Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

UB Study Explores How Women Make Decisions About Breast Cancer Surgery

28.10.2009
For women just diagnosed with breast cancer, one of the important decisions confronting them is whether to have a lumpectomy or mastectomy. A diagnosis of breast cancer will affect one in every eight women in the United States, according to the American Cancer Society, causing them to have to decide quickly about treatment.

Most studies investigating how women make this choice have surveyed women months and sometimes even years after their decision was made. Recently, however, the publication of a new University at Buffalo study, one of the few to focus on the time period between women's breast cancer diagnosis and surgery, provides insight into what women are thinking when faced with this decision.

In the study published in the September issue of Oncology Nursing Forum, women who were diagnosed with early-stage breast cancer were interviewed during the period just after surgical consultation and before surgery. Performing the interviews at this time allowed for an in-the-moment snapshot of how women arrived at their decisions. These interviews were then transcribed, coded and analyzed to identify themes in the participants' thought processes.

"This is one of the very few studies to be conducted in the pretreatment period when women were actually engaged in the decision-making process, whether they had declared a decision or were still contemplating -- these thoughts were fresh and appointments with physicians still ongoing," according to primary investigator Robin Lally, PhD, RN, assistant professor of nursing in the UB School of Nursing and adjunct assistant professor at Roswell Park Cancer Institute.

One of the study's most interesting findings was that when women were presented with options and felt they had control over their choices they considered this to be a positive prognostic indicator -- or an encouraging sign of their future survival. "Women reported gaining confidence in their decision-making role through the confidence and support they felt from their surgeon and staff," Lally said. "The women in the study valued receiving options, even if they had one already in mind, and though they may not have seen themselves as a person who is typically good at making decisions, they drew confidence from the support provided to them by their health care team while making the decision."

Most often, women's surgical treatment decision making has been studied using a structured response format that limits the nature of the answers by providing predetermined choices (multiple choice or yes/no answers). This structured approach eliminates the context in which decisions are made and limits women's ability to reveal their thoughts behind how and why they make certain choices.

In contrast, the qualitative research approach used by Lally in this study assembles participants who can provide rich insight and expert knowledge on a particular phenomenon so that it can be better understood in a real-world context.

"This research provides insight into what women newly diagnosed with breast cancer may do, think about and expect even before they see the surgeon at the clinic for the first time," Lally said.

Specifically, Lally's research showed that women felt that information about breast cancer was important, but that they needed to manage the amount and timing of the information they took in, in order to prevent themselves from becoming overwhelmed. More was not necessarily better. Some women preferred to use only the verbal information provided by their care team on which to base their decision and put the breast cancer literature away until just days before their surgery.

Age was not a defining factor in how much information women wanted or whether they used what was provided. Women of all ages used information that answered their questions and tended to avoid information that upset them emotionally.

Lally found that many women already had a plan in mind when they entered the surgeon's office which they then weighed against the surgeon's input. Their surgical treatment decisions were motivated by the desire to: eliminate future inconvenience and worry about cancer balanced by avoiding mastectomy unless medically required; maintain physical function and appearance; and recover rapidly. Most women felt that mastectomy should be reserved only for the worst breast cancers. Older women saw advanced age as an advantage -- age protected them from worry of recurrence and/or the significant concern over loss of their breast although they still chose lumpectomy.

Women of all ages expressed surprise that their surgeons did not make a definitive recommendation, but that the choice of mastectomy or lumpectomy was ultimately their own. Even women who wanted to make their own decision still desired a recommendation from the surgeon. When making a choice, however, they drew confidence from the surgeons' support of their decision.

Lally hopes that surgeons and nurses will be inspired by her findings to assess their breast cancer patients' expectations and understanding regarding their options and the decision-making process at the beginning of each consultation and be aware of the important role providers play in supporting women's ability to make this decision.

Breast cancer survivors can also benefit from this research. Lally hopes that, "survivors reading this study may find 'a little of themselves' in the women's narratives and feel comforted in the realization that others also had moments of feeling overwhelmed, uncertain or surprised by the surgical decision-making process -- you are not alone."

Lally currently has a grant under review in collaboration with Roswell Park Cancer Institute's Breast Center to study the thought processes of African-American women in response to their breast cancer diagnosis. She intends to use all of her research to develop assessment and intervention tools for health care professionals in order to identify women who may be at risk for ongoing distress beyond this early time period.

The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. The School of Nursing is one of five schools that constitute UB's Academic Health Center. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.

Sara Saldi | EurekAlert!
Further information:
http://www.buffalo.edu

More articles from Studies and Analyses:

nachricht Antarctic Ice Sheet mass loss has increased
14.06.2018 | Technische Universität Dresden

nachricht WAKE-UP provides new treatment option for stroke patients | International study led by UKE
17.05.2018 | Universitätsklinikum Hamburg-Eppendorf

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Temperature-controlled fiber-optic light source with liquid core

In a recent publication in the renowned journal Optica, scientists of Leibniz-Institute of Photonic Technology (Leibniz IPHT) in Jena showed that they can accurately control the optical properties of liquid-core fiber lasers and therefore their spectral band width by temperature and pressure tuning.

Already last year, the researchers provided experimental proof of a new dynamic of hybrid solitons– temporally and spectrally stationary light waves resulting...

Im Focus: Overdosing on Calcium

Nano crystals impact stem cell fate during bone formation

Scientists from the University of Freiburg and the University of Basel identified a master regulator for bone regeneration. Prasad Shastri, Professor of...

Im Focus: AchemAsia 2019 will take place in Shanghai

Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.

Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...

Im Focus: First real-time test of Li-Fi utilization for the industrial Internet of Things

The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.

Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.

Im Focus: Sharp images with flexible fibers

An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.

Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Munich conference on asteroid detection, tracking and defense

13.06.2018 | Event News

2nd International Baltic Earth Conference in Denmark: “The Baltic Sea region in Transition”

08.06.2018 | Event News

ISEKI_Food 2018: Conference with Holistic View of Food Production

05.06.2018 | Event News

 
Latest News

Better model of water under extreme conditions could aid understanding of Earth's mantle

21.06.2018 | Earth Sciences

What are the effects of coral reef marine protected areas?

21.06.2018 | Life Sciences

The Janus head of the South Asian monsoon

21.06.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>