Welcome to the B.R.E.A.S.T. Choice (Breast Reconstruction Education and Support Tool) study. This multi-site randomized controlled trial is implementing a decision support tool called BREASTChoice and testing its effectiveness in clinical practice. BREASTChoice helps women considering a mastectomy decide whether or not to have breast reconstruction, and which breast reconstruction option is best for them.

What we know already

Breast reconstruction after mastectomy can be an important part of breast cancer treatment. Breast reconstruction can restore quality of life and body image for some women. But there are also risks from having breast reconstruction. Some characteristics of patients can make them more likely to have a complication from breast reconstruction. And many women who are thinking about having breast reconstruction have questions about what type of breast reconstruction to have and when to have it.

What methods we used in earlier work

  • We developed BREASTChoice, an interactive decision support tool to help women make decisions about breast reconstruction after mastectomy. 
  • We interviewed breast cancer survivors and clinicians before developing the tool, and we used their feedback to improve the tool.
  • The tool incorporates individual, personal risks of complications from breast reconstruction. It also helps women think about what matters most to them about the decision.
  • In an earlier study, we compared patients receiving BREASTChoice via email and a website link, to usual care (what normally happens in the clinic).

What we found in earlier work

  • BREASTChoice improved knowledge without affecting consult time.
  • Many patients preferred using BREASTChoice at home rather than in clinic.
  • Surgeons liked BREASTChoice’s personal risk calculation, but didn’t always know what the tool stated about risk or preferences.

Surgeons and patients both wanted a summary in the electronic health record so they could review risks and preferences during the consult.