Factors that influence surgical choices in women with breast carcinoma.
BACKGROUND
In the absence of medical contraindications, survival after undergoing breast-conserving therapy (BCT), mastectomy (M), and mastectomy with immediate reconstruction (MIR) is equal. The authors studied demographic factors to identify the variables that differed significantly among women making different surgical choices.


METHODS
Women with ductal carcinoma in situ or clinical Stage I or II breast carcinoma with no contraindications for BCT or MIR who were treated between 1995 and 1998 were identified from a prospectively collected data base. Demographic and tumor factors were compared using the Fisher exact test.


RESULTS
There were 578 women with 586 tumors who did not have contraindications for BCT or MIR. Among this group, 85.2% of women chose BCT, 9.2% of women chose M, and 5.6% of women chose MIR. Women undergoing M alone were older and were more likely to have Stage II carcinoma compared with women undergoing BCT. Patients undergoing M or MIR were more likely to have had a prior breast biopsy compared with patients who chose BCT. Marital status and employment approached significance (P = 0.06); however, a family history of breast carcinoma was not a predictor of treatment choice.


CONCLUSIONS
The current findings suggest a need for patient education strategies that emphasize the lack of influence of age and prior breast biopsy on the use of BCT. Differences in demographic variables may reflect true variations in patient preference among groups, emphasizing the need to address the spectrum of treatment options with patients.
Staradub
Valerie L
VL
Division of Surgical Oncology, Department of Surgery, Northwestern University Medical School, Chicago, Illinois, USA. vstaradu@nmff.org
Hsieh
Yi-Ching
YC
Clauson
Jennifer
J
Langerman
Alexander
A
Rademaker
Alfred W
AW
Morrow
Monica
M
D000367:Age Factors; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D002755:Choice Behavior; D004651:Employment; D005260:Female; D006801:Humans; D017533:Marital Status; D008408:Mastectomy / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology; D008875:Middle Aged; D011446:Prospective Studies; D014930:Women / Q000523:psychology*