The development and comparative effectiveness of a patient-centered pathology report for breast cancer care: a randomized clinical trial.

Abstract

Purpose: Pathology reports contain complex medical terminology that may be confusing or overwhelming for patients newly diagnosed with breast cancer. We evaluated the effectiveness of patient-centered pathology reports (PCPRs), which translate pathology results into patient-friendly language.

Methods: Sixty-six participants newly diagnosed with breast cancer were randomized to receive either a PCPR and standard pathology report (intervention arm) or a standard pathology report alone (control arm). Patients were surveyed at initial pathology disclosure and 1 month later to assess breast cancer knowledge and ratings of decisional confidence, conflict, and self-efficacy for treatment decision-making. Knowledge was assessed for four pathology domains independently.

Results: Accuracy of breast cancer knowledge across all domains trended higher for the intervention group compared with the control group (66% vs. 50%, p = 0.11); cancer type and surgical margin status knowledge domains exceeded 75% accuracy for the intervention group. No significant differences between groups were observed for patient-reported ratings of communication, decisional conflict, and decision self-efficacy.

Conclusions: PCPRs in lay language appeared to improve patients' knowledge of their breast cancer diagnosis, were acceptable to patients and providers, and have the potential to be broadly applied in an effort to improve patient knowledge and improve the patient experience surrounding a breast cancer diagnosis.