The study looked at factors affecting a woman's choice between a mastectomy to remove the entire breast or breast-conserving surgery, which involves removing only the tumor and is followed by radiation treatments. It found that when the patient, rather than the doctor, drives the surgery decision, the patient is more likely to choose a mastectomy. This proved to be the case among all racial and ethnic groups.
The paper appears online Aug. 31 in the Journal of the National Cancer Institute.
The study also found that women who had a friend or family member accompany them to the surgical consultation were more likely to receive a mastectomy, compared to women who attended the appointment alone. Latinas who speak little English were most influenced by family in their decision-making: 75 percent, compared to 34 percent of white women.
"Family and friends have a potentially important role in treatment discussions. More than 70 percent of women brought someone with them to the appointment, providing a chance for surgeons to convey information to both the patient and her support person. Clearly, others help with and contribute to decision making, and may do so differently for different racial or ethnic groups," says lead study author Sarah Hawley, Ph.D., M.P.H., research associate professor of internal medicine at the U-M Medical School.
Researchers also found that factors such as concern about cancer recurrence, body image and the effects of radiation impacted a woman's surgery decision. Women who said that concerns about recurrence or radiation were very important in their surgical treatment decision-making were more likely to choose mastectomy, while women very concerned about body image were more likely to have breast conserving surgery.
"We want to ensure a woman's decision is high quality, which means it's based on accurate knowledge about treatment risks and benefits and is consistent with the underlying values of the patient," Hawley says.
The researchers plan to develop a decision tool to help women and their families understand the surgical decision, and future studies will look at the issues important to patients and their spouses around decision making.
Methodology: Researchers analyzed survey responses from 1,651 women diagnosed with early stage breast cancer in the Detroit and Los Angeles metropolitan areas. Patients were selected from each city's Surveillance Epidemiology and End Results database, which collects information about cancer incidence, treatment and mortality.
Patients were asked about their surgical treatment decision, including how involved they were in the decision making, whether a family member or friend accompanied them to the appointment and their attitudes toward surgery. Higher numbers of African Americans and Latinas were included.
Breast cancer statistics: 194,280 Americans will be diagnosed with breast cancer this year and 40,610 will die from the disease, according to the American Cancer Society
Additional authors: Jennifer Griggs, Reshma Jagsi, Barbara Salem, and Steven Katz, all from U-M Medical School; Nancy Janz, U-M School of Public Health; Ann Hamilton, University of Southern California; John Graff, Wayne State University; Monica Morrow, Memorial Sloan Kettering Cancer Center
Funding: National Cancer Institute
Reference: Journal of the National Cancer Institute, Vol. 101, No. 19, Oct. 7, 2009; published online ahead of print Aug. 31, 2009Resources:
Nicole Fawcett | EurekAlert!
Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.
Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...
Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong
Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
13.12.2017 | Health and Medicine
13.12.2017 | Physics and Astronomy
13.12.2017 | Life Sciences