaNational Cancer Institute (NCI)TerminatedMale Breast Cancer | Stage IV Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast Cancer | Recurrent Breast CancerUnited States
-
University of WashingtonTerminatedBreast Cancer | Breast Cancer Stage I | Breast Cancer Stage II | Breast Cancer Stage III | Breast Cancer Stage IIB | Breast Cancer Stage IIA | Breast Cancer Stage IIIA | Breast Cancer Stage IIIB | Breast Cancer Stage IIIcUnited States
-
CelgeneCompletedBreast Cancer | Metastatic Breast Cancer | Stage IV Breast Cancer | Triple-negative Breast Cancer | Recurrent Breast Cancer | Breast Tumor | Cancer of the Breast | Triple-negative Metastatic Breast Cancer | Estrogen Receptor- Negative Breast Cancer | HER2- Negative Breast Cancer | Progesterone Receptor- Negative...United States, United Kingdom, Italy, Germany, Spain, Canada, Portugal, Australia, Austria, Greece, Brazil, France
-
University of Southern CaliforniaNational Cancer Institute (NCI)TerminatedHER2-positive Breast Cancer | Stage IV Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast Cancer | Recurrent Breast CancerUnited States
-
University of WashingtonNational Cancer Institute (NCI)CompletedHER2-positive Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Estrogen Receptor-negative Breast Cancer | Estrogen Receptor-positive Breast Cancer | Progesterone Receptor-negative Breast Cancer | Progesterone Receptor-positive Breast...United States
-
University of Southern CaliforniaNational Cancer Institute (NCI)WithdrawnStage IV Breast Cancer | Stage II Breast Cancer | Stage IIIA Breast Cancer | Stage IIIB Breast Cancer | Triple-negative Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIIC Breast Cancer | Recurrent Breast Cancer
-
Baylor Breast Care CenterRecruitingBreast Cancer | Breast Neoplasm | Triple Negative Breast Cancer | Triple Negative Breast Neoplasms | HER2-positive Breast Cancer | Breast Cancer Stage II | Breast Cancer Female | Breast Cancer Stage III | Estrogen Receptor-positive Breast Cancer | Hormone Receptor-positive Breast Cancer | Breast Cancer InvasiveUnited States
-
Innocrin PharmaceuticalCompletedBreast Cancer | Advanced Breast Cancer | Metastatic Breast Cancer | Triple Negative Breast Cancer | Male Breast Cancer | ER+ Breast Cancer | Cancer of the BreastUnited States
Clinical Trials on Usual Care
-
Charite University, Berlin, GermanyCompletedMultiple Sclerosis | FatigueGermany
-
Centers for Disease Control and PreventionCompleted
-
Charite University, Berlin, GermanyMammazentrum Hamburg am Krankenhaus Jerusalem, Germany; Dorit und Alexander...Completed
-
European Institute for Evidence Based Osteopathic...Unknown
-
Suzanna ZickUniversity of MichiganTerminatedQuality of Life | Fatigue | Lupus Erythematosus, Systemic | Sleep | Pain, ChronicUnited States
-
The Miriam HospitalNational Institute on Aging (NIA)RecruitingHeart FailureUnited States
-
Lawson Health Research InstituteUnknownDepression | Quality of Life | Sleep | Anxiety | Dry EyeCanada
-
U.S. Wound RegistryRecruitingWounds and Injuries | Diabetic Foot | Leg Ulcer | Skin Ulcer | Diabetes Complications | Diabetic Neuropathies | Lymphedema | Peripheral Arterial Disease | Vasculitis | Venous Insufficiency | Varicose Ulcer | Pressure Ulcer | Pyoderma | Surgical Wound Dehiscence | Amputation StumpUnited States
-
University Hospital, MontpellierCompletedOsteoarthritis | Mindfulness | MBSRFrance
-
Gachon University Gil Oriental Medical HospitalKorea Health Industry Development InstituteCompletedKnee Replacement | AcupunctureKorea, Republic of