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Article in Journal ()

Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation

Citation
Shearer RD, Rashid M, Hubbard G, Abbott NC, Daltrey IR & Mullen R (2016) Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation, Gland Surgery, 5 (4), pp. 385-390.

Abstract
Background:

Despite being suitable for breast conservation surgery (BCS) a proportion of women choose mastectomy. This study aimed to assess the pre-operative pathological and geographic factors associated with choosing mastectomy rather than BCS in a single centre that serves a large geographical area encompassing urban, rural and remote island populations.
Methods:
A retrospective analysis of all patients suitable for BCS between January 2011 and December 2013 was undertaken. Pre-operative pathological features were compared using the Pearson chi squared test as was distance to the treatment centre from the patient’s home. A questionnaire was sent to all those who chose mastectomy to identify the factors that influenced their decision.
Results:
A total of 446 patients suitable for BCS were identified of which 46 (11%) chose to undergo mastectomy. Patients choosing mastectomy were more likely to present symptomatically (P=0.009), have tumours larger than 20 mm at diagnostic imaging (P=0.001) and have positive axillary staging (P=0.004). Patients choosing mastectomy were more likely to live remotely (P=0.051). Those patients who chose mastectomy felt this gave a better long-term outcome (18 patients, 44%) and peace of mind (14 patients, 34%).
Conclusions:
Adverse pre-operative pathological features were associated with patients choosing mastectomy rather than BCS. There was a trend for patients who chose mastectomy to live remotely from the treatment centre. Patients choosing mastectomy most commonly cited a better long-term outcome and peace of mind as the reason behind their decision. Understanding what influences a patient’s surgical choice will allow clinicians and patients to engage in a fully informed pre-operative decision making process.

Keywords
Breast cancer; breast-conserving surgery; choice behaviour; mastectomy

StatusPublished
AuthorsShearer Rosalyn D, Rashid Majid, Hubbard Gill, Abbott Nick C, Daltrey Ian R, Mullen Russell
Publication date08/2016
Publication date online03/2016
Date accepted by journal16/02/2016
URLhttp://gs.amegroups.com/article/view/9530
PublisherAME Publishing
ISSN 2227-684X
LanguageEnglish

Journal
Gland Surgery: Volume 5, Issue 4

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