Local management of second breast cancer event after primary breast conserving therapy: The patient's perspective

In case of a second ipsilateral breast cancer event (2^ndiBCE) after primary breast conserving treatment (BCT), patients are offered salvage mastectomy (SM) or, for selected patients, 2^ndBCT. An international survey dedicated to breast cancer survivors investigated patients' preferences and expectations.

An international survey was drafted jointly with breast cancer patient advocates from the United States (n = 6) and Europe (n = 2). The survey was validated with 33 questions divided into four themes: demographic data, oncological outcomes, patient views and financial issues. The survey was sent to breast cancer survivors. All information provided was anonymized.

From 06/24 to 10/24, 105 patients answered the online survey. The common patient profile was a white (76 %), married (61.5 %), Christian (58.8 %), US-resident (70.2 %) woman aged between 61 and 70 (62.2 %). Long-term outcomes were perceived as being well established for SM (51.5 %) and 2^ndBCT (17.1 %). Breast re-irradiation was considered at risk of complications (65.7 %), and 63 % of the patients thought that 2^ndBCT provides a more acceptable body self-image. 2^ndBCT was expected to give superior cosmetic outcomes than SM with breast reconstruction (55.4 %). Having enough information and ample time to consider the pros and cons of treatment options were very important/important for 99 % and 96.2 %, respectively. Treatment choice was not influenced by financial concerns for 68.3 %.

Patient perspective is very important in the decision-making process regarding salvage treatments. Physicians must provide clear, timely information which will enable patients to choose the treatment that best meets their expectations.