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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation (Forthcoming/Available Online)
Authors: Shearer, Rosalyn D
Rashid, Majid
Hubbard, Gill
Abbott, Nick C
Daltrey, Ian R
Mullen, Russell
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Keywords: Breast cancer
breast-conserving surgery
choice behaviour
Issue Date: Mar-2016
Publisher: AME Publishing
Citation: Shearer RD, Rashid M, Hubbard G, Abbott NC, Daltrey IR & Mullen R Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation (Forthcoming/Available Online), Gland Surgery [non valid].
Abstract: Background: Despite being suitable for breast conservation surgery (BCS) a proportion of women choose mastectomy. This study aimed to assess the pre-operative pathological and geographic factors associated with choosing mastectomy rather than BCS in a single centre that serves a large geographical area encompassing urban, rural and remote island populations. Methods: A retrospective analysis of all patients suitable for BCS between January 2011 and December 2013 was undertaken. Pre-operative pathological features were compared using the Pearson chi squared test as was distance to the treatment centre from the patient’s home. A questionnaire was sent to all those who chose mastectomy to identify the factors that influenced their decision. Results: A total of 446 patients suitable for BCS were identified of which 46 (11%) chose to undergo mastectomy. Patients choosing mastectomy were more likely to present symptomatically (P=0.009), have tumours larger than 20 mm at diagnostic imaging (P=0.001) and have positive axillary staging (P=0.004). Patients choosing mastectomy were more likely to live remotely (P=0.051). Those patients who chose mastectomy felt this gave a better long-term outcome (18 patients, 44%) and peace of mind (14 patients, 34%). Conclusions: Adverse pre-operative pathological features were associated with patients choosing mastectomy rather than BCS. There was a trend for patients who chose mastectomy to live remotely from the treatment centre. Patients choosing mastectomy most commonly cited a better long-term outcome and peace of mind as the reason behind their decision. Understanding what influences a patient’s surgical choice will allow clinicians and patients to engage in a fully informed pre-operative decision making process.
Type: Journal Article
DOI Link:
Rights: The publisher has not yet responded to our queries therefore this work cannot be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: NHS Highland
NHS Highland
Cancer Care Research Centre
NHS Highland
NHS Highland
NHS Highland

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