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Women's choice between sentinel lymph node biopsy and axillary clearance
Steven Gan1, Christopher Magarey, Peter Schwartz
1St George Hospital, Kogarah, New South Wales, Australia.
ANZ Journal of Surgery
|June 21, 2002
Summary
When offered a choice, many women with potential breast cancer opted for axillary clearance (AC) over sentinel lymph node biopsy (SLNB), despite SLNB
Area of Science:
- Oncology
- Surgical Oncology
- Patient Decision-Making
Background:
- Sentinel lymph node biopsy (SLNB) and axillary clearance (AC) are surgical options for breast cancer treatment.
- Understanding patient preferences is crucial for informed consent and treatment planning.
Purpose of the Study:
- To assess women's treatment choices between SLNB and AC for breast cancer.
- To evaluate patient preferences based on clear information regarding morbidity and mortality.
Main Methods:
- A utility analysis estimated 5-year survival rates for SLNB and AC.
- Questionnaires detailing morbidity and mortality differences were distributed to women undergoing breast screening or consultation.
- A pilot study informed the final questionnaire design.
Main Results:
- 49.8% of mailed questionnaire respondents chose SLNB.
- 35% of women in surgical consultations chose SLNB over AC.
- A significant proportion of women preferred AC despite a minimal survival difference.
Conclusions:
- Women facing potential breast cancer diagnosis exhibit conservative treatment preferences.
- Many women prioritize lower morbidity (AC) over a very small increased mortality risk (SLNB).
- Informed consent requires clear communication of mortality risks associated with SLNB versus AC.