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Development and testing of patient-centered education about hormone replacement therapy for women at high genetic risk of breast and ovarian cancer.

Publication ,  Journal Article
Penvose, KN; Reed, SD; Sepulveda, JMG; Mastylak, A; Scott, A; Hayes, T; Shank, J; Havrilesky, LJ
Published in: Gynecol Oncol
February 2024

OBJECTIVE: In this study, we aimed to develop education to assist BRCA mutation carriers in making informed decisions about HRT in the context of risk-reducing surgery, while simultaneously clarifying their treatment-specific values and reducing decisional conflict. METHODS: We enrolled premenopausal BRCA mutation carriers ages 19-49 without prior cancer or risk-reducing salpingo-oophorectomy to structured interviews in which they reviewed education about the risks and benefits of HRT. Materials included literature-derived data demonstrating associations between HRT and commonly considered health outcomes (breast cancer, vasomotor symptoms, sexual functioning, cardiovascular disease, osteoporosis, and blood clots). Participants completed the 16-item Decisional Conflict Scale (DCS) before and after education, communicated their preferences by rating and ranking the six outcomes, and provided feedback to inform iterative revisions of the educational content. RESULTS: 25 participants completed interviews. DCS scores decreased significantly from 54.6 to 22.8 following education (p < 0.001); sub-scores for uncertainty (71.7 to 37.3), informed (71.7 to 15.3), values clarity (53.7 to 17.0), effective decision (44.2 to 25.5), and support (35.0 to 17.7) also decreased significantly. Participants ranked cardiovascular disease as the most important outcome to consider, followed by breast cancer, osteoporosis, blood clots, decline in sexual function, and hot flashes. Participants with prior mastectomy (N = 10) ranked breast cancer as the most important outcome 25% of the time, compared to 80% in participants without mastectomy (N = 15). CONCLUSION: Following education, BRCA mutation carriers had significantly less decisional conflict regarding the choice to use HRT. This pilot study was successful in generating a prototype educational aid for further testing.

Duke Scholars

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

February 2024

Volume

181

Start / End Page

91 / 98

Location

United States

Related Subject Headings

  • Thrombosis
  • Pilot Projects
  • Patient-Centered Care
  • Ovariectomy
  • Ovarian Neoplasms
  • Osteoporosis
  • Oncology & Carcinogenesis
  • Mutation
  • Mastectomy
  • Humans
 

Citation

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Penvose, K. N., Reed, S. D., Sepulveda, J. M. G., Mastylak, A., Scott, A., Hayes, T., … Havrilesky, L. J. (2024). Development and testing of patient-centered education about hormone replacement therapy for women at high genetic risk of breast and ovarian cancer. Gynecol Oncol, 181, 91–98. https://doi.org/10.1016/j.ygyno.2023.11.022
Penvose, Katherine N., Shelby D. Reed, Juan Marcos Gonzalez Sepulveda, Alicja Mastylak, Amelia Scott, Taylor Hayes, Juliana Shank, and Laura J. Havrilesky. “Development and testing of patient-centered education about hormone replacement therapy for women at high genetic risk of breast and ovarian cancer.Gynecol Oncol 181 (February 2024): 91–98. https://doi.org/10.1016/j.ygyno.2023.11.022.
Penvose KN, Reed SD, Sepulveda JMG, Mastylak A, Scott A, Hayes T, et al. Development and testing of patient-centered education about hormone replacement therapy for women at high genetic risk of breast and ovarian cancer. Gynecol Oncol. 2024 Feb;181:91–8.
Penvose, Katherine N., et al. “Development and testing of patient-centered education about hormone replacement therapy for women at high genetic risk of breast and ovarian cancer.Gynecol Oncol, vol. 181, Feb. 2024, pp. 91–98. Pubmed, doi:10.1016/j.ygyno.2023.11.022.
Penvose KN, Reed SD, Sepulveda JMG, Mastylak A, Scott A, Hayes T, Shank J, Havrilesky LJ. Development and testing of patient-centered education about hormone replacement therapy for women at high genetic risk of breast and ovarian cancer. Gynecol Oncol. 2024 Feb;181:91–98.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

February 2024

Volume

181

Start / End Page

91 / 98

Location

United States

Related Subject Headings

  • Thrombosis
  • Pilot Projects
  • Patient-Centered Care
  • Ovariectomy
  • Ovarian Neoplasms
  • Osteoporosis
  • Oncology & Carcinogenesis
  • Mutation
  • Mastectomy
  • Humans