Journal article
Surgical Decision-Making Surrounding Contralateral Prophylactic Mastectomy: Comparison of Treatment Goals, Preferences, and Psychosocial Outcomes from a Multicenter Survey of Breast Cancer Patients
Annals of surgical oncology, Vol.28(13), pp.8752-8765
12/2021
DOI: 10.1245/s10434-021-10426-y
PMCID: PMC8595775
PMID: 34251554
Abstract
Differences in patient characteristics and decision-making preferences have been described between those who elect breast-conserving surgery (BCS), unilateral mastectomy (UM), or contralateral prophylactic mastectomy (CPM) for breast cancer. However, it is not known whether preferred and actual decision-making roles differ across these surgery types, or whether surgery choice reflects a woman's goals or achieves desired outcomes.
Women diagnosed with stage 0-III unilateral breast cancer across eight large medical centers responded to a mailed questionnaire regarding treatment decision-making goals, roles, and outcomes. These data were linked to electronic medical records. Differences were assessed using descriptive analyses and logistic regression.
There were 750 study participants: 60.1% BCS, 17.9% UM, and 22.0% CPM. On multivariate analysis, reducing worry about recurrence was a more important goal for surgery in the CPM group than the others. Although women's preferred role in the treatment decision did not differ by surgery, the CPM group was more likely to report taking a more-active-than-preferred role than the BCS group. On multivariate analysis that included receipt of additional surgery, posttreatment worry about both ipsilateral and contralateral recurrence was higher in the BCS group than the CPM group (both p < 0.001). The UM group was more worried than the CPM group about contralateral recurrence only (p < 0.001).
Women with CPM were more likely to report being able to reduce worry about recurrence as a very important goal for surgery. They were also the least worried about ipsilateral breast recurrence and contralateral breast cancer almost two years postdiagnosis.
Details
- Title: Subtitle
- Surgical Decision-Making Surrounding Contralateral Prophylactic Mastectomy: Comparison of Treatment Goals, Preferences, and Psychosocial Outcomes from a Multicenter Survey of Breast Cancer Patients
- Creators
- Ingrid M Lizarraga - Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USAMary C Schroeder - Division of Health Services Research, College of Pharmacy, University of Iowa, Iowa City, IA, USA. mary-schroeder@uiowa.eduIsmail Jatoi - Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USASonia L Sugg - Department of Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USAAmy Trentham-Dietz - Carbone Cancer Center and Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USALaurel Hoeth - , Stevens Point, WI, USAElizabeth A Chrischilles - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- Annals of surgical oncology, Vol.28(13), pp.8752-8765
- DOI
- 10.1245/s10434-021-10426-y
- PMID
- 34251554
- PMCID
- PMC8595775
- NLM abbreviation
- Ann Surg Oncol
- ISSN
- 1068-9265
- eISSN
- 1534-4681
- Grant note
- UL1TR002537 / NCATS NIH HHS UL1 TR002537 / NCATS NIH HHS CDRN-1306-04631 / Patient-Centered Outcomes Research Institute P30 CA086862 / NCI NIH HHS P30 CA014520 / NCI NIH HHS
- Language
- English
- Date published
- 12/2021
- Academic Unit
- Pharmacy; Epidemiology; Surgery; Pharmacy Practice and Science
- Record Identifier
- 9984214824502771
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