{"title":"影响早期乳腺癌选择乳房切除术或保乳手术的因素:对印度患者观点的前瞻性定性研究","authors":"Rebba Ephraim, Madhabananda Kar, Mahesh Sultania, Suprava Naik, Saroj Majumdar, Dillip Kumar Muduly","doi":"10.1002/jso.70088","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Breast conservation surgery (BCS) has not been a widely adopted treatment in early breast cancer despite its oncological outcomes similar to mastectomy. In emerging economies, BCS rates are < 40% compared to > 70% in the West. Hence, this study was undertaken to describe factors influencing the underutilization of BCS.</p><p><strong>Methods: </strong>A prospective longitudinal study was conducted between September 2019 and December 2021 on patients with biopsy-proven early breast cancer eligible for BCS. The choice of surgery (mastectomy vs. breast conservation) by patients was recorded at initial diagnosis and staging. A predesigned structured questionnaire was used to identify the factors associated with their choice of mastectomy. The patients received multiple counseling sessions by the operating surgeon(s), and the choice of surgery was recorded again. Factors associated with the choice of surgery were identified and evaluated by univariate or multivariate logistic regression.</p><p><strong>Results: </strong>Out of 238 consecutive patients operated on in the study period, 84 met eligibility criteria and were recruited. At the time of initial diagnosis and staging, 13 (15.5%) patients wanted BCS. After multiple counseling sessions, finally, 75 (89.3%) opted for BCS; however, 9 (10.7%) still wanted mastectomy. The factors influencing the choice of mastectomy were fear of outcome (90% of patients), followed by family influence (35%), radiation-related factors (30%), personal factors (25%), and surgery-related factors (25%).</p><p><strong>Conclusions: </strong>Systematic counseling by the treating team markedly improved breast conservation acceptance rates from 15.5% to 89.3%. Fear of outcome is the major factor influencing the choice of mastectomy over BCS in early breast cancer patients suitable for BCS.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Influencing the Choice of Mastectomy Over Breast Conservation Surgery in Early Breast Cancer: A Prospective Qualitative Exploration of Patient Perspectives From India.\",\"authors\":\"Rebba Ephraim, Madhabananda Kar, Mahesh Sultania, Suprava Naik, Saroj Majumdar, Dillip Kumar Muduly\",\"doi\":\"10.1002/jso.70088\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Breast conservation surgery (BCS) has not been a widely adopted treatment in early breast cancer despite its oncological outcomes similar to mastectomy. In emerging economies, BCS rates are < 40% compared to > 70% in the West. Hence, this study was undertaken to describe factors influencing the underutilization of BCS.</p><p><strong>Methods: </strong>A prospective longitudinal study was conducted between September 2019 and December 2021 on patients with biopsy-proven early breast cancer eligible for BCS. The choice of surgery (mastectomy vs. breast conservation) by patients was recorded at initial diagnosis and staging. A predesigned structured questionnaire was used to identify the factors associated with their choice of mastectomy. The patients received multiple counseling sessions by the operating surgeon(s), and the choice of surgery was recorded again. Factors associated with the choice of surgery were identified and evaluated by univariate or multivariate logistic regression.</p><p><strong>Results: </strong>Out of 238 consecutive patients operated on in the study period, 84 met eligibility criteria and were recruited. At the time of initial diagnosis and staging, 13 (15.5%) patients wanted BCS. After multiple counseling sessions, finally, 75 (89.3%) opted for BCS; however, 9 (10.7%) still wanted mastectomy. The factors influencing the choice of mastectomy were fear of outcome (90% of patients), followed by family influence (35%), radiation-related factors (30%), personal factors (25%), and surgery-related factors (25%).</p><p><strong>Conclusions: </strong>Systematic counseling by the treating team markedly improved breast conservation acceptance rates from 15.5% to 89.3%. Fear of outcome is the major factor influencing the choice of mastectomy over BCS in early breast cancer patients suitable for BCS.</p>\",\"PeriodicalId\":17111,\"journal\":{\"name\":\"Journal of Surgical Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Surgical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jso.70088\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.70088","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Factors Influencing the Choice of Mastectomy Over Breast Conservation Surgery in Early Breast Cancer: A Prospective Qualitative Exploration of Patient Perspectives From India.
Background: Breast conservation surgery (BCS) has not been a widely adopted treatment in early breast cancer despite its oncological outcomes similar to mastectomy. In emerging economies, BCS rates are < 40% compared to > 70% in the West. Hence, this study was undertaken to describe factors influencing the underutilization of BCS.
Methods: A prospective longitudinal study was conducted between September 2019 and December 2021 on patients with biopsy-proven early breast cancer eligible for BCS. The choice of surgery (mastectomy vs. breast conservation) by patients was recorded at initial diagnosis and staging. A predesigned structured questionnaire was used to identify the factors associated with their choice of mastectomy. The patients received multiple counseling sessions by the operating surgeon(s), and the choice of surgery was recorded again. Factors associated with the choice of surgery were identified and evaluated by univariate or multivariate logistic regression.
Results: Out of 238 consecutive patients operated on in the study period, 84 met eligibility criteria and were recruited. At the time of initial diagnosis and staging, 13 (15.5%) patients wanted BCS. After multiple counseling sessions, finally, 75 (89.3%) opted for BCS; however, 9 (10.7%) still wanted mastectomy. The factors influencing the choice of mastectomy were fear of outcome (90% of patients), followed by family influence (35%), radiation-related factors (30%), personal factors (25%), and surgery-related factors (25%).
Conclusions: Systematic counseling by the treating team markedly improved breast conservation acceptance rates from 15.5% to 89.3%. Fear of outcome is the major factor influencing the choice of mastectomy over BCS in early breast cancer patients suitable for BCS.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.