Surgical treatment preferences in Chinese-American women with early-stage breast cancer.
Breast-conserving treatment (BCT) is considered preferable to radical or modified radical mastectomy (MRM) for most women diagnosed with early-stage breast cancer. Studies have found that Chinese-American women are more likely to be treated with MRM, regardless of age or stage of disease. The central question posed in this study is: what are the cultural factors that influence the selection of treatments by Chinese-American patients and the presentation of treatment options by providers? Focused group discussions, semi-structured interviews, and ethnographic observations were conducted with 69 Chinese-American women and 14 health professionals. Results indicated that (1) many Chinese-American women, regardless of age, migration status, education, and income level, expressed a preference for MRM because it was seen as safer; (2) this was primarily a communal belief that even women who had BCT felt pressure to conform to; (3) some women felt pressured into the BCT decision by their physician and/or were unhappy with their choice; (4) patient and physician bias and difficulties with translation issues and supplemental materials all led to cross-cultural miscommunication; and (5) this miscommunication was cited as a reason for (a) not completing treatment regimes or (b) drastic changes in the treatment selected.
The George Washington University Medical Center, USA.
Moira
M
Killoran
Anne
A
Moyer
D000328:Adult; D000368:Aged; D001213:Asian / Q000523:psychology*; D001294:Attitude to Health / Q000208:ethnology; D001943:Breast Neoplasms / Q000208:ethnology* / Q000523:psychology* / Q000601:surgery; D002755:Choice Behavior; D003142:Communication; D003431:Cross-Cultural Comparison; D005260:Female; D017144:Focus Groups; D006801:Humans; D007802:Language; D015411:Mastectomy, Modified Radical / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D012495:San Francisco; D016312:Treatment Refusal / Q000208:ethnology / Q000706:statistics & numerical data