Factors influencing older women's decision‐making related to treatment of operable breast cancer: A qualitative systematic review

Malcolm, Francesca Ligori; Howard, Penny; Klukowska, Anita Maria; Parks, Ruth Mary; Minhas, Nikita; Cheung, Kwok Leung

Abstract

Objective: There is variation in practice in the treatment of older women with breast cancer. International guidelines highlight the importance of patient autonomy in treatment decision‐making. The aim of this study is to identify factors which influence decision‐making in older women with operable breast cancer, which will enable us to further understand how to support these patients. Methods: Systematic review in accordance with the PRISMA guidelines was performed to identify factors which influence treatment decision‐making in older women with operable breast cancer. Medline, Web of Science and SCOPUS were searched. Results: The search yielded 5840 results; 13 articles met the inclusion criteria and reported on a total of 1118 women. Thematic analysis identified three key themes in which decision‐making factors could be categorised. These were healthcare‐related factors, patient‐related factors and impact of treatment. Healthcare‐related factors included communication with clinicians and provision of information. Patient‐related factors were age, pre‐existing knowledge, preconceptions of breast cancer and treatment, decision‐making style and co‐morbidities. The impact of treatment considerations included body image and effect on quality of life. Decision‐making style was frequently reported; older women did not demonstrate one preferred style. Conclusions: The findings have highlighted the complex interplay of factors which influence how older women make breast cancer treatment‐decisions. Clinicians should have an awareness of the factors highlighted to maximise their ability to provide support and personalised care to older women with breast cancer whilst treatment decisions are made.

Citation

Malcolm, F. L., Howard, P., Klukowska, A. M., Minhas, N., Parks, R. M., & Cheung, K. L. (2024). Factors influencing older women's decision‐making related to treatment of operable breast cancer: A qualitative systematic review. Psycho-Oncology, 33(1), Article e6294. https://doi.org/10.1002/pon.6294

• Journal Article Type: Review
• Acceptance Date: Jan 2, 2024
• Online Publication Date: Jan 10, 2024
• Publication Date: 2024-01
• Deposit Date: Jan 31, 2024
• Publicly Available Date: Jan 31, 2024
• Journal: Psycho‐Oncology
• Print ISSN: 1057-9249
• Electronic ISSN: 1099-1611
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 33
• Issue: 1
• Article Number: e6294
• DOI: https://doi.org/10.1002/pon.6294
• Keywords: treatment options, older women, breast cancer, cancer, decision‐making, treatment decision‐making, oncology
• Public URL: https://nottingham-repository.worktribe.com/output/29825230
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1002/pon.6294
• Additional Information: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2024 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.