Measuring Preferences for Fertility in Breast Cancer for a Decision Aid

描述（由申请人提供）：被诊断患有乳腺癌的女性不仅必须面对各种侵入性的长期治疗，包括手术，化疗和放射治疗，而且由于这些治疗，她们还经常面临生育能力的威胁。接受过癌症治疗的年轻女性一直认为生育问题是最令人不安的问题之一，这些问题不会随着时间的推移而减弱。保留生育能力的选择是可用的，但决定追求现有的选择复杂，因为这些决定可能会影响妇女的复发，死亡率和她的生活质量的风险。如果没有单一的选择可供提倡，就必须将妇女的偏好纳入决策过程。决策辅助工具可以帮助做出困难的决定，包括评估不确定的科学证据和权衡治疗方案的益处和风险。他们被认为是可以接受的病人和可行的实施。该项目的具体目标是：1）描述年轻人的决策需求（2）根据定性研究收集的信息，建立乳腺癌妇女生育保留决策的决策分析模型;（3）利用期望效用理论中的时间权衡法，测量被诊断患有乳腺癌的年轻女性对生育保留的偏好;（4）利用决策模型开发生育保留决策的决策辅助工具;第五章）在一小部分被诊断患有乳腺癌的年轻女性中进行了初步测试，这些女性面临生育能力丧失的风险，并面临生育能力保护决定这项研究将是乳腺癌人群中生育能力保留决策的第一个决策辅助工具，特别是结合患者的偏好。从这项研究中获得的信息将是非常宝贵的，在开发未来的工具，妇女作出决定，生育，并将有一个有益的影响，乳腺癌幸存者的生活，并减轻与癌症治疗相关的发病率。

DESCRIPTION (provided by applicant): Women diagnosed with breast cancer must not only face a variety of invasive, lengthy treatments that can involve surgery, chemotherapy, and radiation therapy, they also often face a threat to their fertility as a result of these treatments. Young women who have undergone cancer treatment consistently identify fertility concerns among the most troubling issues and these concerns do not abate with time. Options for preserving fertility are available, but decisions to pursue available options complicated as these decisions potentially affect a woman's risk for recurrence, mortality, and her quality of life. When there is no single option to be advocated, it is imperative to incorporate a woman's preferences into the decision making process. Decision aids can assist with difficult decisions that involve evaluating uncertain scientific evidence and weighing the benefits and risks of treatment options. They have been found to be acceptable to patients and feasible to implement. The Specific Aims of this project are to: 1) Characterize the decision making needs of young (aged 21-45) breast cancer patients regarding fertility preservation by conducting focus groups that explore the knowledge, personal risk information, and weighing of competing factors; 2) Develop a decision analytic model of the fertility preservation decision in women with breast cancer, based on information gleaned from qualitative studies; 3) Measure the preferences for fertility preservation in young women diagnosed with breast cancer, using the Time Trade-Off method derived from expected utility theory; 4) Develop a decision aid for the fertility preservation decision using the decision model; 5) Pilot test the decision aid in a small sample of young women diagnosed with breast cancer who are at risk of fertility loss and are facing the fertility preservation decision. This research will be the first decision aid for fertility preservation decisions in a breast cancer population that specifically incorporates patient preferences. The information gained from this research will be invaluable in developing future tools for women to make decisions regarding fertility and will have a beneficial effect on breast cancer survivors' lives, and relieve morbidity associated with cancer treatments.