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Background <p>Chronic breast cancer-related lymphedema (cBCRL) is a lifelong risk for breast cancer survivors. Management strategies for this condition involve trade-offs across various attributes. We aimed to identify the preferences of breast cancer survivors in China for cBCRL management strategies using a discrete choice experiment (DCE).</p> Methods <p>We conducted a cross-sectional DCE among patients with cBCRL in Shanxi Province, China, from December 2023 to October 2025. The DCE included five attributes: treatment method (non-surgical, surgical, mixed), lymphedema volume reduction (≤ 20%, 40%, ≥ 60%), functional improvement in the affected area (≤ 30%, 30–70%, &gt; 70%), probability of adverse event (low, medium, high), and out-of-pocket cost per treatment course (ranging from 200 to 800 CNY). Preferences were estimated using a multinomial logit model, and heterogeneity was analyzed using latent class models and subgroup analysis.</p> Results <p>A total of 446 participants, who completed the survey and passed the data quality control, were included in the final analyses. The majority of them were aged 25–44 years old, held a university degree or above, and resided in urban areas. Respondents valued cost (relative importance: 53.9%) the most, followed by functional improvement (14.5%). Additionally, the results showed that participants preferred non-surgical management over surgical treatment (<i>β</i> = 0.152, 95% CI 0.099–0.205; <i>p</i> &lt; 0.001). LCM identified three distinct preference groups, in which the first group preferred the cost most (30.0%), the second group valued balanced cost and clinical benefits (58.6%), and the third group focused on treatment method and function (11.3%).</p> Conclusion <p>This study suggests that patients with cBCRL place the greatest importance on treatment cost, followed by functional improvement and treatment method. Incorporating patient preferences into survivorship care through affordable, function-oriented, and patient-centred management strategies may help improve the alignment of care with patients’ values and priorities. However, because these findings reflect stated preferences under hypothetical scenarios, the real-world effects of reducing out-of-pocket costs on treatment uptake, adherence, and clinical outcomes require further study.</p> Trial registration <p>Not applicable.</p>

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Patient preferences for managing chronic breast cancer–related lymphedema in China: evidence from a discrete choice experiment

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月1日

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  • Leilei Gao,
  • Yangyang Gao,
  • Taoran Liu,
  • Jing Yu,
  • Jingjing Han,
  • Shuxian Liu,
  • Rui Wang,
  • Wai-kit Ming,
  • Jun Guo

摘要

Background

Chronic breast cancer-related lymphedema (cBCRL) is a lifelong risk for breast cancer survivors. Management strategies for this condition involve trade-offs across various attributes. We aimed to identify the preferences of breast cancer survivors in China for cBCRL management strategies using a discrete choice experiment (DCE).

Methods

We conducted a cross-sectional DCE among patients with cBCRL in Shanxi Province, China, from December 2023 to October 2025. The DCE included five attributes: treatment method (non-surgical, surgical, mixed), lymphedema volume reduction (≤ 20%, 40%, ≥ 60%), functional improvement in the affected area (≤ 30%, 30–70%, > 70%), probability of adverse event (low, medium, high), and out-of-pocket cost per treatment course (ranging from 200 to 800 CNY). Preferences were estimated using a multinomial logit model, and heterogeneity was analyzed using latent class models and subgroup analysis.

Results

A total of 446 participants, who completed the survey and passed the data quality control, were included in the final analyses. The majority of them were aged 25–44 years old, held a university degree or above, and resided in urban areas. Respondents valued cost (relative importance: 53.9%) the most, followed by functional improvement (14.5%). Additionally, the results showed that participants preferred non-surgical management over surgical treatment (β = 0.152, 95% CI 0.099–0.205; p < 0.001). LCM identified three distinct preference groups, in which the first group preferred the cost most (30.0%), the second group valued balanced cost and clinical benefits (58.6%), and the third group focused on treatment method and function (11.3%).

Conclusion

This study suggests that patients with cBCRL place the greatest importance on treatment cost, followed by functional improvement and treatment method. Incorporating patient preferences into survivorship care through affordable, function-oriented, and patient-centred management strategies may help improve the alignment of care with patients’ values and priorities. However, because these findings reflect stated preferences under hypothetical scenarios, the real-world effects of reducing out-of-pocket costs on treatment uptake, adherence, and clinical outcomes require further study.

Trial registration

Not applicable.