Patient Preferences in Decision-Making for Systemic Treatment of Early Breast Cancer: A Scoping Review

<ns3:p> Background Patient preferences are a critical aspect of decision-making processes in early breast cancer care. This study aimed to provide an overview over the existing literature on patient preferences regarding systemic treatment and related decision-making processes in early breast cancer. Methods We conducted a scoping review searching for relevant articles in MEDLINE, EMBASE, CINAHL and EconLit up to January 2023. References were screened and assessed for eligibility, and two reviewers extracted data and performed quality assessment using the PREFS, GRADE risk of bias and CASP checklists. The thematic focus of included studies was assessed based on an iterative coding process and summarized descriptively. Results A total of 49 studies were included, with 20 studies using qualitative, 27 quantitative, and 2 mixed designs. Studies were highly heterogeneous in terms of methodology, sample, and thematic focus. 31 (63%) evaluated patient preferences regarding treatment and 26 (53%) evaluated preferences regarding the decision-making process. 14 studies (29%) assessed preference heterogeneity between patients, although explicit statistical modeling of such heterogeneity was rare. Meanwhile, 25 (51%) evaluated age as a determinant of patient preferences, with inconsistent definitions and reporting. Minimal benefits required to accept treatment, biomarker or genomic testing, and fertility concerns were further recurring topics in the literature, while preferences across diverse population groups were explicitly addressed by few studies. Conclusions Our review found substantial literature on patient preferences related to systemic treatment in early breast cancer. However, the designs and specific thematic focus of studies widely varied, and preference heterogeneity and age group differences were common but inconsistently addressed topics, limiting comparability. Future research should further evaluate preference heterogeneity between individuals using appropriate statistical methods and systematically investigate how preferences differ across different age groups and diverse populations. <ns3:bold>Study Registration</ns3:bold> : https://doi.org/10.17605/OSF.IO/MRYU9 </ns3:p>