What matters most? Understanding patient preferences in breast cancer treatment: A systematic review of discrete choice experiments

Breast cancer treatment decisions often involve complex trade-offs between survival, quality of life, treatment burden, and financial costs. Understanding how patients weigh these factors is essential for patient-centered care. We conducted a systematic review following PRISMA guidelines, searching...

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Vydané v:The American journal of surgery Ročník 250; s. 116642
Hlavní autori: Chua, Pei Xuan, Soh, Song Hen, Ng, Qin Xiang, Zhou, Kevin Xiang, Chan, Joel Ming En, Yaow, Clyve Yu Leon, Goh, Serene Si Ning
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.12.2025
Elsevier Limited
Predmet:
Breast cancer
Breast Neoplasms - economics
Breast Neoplasms - mortality
Breast Neoplasms - psychology
Breast Neoplasms - therapy
Cancer therapies
Chemotherapy
Choice Behavior
Conjoint analysis
Decision making
Decisions
Design of experiments
Discrete choice experiment
Endocrine therapy
Female
Fertility
Humans
Metastases
Metastasis
Patient Preference
Patient preferences
Patients
Preferences
Quality of Life
Radiation therapy
Side effects
Surgery
Survival
Systematic review
Toxicity
Treatment
Validity
Willingness to pay
Womens health
Patient preferences
Systematic review
Breast cancer
Treatment
Discrete choice experiment
ISSN:0002-9610, 1879-1883, 1879-1883
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Shrnutí:Breast cancer treatment decisions often involve complex trade-offs between survival, quality of life, treatment burden, and financial costs. Understanding how patients weigh these factors is essential for patient-centered care. We conducted a systematic review following PRISMA guidelines, searching Medline, EMBASE, and the Cochrane Library databases up to February 28, 2025 for discrete choice experiment (DCE) studies involving adult women with breast cancer. Using a predefined protocol, two reviewers independently screened and extracted data and findings were narratively synthesized. Methodological quality was assessed using the ROBVALU tool. Seventeen studies (n ​= ​5873; 12 countries) were included. Treatment efficacy was the most important attribute in 88 ​% of studies. However, many patients, particularly younger women and those with early-stage disease, prioritized quality of life over modest survival gains. Notably, cost and logistical burden were influential in lower-income settings. Because many DCEs sampled advanced/metastatic populations, generalizability to low-risk early-stage disease is limited. In summary, patients often trade survival gains to reduce toxicity and treatment burden, underscoring the importance of integrating preferences into care decisions. •Synthesizes DCE evidence to clarify patient preferences in breast cancer treatment choices.•Patients often trade survival gains for lower burden, fewer side effects, and better quality of life.•Incorporating preferences into HTAs supports value-based care and more patient-centered decisions.
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ISSN:0002-9610
1879-1883
1879-1883
DOI:10.1016/j.amjsurg.2025.116642