了解乳腺癌手术中的患者决策:风险感知,沟通和心理社会影响
Eman Sbaity1, Tasnim Diab2, Jana Haroun3
1Department of General Surgery, American University of Beirut Medical Center, Beirut P.O. Box 11-0236, Lebanon.
Medical sciences (Basel, Switzerland)
|October 24, 2025
概括
中东和北非 (MENA) 地区的反侧预防性乳房切除术 (CPM) 决策是由个人偏好驱动的,而不是临床风险. 改善风险沟通和共享决策对于早期乳腺癌患者至关重要.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 健康心理学 心理健康心理学
背景情况:
- 逆侧预防性乳房切除术 (CPM) 的使用在全球范围内不断增加,尽管对中等风险患者的证据相反.
- 影响中东和北非 (MENA) 地区CPM决策的因素仍未得到充分研究.
- 这项研究调查了早期乳腺癌患者的CPM选择中的临床,心理和沟通因素.
研究的目的:
- 探索影响中东北非地区早期乳腺癌妇女进行逆向预防性乳房切除术 (CPM) 决策的因素.
- 为了比较CPM和单边乳房切除 (UM) 组之间的特征和决策驱动因素.
- 确定改善患者咨询和手术规划的领域.
主要方法:
- 对253名乳腺癌早期患者的回顾性研究,这些患者在第三级护理中心接受了乳房切除术 (有或没有CPM).
- 数据收集包括临床/人口统计信息的医疗记录和决策因素的患者问卷.
- 统计分析采用了千平方测试和多变量后勤回归.
主要成果:
- 选择CPM的女性 (37/253) 与UM患者 (216/253) 相比,受过更高的教育,就业,并有乳腺癌家族史.
- CPM患者更频繁地接受了立即重建,并且有更高的30天再住院率.
- CPM的决策是以患者为导向的,优先考虑安宁和降低风险的信念,而UM的决策则更多地受到医生的影响.
结论:
- 在MENA地区,CPM选择主要受到个人偏好而不是临床风险评估的影响.
- 调查结果强调需要加强风险沟通和共享决策流程.
- 建议将遗传咨询整合到手术规划中,以改善患者的结果和选择.
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