Changing trends in the decision-making preferences of women with early breast cancer

Background: Previous studies have indicated a predominance of passive decision‐making styles among women with early‐stage breast cancer in the UK offered a choice between breast‐conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision‐making styles and establi...

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Published inBritish journal of surgery Vol. 95; no. 3; pp. 312 - 318
Main Authors Caldon, L. J. M., Walters, S. J., Reed, M. W. R.
Format Journal Article
LanguageEnglish
Published Chichester, UK John Wiley & Sons, Ltd 01.03.2008
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Abstract Background: Previous studies have indicated a predominance of passive decision‐making styles among women with early‐stage breast cancer in the UK offered a choice between breast‐conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision‐making styles and establish their association with operation choice and breast unit mastectomy rate. Methods: A questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix‐adjusted mastectomy rates. Results: Of 697 consecutive patients, 356 (51·1 per cent) completed the questionnaire, a mean of 6·9 (range 1·3–48·6) weeks after surgery. Some 262 women (73·6 per cent) underwent BCS and 94 (26·4 per cent) had a mastectomy. Some 218 patients (61·2 per cent) achieved their preferred decision‐making style. The proportions of women achieving an active decision‐making style were high, particularly for those choosing mastectomy (83 versus 58·0 per cent for BCS; P < 0·001) and in the high mastectomy rate unit (79·6 versus 53 and 52·2 per cent for medium and low rate units respectively; P < 0·001). Conclusion: More women chose an active decision‐making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Women may not always choose breast conservation
AbstractList Previous studies have indicated a predominance of passive decision-making styles among women with early-stage breast cancer in the UK offered a choice between breast-conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision-making styles and establish their association with operation choice and breast unit mastectomy rate. A questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix-adjusted mastectomy rates. Of 697 consecutive patients, 356 (51.1 per cent) completed the questionnaire, a mean of 6.9 (range 1.3-48.6) weeks after surgery. Some 262 women (73.6 per cent) underwent BCS and 94 (26.4 per cent) had a mastectomy. Some 218 patients (61.2 per cent) achieved their preferred decision-making style. The proportions of women achieving an active decision-making style were high, particularly for those choosing mastectomy (83 versus 58.0 per cent for BCS; P < 0.001) and in the high mastectomy rate unit (79.6 versus 53 and 52.2 per cent for medium and low rate units respectively; P < 0.001). More women chose an active decision-making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates.
Background: Previous studies have indicated a predominance of passive decision‐making styles among women with early‐stage breast cancer in the UK offered a choice between breast‐conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision‐making styles and establish their association with operation choice and breast unit mastectomy rate. Methods: A questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix‐adjusted mastectomy rates. Results: Of 697 consecutive patients, 356 (51·1 per cent) completed the questionnaire, a mean of 6·9 (range 1·3–48·6) weeks after surgery. Some 262 women (73·6 per cent) underwent BCS and 94 (26·4 per cent) had a mastectomy. Some 218 patients (61·2 per cent) achieved their preferred decision‐making style. The proportions of women achieving an active decision‐making style were high, particularly for those choosing mastectomy (83 versus 58·0 per cent for BCS; P < 0·001) and in the high mastectomy rate unit (79·6 versus 53 and 52·2 per cent for medium and low rate units respectively; P < 0·001). Conclusion: More women chose an active decision‐making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Women may not always choose breast conservation
Women may not always choose breast conservation
