Influences on decision for mastectomy in patients eligible for breast conserving surgery

E E Rippy; R Ainsworth; D Sathananthan; J Kollias; M Bochner; R Whitfield

doi:10.1016/j.breast.2013.12.009

Influences on decision for mastectomy in patients eligible for breast conserving surgery

Breast. 2014 Jun;23(3):273-8. doi: 10.1016/j.breast.2013.12.009. Epub 2014 Jan 21.

Authors

E E Rippy¹, R Ainsworth², D Sathananthan³, J Kollias⁴, M Bochner⁵, R Whitfield⁶

Affiliations

¹ Breast, Endocrine and Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, 5000 SA, Australia. Electronic address: elisabethrippy@hotmail.com.
² Breast, Endocrine and Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, 5000 SA, Australia. Electronic address: rachel.ainsworth@nhs.net.
³ Breast, Endocrine and Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, 5000 SA, Australia. Electronic address: dharshan.satha@gmail.com.
⁴ Breast, Endocrine and Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, 5000 SA, Australia. Electronic address: james.kollias@health.sa.gov.au.
⁵ Breast, Endocrine and Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, 5000 SA, Australia. Electronic address: melissa.bochner@health.sa.gov.au.
⁶ Breast, Endocrine and Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, 5000 SA, Australia. Electronic address: robert.whitfield@health.sa.gov.au.

PMID: 24456967
DOI: 10.1016/j.breast.2013.12.009

Abstract

Increasing emphasis is being placed on low mastectomy rates. Our objective was to investigate factors influencing rates of mastectomy and breast conserving surgery. A group of 171 patients (27%) who could have had breast conserving surgery (BCS) but chose mastectomy was identified as well as all patients who underwent BCS over a 6 year period. A questionnaire asking patient's attitudes to factors which could influence their choice of operation was compiled and sent to this study group. Results showed surgical advice to be the most important factor, with significantly more influence in BCS patients. No significant difference was found in distance to treatment between the groups. Shorter duration radiotherapy would have made 47% of mastectomy patients more likely to accept BCS. BCS rates are a poor measure of quality of patient care. More emphasis should be put on choices offered to patients rather than overall uptake of a specific choice.

Keywords: Breast conserving surgery; Mastectomy; Radiotherapy.

Publication types

Comparative Study

MeSH terms

Adult
Attitude to Health
Australia / epidemiology
Breast Neoplasms* / epidemiology
Breast Neoplasms* / psychology
Breast Neoplasms* / surgery
Choice Behavior*
Directive Counseling* / methods
Directive Counseling* / standards
Directive Counseling* / statistics & numerical data
Eligibility Determination
Female
Humans
Mastectomy* / methods
Mastectomy* / psychology
Mastectomy* / statistics & numerical data
Middle Aged
Organ Sparing Treatments* / methods
Organ Sparing Treatments* / psychology
Organ Sparing Treatments* / statistics & numerical data
Outcome Assessment, Health Care
Patient Selection
Quality Improvement
Radiotherapy, Adjuvant / methods
Radiotherapy, Adjuvant / psychology*
Surveys and Questionnaires