Decision Regret About Treatment Amongst Women With Early Breast Cancer: An Integrative Review

Abstract

Aims

To synthesise evidence on decision regret about treatment amongst women with early breast cancer, including (1) the type of treatment related to decision regret, (2) the level of decision regret, and (3) factors associated with decision regret.

Design

Integrative review.

Methods

Studies published between January 2000 and December 2023 were searched from five online databases to provide up-to-date evidence. The Joanna Briggs Institute critical appraisal tools were used to evaluate the quality of the studies. The constant comparison strategy was employed for data analysis.

Results

A total of 26 studies were included. Breast cancer surgery was the most frequently studied treatment in relation to decision regret amongst women with early breast cancer, while adjuvant therapies were less studied. Most studies reported low levels of decision regret, while several studies found high levels. The proportion of women reporting decision regret varied considerably from 2.5% to 69% across the included studies. Factors associated with decision regret included various socio-demographic and clinical characteristics (age, ethnicity, employment, education, health literacy, cancer stage, and treatment types), decision-making experiences (patient involvement, patient preference, accessing information, and the use of decision support tools), and mental health.

Conclusion

Decision regret occurs in women with early breast cancer after surgery and adjuvant therapies. A variety of factors should be considered during the treatment decision-making process to minimise decision regret. More robust studies are needed to disaggregate decision regret by treatment type and to evaluate the effectiveness of decision support tools in reducing decision regret in women with early breast cancer.

Impact

Nurses and other healthcare professionals should be aware of the potential for decision regret related to surgery and adjuvant therapies in women with early breast cancer. The findings can help nurses and other healthcare professionals identify women at higher risk of experiencing decision regret and provide support during the treatment decision-making process to mitigate it.

Reporting Method

PRISMA 2020 Statement.

Patient or Public Contribution

No patient or public contribution to this review.