Previous studies have indicated a predominance of passive decision-making styles among women with early-stage breast cancer in the UK offered a choice between breast-conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision-making styles and establish their association with operation choice and breast unit mastectomy rate.BACKGROUNDPrevious studies have indicated a predominance of passive decision-making styles among women with early-stage breast cancer in the UK offered a choice between breast-conserving surgery (BCS) and mastectomy. The aim of this study was to determine current decision-making styles and establish their association with operation choice and breast unit mastectomy rate.A questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix-adjusted mastectomy rates.METHODSA questionnaire survey was conducted among women from three specialist breast units representing high, medium and low case mix-adjusted mastectomy rates.Of 697 consecutive patients, 356 (51.1 per cent) completed the questionnaire, a mean of 6.9 (range 1.3-48.6) weeks after surgery. Some 262 women (73.6 per cent) underwent BCS and 94 (26.4 per cent) had a mastectomy. Some 218 patients (61.2 per cent) achieved their preferred decision-making style. The proportions of women achieving an active decision-making style were high, particularly for those choosing mastectomy (83 versus 58.0 per cent for BCS; P < 0.001) and in the high mastectomy rate unit (79.6 versus 53 and 52.2 per cent for medium and low rate units respectively; P < 0.001).RESULTSOf 697 consecutive patients, 356 (51.1 per cent) completed the questionnaire, a mean of 6.9 (range 1.3-48.6) weeks after surgery. Some 262 women (73.6 per cent) underwent BCS and 94 (26.4 per cent) had a mastectomy. Some 218 patients (61.2 per cent) achieved their preferred decision-making style. The proportions of women achieving an active decision-making style were high, particularly for those choosing mastectomy (83 versus 58.0 per cent for BCS; P < 0.001) and in the high mastectomy rate unit (79.6 versus 53 and 52.2 per cent for medium and low rate units respectively; P < 0.001).More women chose an active decision-making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates.CONCLUSIONMore women chose an active decision-making style than in previous UK studies. The provision of greater treatment selection autonomy to women suitable for BCS may not reduce mastectomy rates.
Author Caldon, L. J. M.
Reed, M. W. R.
Walters, S. J.
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ContentType Journal Article
Copyright Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Issue 3
Keywords Human
Decision making
Trend
Breast cancer
Change
Malignant tumor
Medicine
Mammary gland diseases
Treatment
Preference
Surgery
Adult
Female
Early
Mammary gland
Woman
Cancer
Language English
License CC BY 4.0
2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Presented in part to the BJS prize session of the Annual Scientific Meeting of the British Association of Surgical Oncology ∼ the Association for Cancer Surgery, London, UK, November 2006, and published in abstract form as Eur J Surg Oncol 2006; 32(Suppl): 1028
(Suppl): 1028
2006
Presented in part to the BJS prize session of the Annual Scientific Meeting of the British Association of Surgical Oncology ∼ the Association for Cancer Surgery, London, UK, November 2006, and published in abstract form as
Eur J Surg Oncol
32
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2003; 80
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1994; 150
1997; 67
2006; 15
1997; 277
2005; 40
2000; 92
2003
2005; 48
1995; 152
2007; 15
2002; 25
1984; 252
2003; 90
2000; 39
2002; 20
1995; 48
2004; 292
2001; 19
1997; 17
2002; 347
1997; 16
2005; 92
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1994; 3
2001; 35
1998; 4
1992; 45
1996; 3
2001; 53
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Snippet Background: Previous studies have indicated a predominance of passive decision‐making styles among women with early‐stage breast cancer in the UK offered a...
Previous studies have indicated a predominance of passive decision-making styles among women with early-stage breast cancer in the UK offered a choice between...
Women may not always choose breast conservation
SourceID pubmedcentral
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SourceType Open Access Repository
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StartPage 312
SubjectTerms Adult
Age Factors
Aged
Aged, 80 and over
Biological and medical sciences
Breast Neoplasms - pathology
Breast Neoplasms - psychology
Breast Neoplasms - surgery
Decision Making
Female
General aspects
Gynecology. Andrology. Obstetrics
Humans
Mammary gland diseases
Mastectomy - psychology
Medical sciences
Middle Aged
Original
Patient Participation
Patient Satisfaction
Tumors
Title Changing trends in the decision-making preferences of women with early breast cancer
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https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fbjs.5964
https://www.ncbi.nlm.nih.gov/pubmed/17853508
https://www.proquest.com/docview/70314191
https://pubmed.ncbi.nlm.nih.gov/PMC11440001
Volume 95
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