scholarly journals Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who are in Line with Breast Conserving

2021 ◽  
Author(s):  
Pingting Zhu ◽  
Qiaoying Ji ◽  
Xinyi Liu ◽  
Ting Xu ◽  
Qiwei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Chinese Culture ◽  
Breast Conservation ◽  
Breast Cancer Surgery ◽  
Oncologic Outcomes ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
Colaizzi's Method

Abstract Purpose Breast cancer patients who are in line with breast conserving are faced more challenges in making surgery decision, because breast conservation and mastectomy have equivalent oncologic outcomes. The purpose of this study is to analyze the surgical decision-making process for breast cancer patients and further explore the reasons why do Chinese women who are in line with breast conserving are more likely to choose mastectomy. Methods A qualitative study was conducted. With the sample saturation principle, data collected by semi-structured interviews with 24 breast cancer patients who are in line with breast conserving. Colaizzi’s method of phenomenology was used for data analysis. Results Three major themes emerged from the data. The themes were the following: (1) lack of significant decision-making support (stereotyping of breast cancer surgery, inferior quality of interaction with health professions, and without the help of decision aids); (2) can’t mull under the strike (immediacy of the decision, breasts are out of deliberating, and escape); and (3) edified by the Chinese culture (deep family values, hiding concerns about femininity, and conservative character). Conclusions Our findings explore the reasons why more Chinese breast cancer patients with breast conserving conditions choose mastectomy, and help patients to choose knowledge-based treatment options which are concordant with their needs, values, and preferences.

scholarly journals Resection or Preservation? A Tough Surgical Decision for Chinese Breast Cancer Patients Who Are in Line with Breast Conserving

2021 ◽  
Author(s):  
Pingting Zhu ◽  
Qiaoying Ji ◽  
Xinyi Liu ◽  
Ting Xu ◽  
Qiwei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Chinese Culture ◽  
Breast Conservation ◽  
Breast Cancer Surgery ◽  
Oncologic Outcomes ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
Colaizzi's Method

Abstract Purpose Breast cancer patients who are in line with breast conserving are faced more challenges in making surgery decision, because breast conservation and mastectomy have equivalent oncologic outcomes. The purpose of this study is to analyze the surgical decision-making process for breast cancer patients and further explore the reasons why do Chinese women who are in line with breast conserving are more likely to choose mastectomy. Methods A qualitative study was conducted. With the sample saturation principle, data collected by semi-structured interviews with 14 breast cancer patients who are in line with breast conserving. Colaizzi’s method of phenomenology was used for data analysis. Results Three major themes emerged from the data. The themes were the following: (1) lack of significant decision-making support (stereotyping of breast cancer surgery, Inferior quality of interaction with health professions, and without the help of decision aids); (2) can’t mull under the strike (immediacy of the decision, breasts are out of deliberating, and escape); and (3) edified by the Chinese culture (deep family values, hiding concerns about femininity, and conservative character). Conclusions Our findings explore the reasons why more Chinese breast cancer patients with breast conserving conditions choose mastectomy, and help patients to choose knowledge-based treatment options which are concordant with their needs, values, and preferences.

Preoperative genetic testing affects surgical decision making in breast cancer patients

2014 ◽  
Vol 134 (2) ◽  
pp. 326-330 ◽  
Author(s):  
Elizabeth Lokich ◽  
Ashley Stuckey ◽  
Christina Raker ◽  
Jennifer Scalia Wilbur ◽  
Jessica Laprise ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Genetic Testing ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
Surgical Decision Making

Anxiety in breast cancer patients treated with neoadjuvant therapy: Effects on surgical plan and role of supportive care.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 35-35 ◽  
Author(s):  
Huaqi Li ◽  
Winson Y. Cheung ◽  
Paula Myers ◽  
Elaine McKevitt ◽  
Kaylie Willemsma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Bilateral Mastectomy ◽  
Breast Cancer Patients ◽  
Supportive Services ◽  
High Anxiety ◽  
Surgical Decision ◽  
Surgical Decision Making

