Why Taranaki women choose to have a mastectomy when suitable for breast conservation treatment.
BACKGROUND
Breast conservation treatment (BCT) rate is recognized as a marker of surgical practice. An historically low BCT rate may reflect the requirement for Taranaki women to travel for adjuvant radiotherapy. The aim of this study was to determine the reasons Taranaki women with breast cancer choose mastectomy or BCT.


METHODS
Prospective information, on all women presenting with breast cancer between May 2004 and December 2006, was collected on a standardized questionnaire.


RESULTS
BCT was offered to 68% (140 of 206), but chosen by only 46% (n = 64) of suitable patients. If radiotherapy had been available locally, 23% (17 of 73) of patients who chose mastectomy would have instead opted for BCT. A quarter of each group of women thought they knew their surgeon's treatment preference and most chose this option. Fear of local recurrence and need for further surgery were significantly more important to those choosing mastectomy over BCT whereas what the surgeon was perceived to prefer was more important to those choosing BCT.


CONCLUSIONS
The rate of BCT in Taranaki is low, despite it being offered by surgeons to the majority of patients. Local availability of radiotherapy may increase the BCT rate to a level more consistent with larger centres in New Zealand. Care must be taken to provide neutral patient guidance.
Gollop
Susan J
SJ
Department of Surgery, Taranaki Base Hospital, New Plymouth, New Zealand. susangollop@xtra.co.nz
Kyle
Stephen M
SM
Fancourt
Michael W
MW
Gilkison
William T C
WT
Mosquera
Damien A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000532:radiotherapy / Q000601:surgery*; D002755:Choice Behavior; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology; D009520:New Zealand / Q000208:ethnology; D011878:Radiotherapy / Q000523:psychology