Association of shared decision-making with type of breast cancer surgery: a cross-sectional study.
BACKGROUND
Although some studies examined the association between shared decision-making (SDM) and type of breast cancer surgery received, it is little known how treatment decisions might be shaped by the information provided by physicians. The purpose of this study was to identify the associations between shared decision making (SDM) and surgical treatment received.


METHODS
Questionnaires on SDM were administered to 1,893 women undergoing primary curative surgery for newly diagnosed stage 0-II localized breast cancer at five hospitals in Korea. Questions included being informed on treatment options and the patient's own opinion in decision-making.


RESULTS
Patients more likely to undergo mastectomy were those whose opinions were respected in treatment decisions (adjusted odds ratio, aOR), 1.40; 95% confidence interval (CI), 1.14-1.72) and who were informed on chemotherapy (aOR, 2.57; CI, 2.20-3.01) or hormone therapy (aOR, 2.03; CI, 1.77-2.32). In contrast, patients less likely to undergo mastectomy were those who were more informed on breast surgery options (aOR, 0.34; CI, 0.27-0.42). In patients diagnosed with stage 0-IIa cancer, clinical factors and the provision of information on treatment by the doctor were associated with treatment decisions. In patients diagnosed with stage IIb cancer, the patient's opinion was more respected in treatment decisions.


CONCLUSIONS
Our population-based study suggested that women's treatment decisions might be shaped by the information provided by physicians, and that women might request different information from their physicians based on their preferred treatment options. These results might need to be confirmed in other studies of treatment decisions.
Lee
Myung Kyung
MK
Division of Cancer Control, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea.
Noh
Dong Young
DY
Nam
Seok Jin
SJ
Ahn
Se Hyun
SH
Park
Byeong Woo
BW
Lee
Eun Sook
ES
Yun
Young Ho
YH
D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D003142:Communication; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000523:psychology; D008408:Mastectomy / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D056910:Republic of Korea; D011795:Surveys and Questionnaires