35 Background: The impact of high anxiety on surgical decision making has been demonstrated in various cancer settings. For patients undergoing neoadjuvant therapy (NAT) for breast cancer, supportive services can be offered prior to surgery and may help them choose between the options of bilateral mastectomy, unilateral mastectomy, or breast conserving surgery (BCS) where clinically appropriate. However, the effect of anxiety at initial diagnosis and psychological support on these decisions has not yet been studied. Methods: A prospective database of breast cancer patients treated with NAT at the British Columbia Cancer Agency was utilized to extract demographic information, surgical plan with regards to BCS and unilateral or bilateral mastectomy, and information about supportive services utilized. This was correlated with anxiety scores at initial consultation recorded by the Edmonton Symptom Assessment System and the Psychosocial Screen for Cancer. Patients were excluded if they had bilateral breast cancer, BRCA mutation, or missing data. Fisher’s exact tests were applied for statistical analysis. Results: From 2012-2016, 361 potential patients were identified. In total, 203 patients met eligibility criteria: 93 patients (46%) had low anxiety and 110 patients (54%) had high anxiety. Patients with high self-reported anxiety at initial consultation were 19% more likely to undergo aggressive surgery (bilateral mastectomy for unilateral disease or mastectomy for BCS eligible disease) than those with low self-reported anxiety at initial consultation (37% VS 18%; p = 0.003). Of the 110 patients with high anxiety, only 46 patients (42%) utilized counselling before surgery. No significant difference in rate of aggressive surgery was observed in patients with high anxiety who had counselling compared to those who did not (33% VS 41%; p = 0.43). Conclusions: High anxiety at initial consultation is associated with a 19% increase in aggressive surgery compared to patients with low anxiety. Counselling resources are currently underutilized by eligible patients, but this did not have an impact on surgical decision making in this study. This may be an area of opportunity for further research.

Impact of Multigene Panel Testing on Surgical Decision Making in Breast Cancer Patients

2018 ◽  
Vol 226 (4) ◽  
pp. 560-565 ◽  
Author(s):  
Holly J. Pederson ◽  
Dharmesh Gopalakrishnan ◽  
Ryan Noss ◽  
Courtney Yanda ◽  
Charis Eng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
Panel Testing ◽  
Multigene Panel Testing ◽  
Surgical Decision Making ◽  
Multigene Panel

scholarly journals Decision aids on breast conserving surgery for early stage breast cancer patients: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jing Si ◽  
Rong Guo ◽  
Xiang Lu ◽  
Chao Han ◽  
Li Xue ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Early Stage ◽  
Decision Aids ◽  
Breast Conserving Surgery ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Surgical Decision ◽  
Surgical Decision Making

Abstract Background Breast cancer is a worldwide health concern. For early stage breast cancer patients, choosing the surgical method after diagnosis is always a dilemma. Decision aids designed for use by patients are tools which may help with surgical decision making for these patients. Methods We screened through MEDLINE, EMBASE, PubMed and Web of Science using the inclusion criteria which included (1) newly diagnosed patients with early stage breast cancer, (2) outcomes/results involving surgical options including breast conserving surgery. The search strategy used these key words or the combination of these words: “breast cancer”, “decision aid”, “decision making”, “decision support”, “breast conserving surgery”, “breast conserving therapy”. Results A total of 621 studies were identified, but only seven studies were included. Results were synthesized into narrative format. Various patterns of decision aids designed for use by patients were implemented. Mostly were educational materials via booklet, video or CDROM with or without assistance from surgeons. After decision aids, four studies showed that patients were more likely to change their original choices into mastectomy or modified radical instead of sticking to breast conserving surgery. Other results such as knowledge of breast cancer and treatments, decisional conflict and satisfaction, psychological changes after surgery and quality of life were all showed with a better trend in patients with decision aids in most studies. Conclusion Decision aids on breast conserving surgery made it easier for patient involvement in surgical decision making and improved decision-related outcomes in most early stage breast cancer patients. With more attention, improving procedures, and better interdisciplinary cooperation, more research is necessary for the improvement of decision aids. And we believe decision aids with agreed objective information are needed.

scholarly journals Developing a Decision-Aid Website for Breast Cancer Surgery: An Action Research Approach (Preprint)

2018 ◽  
Author(s):  
Yu-Ting Hung ◽  
Ching-Fang Wu ◽  
Te-Hsin Liang ◽  
Shin-Shang Chou ◽  
Guan-Liang Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Action Research ◽  
Cancer Patients ◽  
Medical Information ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Research Approach ◽  
Breast Cancer Patients ◽  
Action Research Approach

