• Kerry A Sherman, Shaw Laura-Kate E LK, Caleb J Winch, Diana Harcourt, John Boyages, Linda D Cameron, Paul Brown, Thomas Lam, Elisabeth Elder, James French, Andrew Spillane, and BRECONDA Collaborative Research Group.
• Sydney, Australia; Bristol, United Kingdom; and Merced, Calif. From the Centre for Emotional Health, Macquarie University; the Westmead Breast Cancer Institute, Westmead Hospital; the Macquarie University Cancer Institute, Australian School of Advanced Medicine, Macquarie University; The Poche Centre, Mater Hospital; the Centre for Appearance Research, University of West of England; and the University of California, Merced.
• Plast. Reconstr. Surg. 2016 Oct 1; 138 (4): 592e-602e.

BackgroundDeciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making.MethodsWomen (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret.ResultsLinear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction.ConclusionsWomen who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision.

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