# Patient Preferences in Breast Cancer: A Scoping Review

## TL;DR

This review summarizes studies on breast cancer patient preferences, highlighting the need for better standardization and patient involvement in decision-making.

## Contribution

The paper provides a comprehensive overview of breast cancer patient preference studies and identifies challenges in their implementation.

## Key findings

- Preference studies in breast cancer show significant diversity in methods and outcomes.
- Survival elements are consistently considered important by patients when included in studies.
- Patient involvement in studies varied, with some studies using advisory boards or feedback sessions.

## Abstract

Patients with breast cancer are all confronted with different needs and preferences concerning their treatment and care. Understanding what matters to breast cancer patients can help tailor decisions. This scoping review aims to provide an overview of published studies identifying breast cancer patient preferences. The review shows how the diversity within and between the preference studies complicates a robust and standardized implementation of preferences in decision-making processes. The article suggests how stakeholders can create valuable impact for and with breast cancer patients, for example, by linking preference studies to clear objectives and implementation strategies, and by involving patients throughout the whole process.

Background: Breast cancer is one of the most common cancers worldwide, with both the disease and the treatments affecting patients’ quality of life and overall survival. Patient preference studies can help to identify what matters most to patients. This study aims to provide an overview of published patient preference studies in breast cancer, focusing on (i) the design of the study, (ii) preference outcomes including preference heterogeneity, (iii) recruitment strategies, and (iv) patient involvement. Methods: For this scoping review, a search strategy was created for five databases (PubMed, Embase, Scopus, Web of Science Core Collection, and CINAHL), based on the concepts ‘breast cancer’ and ‘patient preference’. The articles were screened double-blind in two phases, after which, the relevant data was extracted and analyzed. Results: A total of 31 articles were selected based on the eligibility criteria. The studies were published over a wide time range (1995–2024), and across different countries. Different methodologies were used, and different attributes were included, mainly related to adverse events of treatments and survival elements. Survival elements were almost always considered important when included. Preference heterogeneity was assessed in 24 of the included studies. The involvement of patients in these studies varied; in two studies, patients were involved in an advisory board; in five studies, patients provided feedback on the preference study conduct via interviews or focus group discussions; and in twelve studies, pilot tests were mentioned. Conclusions: The studies show diverse methods, outcomes, and patient involvement strategies. This may complicate the implementation of preferences in decision-making, suggesting preference studies with clear objectives and implementation strategies to create impact for and with patients.