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). 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. 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%). 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. Not applicable.
Gao et al. (Mon,) studied this question.