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Breast cancer survivors and providers are willing to discuss long-term toxicity risks. A co-designed care pathway will personalize communication and risk management strategies from diagnosis.

Keywords:
Breast cancer survivorshipImplementation scienceLong-term toxicitiesRisk communicationRisk prediction

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Area of Science:

  • Oncology
  • Patient Care
  • Health Services Research

Background:

  • Breast cancer (BC) survivors face persistent post-treatment burdens impacting quality of life.
  • Risk prediction algorithms were developed to identify patients at high risk for long-term toxicities.
  • Implementation of these algorithms requires understanding patient and provider perspectives on risk communication.

Purpose of the Study:

  • To co-design a pathway for assessing, communicating, and managing individual risks of long-term BC toxicities.
  • To identify patient and provider preferences, catalysts, and barriers for risk communication.
  • To prepare for the integration of risk algorithms into routine clinical care.

Main Methods:

  • A qualitative co-design study utilizing a participatory research framework.
  • Two phases of focus groups (FG) with patients and providers (n=28).
  • Thematic content analysis of FG discussions guided by specific questions on risk communication.

Main Results:

  • Strong willingness from patients and providers to discuss long-term toxicity risks, especially for high-risk individuals.
  • Willingness is conditional on supportive care pathways offering personalized communication and risk mitigation.
  • Co-designed pathway addresses tailored strategies for communication and management.

Conclusions:

  • Patients and providers are amenable to assessing, communicating, and mitigating long-term toxicities from diagnosis.
  • A tailored care pathway was co-designed to meet these needs in routine practice.
  • The pathway will be formally tested in a hybrid effectiveness/implementation clinical trial (NCT06479057).