Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Nov 11;17(1):189.
doi: 10.1186/s12957-019-1723-4.

Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery

Rui Chen  1 , Sainan You  1 , Zinan Yin  2 , Qiannan Zhu  1 , Chaojun Jiang  1 , Shuo Li  1 , Yan Li  1 , Xiaoming Zha  3 , Jue Wang  4
Affiliations

Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery

Rui Chen et al. World J Surg Oncol. .

Abstract

Background: The rate of breast-conserving surgery (BCS) is low in China. Many patients choose mastectomy even when informed that there is no difference in the overall survival rate compared with that of BCS plus radiotherapy. This study aimed to investigate the factors that influenced the surgical choice in patients eligible for BCS.

Methods: Female patients with breast carcinoma were enrolled in a single center from March 2016 to January 2017. They made their own decision regarding the surgical approach. Univariate analysis was employed to determine the factors associated with the different breast surgical approaches. Significant factors (defined as P < 0.05) were then incorporated into multivariate logistic regression models to determine the factors that independently influenced patients' decision.

Results: Of the 271 patients included, 149 were eligible for BCS; 65 chose BCS and 84 chose mastectomy. On the basis of univariate analysis, patients with younger age, higher income and education, shorter admission to surgery interval, and shorter confirmed diagnosis to surgery interval were more likely to choose BCS than mastectomy (P < 0.05). Meanwhile, patients who resided in rural regions, did not have general medicare insurance, and were diagnosed with breast cancer preoperatively were more inclined to choose mastectomy than BCS (P < 0.05). The multivariate model revealed three independent influencing factors: age at diagnosis (P = 0.009), insurance status (P = 0.035), and confirmed diagnosis to surgery interval (P = 0.037). In addition, patients receiving neoadjuvant chemotherapy (NCT) were more inclined to choose mastectomy.

Conclusion: Surgical choice of patients eligible for BCS was affected by several factors, and age at diagnosis, confirmed diagnosis to surgery interval, and insurance status were independent factors.

Keywords: Breast cancer; Breast-conserving surgery; Mastectomy; Surgical choice.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the breakdown of patient cohort
Fig. 2
Fig. 2
Multivariate analysis of the factors associated with the choice of BCS rather than mastectomy in patients who were eligible for BCS. OR, odds ratio; CI, confidence interval
Fig. 3
Fig. 3
The questionnaire regarding the main reason for 84 patients choosing mastectomy rather than BCS among patients who were eligible for BCS
See this image and copyright information in PMC

References

    1. Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2015;366:2087–2106. - PubMed
    1. Morris AD, Morris RD, Wilson JF, White J, Steinberg S, Okunieff P, et al. Breast conserving therapy versus mastectomy in early stage breast cancer: a meta-analysis of 10 year survival. Cancer J Sci Am. 1997;3:6–12. - PubMed
    1. Al-Ghazal SK, Fallowfield L, Blamey R. Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer. 2000;36:1938–1943. doi: 10.1016/S0959-8049(00)00197-0. - DOI - PubMed
    1. Schain WS, d’Angelo TM, Dunn ME, Lichter AS, Pierce LJ. Mastectomy versus conservative surgery and radiation therapy: psychological consequences. Cancer. 1994;73:1221–1228. doi: 10.1002/1097-0142(19940215)73:4<1221::AID-CNCR2820730416>3.0.CO;2-S. - DOI - PubMed
    1. NIH consensus conference. Treatment of early-stage breast cancer. JAMA. 1991;265:391–5. - PubMed

MeSH terms