Patient values in breast cancer surgical decision-making - The WhySurg study

Area of Science:

• Oncology
• Psychology
• Surgical Oncology

Background:

• Understanding patient decision-making in breast cancer surgery is crucial.
• Patient values and personality traits can influence surgical choices.
• Previous research has not fully elucidated these associations.

Purpose of the Study:

• To identify patient values and personality traits linked to specific breast cancer surgery options.
• To explore the factors influencing the choice between breast-conserving surgery (BCS), unilateral mastectomy (UM), and bilateral mastectomy (BM).

Main Methods:

• A survey was administered to 1497 breast cancer surgery patients (2009-2020).
• The survey incorporated qualitative interview data and the Big-Five personality trait profile.
• Multivariable logistic regression analyzed associations between patient characteristics and surgical choice.

Main Results:

• Open-mindedness correlated with unilateral mastectomy (UM).
• Sociability was associated with bilateral mastectomy (BM).
• Patients choosing BCS and UM prioritized self-image, recovery, and physician recommendations over BM patients, who mainly focused on cancer outcomes.

Conclusions:

• Patient values beyond cancer outcomes significantly differentiate surgical choices.
• Self-image, recovery optimization, and physician guidance are key factors in BCS and UM selection.
• Personality traits like open-mindedness and sociability show distinct associations with different surgical pathways.