CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2021; 81(06): 679-698
DOI: 10.1055/a-1326-1792
GebFra Science
Review/Übersicht

Decision Aids for Preventive Treatment Alternatives for BRCA1/2 Mutation Carriers: a Systematic Review

Article in several languages: English | deutsch
Lisa Marlene Krassuski
1  Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universitätsklinikum Köln, Köln
,
Sibylle Kautz-Freimuth
1  Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universitätsklinikum Köln, Köln
,
Vera Vennedey
1  Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universitätsklinikum Köln, Köln
,
Kerstin Rhiem
2  Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln
,
Rita K. Schmutzler
2  Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln
,
Stephanie Stock
1  Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universitätsklinikum Köln, Köln
› Author Affiliations

Abstract

Introduction Women with a pathogenic BRCA1/2 mutation have a markedly increased lifetime risk of developing breast and/or ovarian cancer. The current preventive treatment alternatives that are offered are an intensified breast cancer screening programme and risk-reducing operations. Before deciding on one option, medical and personal factors such as life situation and individual preferences must be weighed carefully. Decision aids are used internationally to support BRCA1/2 mutation carriers during their decision-making process. In this study these are analysed structurally for the first time and their applicability to the German context is examined.

Material and Methods A systematic literature search in five electronic databases and a manual search were performed. The identified decision aids were evaluated with regard to formal criteria, medical content and quality. The qualitative assessment used the criteria of the International Patient Decision Aid Standards Collaboration (IPDASi v4.0), which examined various dimensions (e.g., information, probabilities, values).

Results Twenty decision aids, which were published between 2003 and 2019 in Australia (n = 4), the United Kingdom (n = 3), Canada (n = 2), the Netherlands (n = 2) and the USA (n = 9), were included. Nine focus on BRCA1/2 mutation carriers and eleven include other risk groups. Eighteen include risk-reducing operations as decision options, 14 list screening methods for breast and/or ovarian cancer, and 13 describe the possibility of pharmacological prevention by means of selective oestrogen receptor modulators or aromatase inhibitors. Nine of the 20 decision aids meet fundamental quality criteria (IPDASi v4.0 qualification criteria).

Conclusion International decision aids can serve formally as a basis for a German decision aid for BRCA1/2 mutation carriers. Some of them differ markedly in content from the recommendations of German guidelines. Only a few achieve a high quality.

Supporting Information

Supporting Information



Publication History

Received: 07 August 2020

Accepted after revision: 29 November 2020

Publication Date:
21 June 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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