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Additional file 2. Identified decision aids. Table S1 Systematic literature research: List of identified decision aids. Table S2 Systematic literature research: Evaluation of the identified decision aids with regard to the given target definitions.

Additional file 4. User tests. Table S1 Basic results of the user tests with previvors (n = 6) for DA A. Table S2 Basic results of the user tests with survivors (n = 5) for DA B. Table S3 Interview guideline for the user test of the beta version of decision aid A for previvors and decision aid B for survivors..

Additional file 4. User tests. Table S1 Basic results of the user tests with previvors (n = 6) for DA A. Table S2 Basic results of the user tests with survivors (n = 5) for DA B. Table S3 Interview guideline for the user test of the beta version of decision aid A for previvors and decision aid B for survivors..

Additional file 3. Focus group discussions. Table S1 Characteristics of the focus group participants. Table S2 Basic results of the focus group discussions with previvors and survivors.

In einem prospektiven hypothesengeleiteten Design wurden Einstellungen, Inanspruchnahmeverhalten und Zufriedenheit nach prophylaktischer Chirurgie bei 285 Risikopatientinnen für familiären Brust- und Eierstockkrebs im Kontext genetischer Diagnostik untersucht. Die Inanspruchnahme prophylaktischer Brustentfernung war mit 7 %, die Inanspruchnahme einer vorbeugenden Eierstockentfernung mit 8 % im Vergleich mit internationalen Daten gering. Eine eigene Erkrankung, krankheitsspezifische Ängste und die ärztliche Empfehlung sagten eine positive Einstellung gegenüber einer prophylaktischen Brust- oder Eierstockentfernung voraus, während gesundheitsbezogene Kontrollüberzeugungen, die regelmäßige Inanspruchnahme einer Mammographie und eine positive Bewertung der Brustselbstuntersuchung als Früherkennungsmethode sich als Protektionsfaktoren herausstellten. 71 % bzw. 53 % der Befragten waren mit der Entscheidung für eine prophylaktische Brust- bzw. Eierstockentfernung sehr zufrieden. Zwei Fallbeschreibungen weisen auf eine Unterschätzung des Eingriffs und auf das Risiko erheblicher peri- und postoperativer Komplikationen hin.

Psychological factors may influence survival in breast cancer patients but results of previous research are inconclusive. This prospective population-based study tested whether depression predicts mortality in breast cancer patients. Routinely collected depression screening data were merged with electronically archived provincial cancer registry data and censored data from British Columbia Vital Statistics (extracted in December 2012). Cox proportional-hazards regression analyses were conducted to predict all-cause and breast cancer-specific mortality as a function of depression after controlling for biomedical confounders. Of 1,646 patients, 1,604 had breast cancer stages I-III and 42 had stage IV breast cancer. 176 (11.0 %) versus 28 (66.7 %) were deceased after a median follow-up of 76 months. In patients with curable breast cancer, depression predicted all-cause (HR = 1.54 (95 % CI 1.06-2.25); p = 0.024), but not breast cancer-specific mortality (HR = 1.51 (95 % CI 0.95-2.41); p = 0.084). No association was shown for metastatic disease. Stage-specific analyses demonstrated a 2-2.5-fold increase in breast cancer-specific and all-cause mortality in patients with stage I and II disease, but not in patients with stage III or IV breast cancer. In stage I breast cancer patients, age moderated effects of depression such that depressed younger patients diagnosed at age 45 (i.e., mean age -1SD) showed a ninefold (HR = 9.82 (95 % CI 2.26-42.68); p = 0.002) increase in all-cause mortality and depressed patients at 57 a 3.7-fold (HR = 3.69 (95 % CI 1.44-9.48); p = 0.007) increase, while no association was evident in older patients at age 69 (mean age +1SD). Depression is strongly associated with mortality in younger patients with early stage breast cancer.