BACKGROUND Patients with early-stage breast cancer have numerous options when choosing the type of breast surgery method to be applied. Each of these options lead to a similar long-term survival rate, but result in significant differences in appearance, function, cost, recurrence rate, and various other relevant considerations. However, the time available for detailed communication with each patient is often limited in clinics, which puts these women under great psychological stress and can hinder their surgery-related decision making. OBJECTIVE The objective of this study was to develop a multipurpose surgery decision-making website providing medical information, psychological support, and decision-related simulation for women during breast cancer surgery-related decision making. METHODS Using the 4 steps of action research, which involve multigroup teamwork via regular team meetings, the following were performed: (1) Planning: searching, analyzing, and evaluating health websites to consensually decide the major infrastructure; (2) Action: work was performed simultaneously in 4 groups, which consisted of medical information collection and editing, patient interviews and data extraction, webpage content design, and programming to create or host the website; (3) Evaluation: the website was tested by clinical experts and focus groups of former breast cancer patients to assess its effectiveness and pinpoint appropriate improvements; and (4) Reflection: constant dialogue was conducted between the various participants at each step, which was used as the foundation and motivation of next plan-action-evaluation-reflection circle. RESULTS Using the action research approach, we completed the development of our website, which includes the following: (1) “Woman’s Voice”—an animated comic depicting the story of a female breast cancer patient with interspersed questions for the users that will help them better empathize with the experience; (2) “Cancer Information Treasure House”—providing breast cancer surgery-related information through text, tables, pictures and a presentation video; (3) “Decision-making Simulator”—helping patients think through and check the pros and cons of the different surgical options via visual-based interactions including “Stairs Climbing” and “Fruit of Hope”; and (4) “Recommended Links”—providing reliable websites for further reference. Additionally, we have further improved the website based on the feedback received from postsurgery breast cancer patients and clinicians. We hope to continue improving to better meet both the patients’ and health providers’ needs and become a practical decision-making aid for patients undergoing breast cancer surgery. CONCLUSIONS We have created the first breast cancer surgery decision-making assistance tool in Taiwan using a “Web-based” and multifunctional website design. This site aims to provide health care knowledge, psychological healing, and emotional support functions, as well as decision-making capability enhancement simulations. We look forward to assisting breast cancer patients in their decision-making process and expect our website to increase patient’s autonomy and improve their communication with clinicians.

Cancer Recovery Analysis System

2014 ◽  
Author(s):  
Priya Balasubramanian ◽  
Archana Pradeep ◽  
Deepak Dileepkumar ◽  
John P. Farris ◽  
Hugh Jack
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Range Of Motion ◽  
Cancer Patients ◽  
Healthcare Professionals ◽  
Breast Conservation ◽  
Breast Conservation Surgery ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Accuracy And Repeatability

Breast cancer is one of the most common types of cancer among women with over 230,000 incidences diagnosed every year. A typical breast cancer surgery might include but is not limited to, biopsies, breast conservation surgery or mastectomies. Moreover, these surgeries usually cause soreness in the shoulder and arms which in turn affect the ability of the patient to perform simple everyday activities. Lymphedema, another serious side effect of these surgeries, when coupled with radiation therapy, can appear in breast cancer patients during months or even years after the treatment ends. Lymphedema is a condition in which high-protein fluid collects beneath the skin and causes swelling, redness and discomfort. This condition occurs in breast cancer patients when lymph nodes are damaged or removed during the procedures. Research suggests that early physiotherapy as well as exercises can reduce the risk of lymphedema. Monitoring the progress during these exercises can be a first step in diagnosing lymphedema. Along with better prognosis, the patients can observe the benefits of early diagnosis with insurance coverage, since most insurance companies do not cover treatments associated with advanced stages of lymphedema. The initial stretching workouts, done during recovery, target the range of motion of the shoulder that is affected by the surgery. This range of motion, determined by the severity of the surgery, improves over time. These exercises can then be used to drain the lymph nodes and help retain flexibility in the affected muscles. A monitoring device engineered to provide data about the extent of recovery would be a significant aide to both the patients and healthcare professionals. The intent of the paper is to introduce a distinctive device that monitors workouts and uses the data as a motivating factor for the patient as well as an early detection system for lymphedema. The device shows the effort that the patient has put for each workout into user friendly real time graphs. Patients and healthcare professionals can then use this data and graphs to identify problem areas in the recovery process. Preliminary tests of this device, which are presented in this paper, showed promising results in accuracy and repeatability as the device calculated and displayed graphs which were a quantified estimation of the range of motion and workout effort of the user.

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