A case-control study of treatment choices made by doctors diagnosed with early breast cancer.
BACKGROUND
Doctors who are diagnosed with breast cancer form a small subset of women with unique insight into their disease. The aim of this study was to compare key treatment decisions in medically-qualified doctors with equivalent degree-educated, matched controls diagnosed with early breast cancer.


METHODS
Patients diagnosed with breast cancer between 01/01/2006 and 31/12/2011 were included and screened for occupation by 2 independent investigators. Allied health professionals with a medical background (e.g. nurses, physiotherapists) were excluded. Patient controls were matched by age, nodal status and grade. If there were more than 5 possible matches then those patients with the closest tumour size were selected.


RESULTS
5259 of 8623 patients had signed the generic research consent form. 619 of these were either doctors, or had received tertiary level education and could form appropriate controls. After exclusions, 46 medically-qualified doctors and 230 matched control patients were included in the analysis. No statistical differences in age or tumour characteristics were identified between doctors with breast cancer and matched controls. No differences were identified between the two groups in the uptake of mastectomy, chemotherapy, immediate breast reconstruction or post-mastectomy radiotherapy.


CONCLUSIONS
Medically-qualified patients diagnosed with early breast cancer are no more likely to opt for mastectomy, chemotherapy, immediate breast reconstruction or post-mastectomy radiotherapy than non-medically-qualified controls. The level of information generally provided to patients with breast cancer is adequate for a similar decision to be made by control patients with equivalent levels of education, independent of any knowledge of pathology or understanding of the medical system that medically-qualified patients may possess.
Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, United Kingdom. Electronic address: roconnell@doctors.org.uk.
Rachel L
RL
O'Connell
Department of Statistics, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, United Kingdom. Electronic address: kabir.mohammed@rmh.nhs.uk.
Kabir
K
Mohammed
Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, United Kingdom. Electronic address: gerald.gui@rmh.nhs.uk.
Gerald P H
GP
Gui
Department of Breast Surgery, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, United Kingdom. Electronic address: jennifer.rusby@rmh.nhs.uk.
Jennifer E
JE
Rusby
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016022:Case-Control Studies; D002983:Clinical Competence; D003657:Decision Making; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D012189:Retrospective Studies
Breast cancer; Decision making; Mastectomy