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Mastectomy or conservation: the patient's choice.
R G Wilson1, A Hart, P J Dawes
1Newcastle General Hospital, Newcastle upon Tyne.
BMJ (Clinical Research Ed.)
|November 5, 1988
Summary
Breast cancer patients can choose between mastectomy or breast conservation treatment. Most preferred mastectomy, but few regretted their decision, indicating patient capability in treatment selection.
Area of Science:
- Oncology
- Surgical Oncology
- Patient-Centered Care
Background:
- Breast cancer treatment decisions historically favored physician-led choices.
- The efficacy of mastectomy versus breast conservation for early-stage breast cancer was not definitively established, creating a need to understand patient preferences.
Purpose of the Study:
- To ascertain patient preference between mastectomy and breast conservation surgery when both options are viable.
- To evaluate patient satisfaction and decision-making capacity in breast cancer treatment choices.
Main Methods:
- A non-randomized case series involving 153 women under 65 with early-stage breast cancer (T1-T2, N0-N1).
- Patients received information and counseling before choosing between mastectomy or conservation treatment.
- Follow-up included interviews after two years to assess treatment choice and satisfaction.
Main Results:
- Of 153 patients, 99 chose mastectomy and 54 opted for breast conservation.
- Key reasons for mastectomy preference included a desire for definitive treatment and fear of future surgery.
- Only two patients regretted their chosen treatment, and no significant differences in recurrence or survival were observed between the groups during follow-up.
Conclusions:
- Patients with breast cancer are capable of making informed treatment decisions and should be involved in the choice.
- Patient preferences are not uniformly in favor of breast-conserving surgery; mastectomy remains a significant choice for many.