title: Decision-Making in Breast Cancer Surgery: Where Do Patients Go for Information?
abstract: Patient decision-making regarding breast cancer surgery is multifactorial, and patients derive information on surgical treatment options from a variety of sources which may have an impact on choice of surgery. We investigated the role of different information sources in patient decision-making regarding breast cancer surgery. Two hundred and sixty-eight patients with breast cancer, eligible for breast-conserving therapy were surveyed in the immediate preoperative period, and clinical data were also collected. This survey evaluated the scope and features of patient-driven research regarding their ultimate choice of surgical treatment. The two most common sources of information used by patients were written material from surgeons (199/268-74%) and the Internet (184/268-69%). There was a trend for women who chose bilateral mastectomy to use the Internet more frequently than those choosing unilateral mastectomy (P = 0.056). Number of surgeons consulted, genetic testing, and MRI were significant predictors of patient choice of mastectomy over breast-conserving therapy. Multivariate analysis showed that the number of surgeons consulted (P < 0.001) and genetic testing (P < 0.001) were independent predictors of choosing mastectomy, whereas MRI was not. In conclusions, understanding factors driving patient decision-making may promote more effective education for patients requiring breast cancer surgery.
authors.affiliation: Department of Surgery, Dubin Breast Center/Mount Sinai Medical Center, New York, New York, USA.
authors.forename: Hank
authors.initials: H
authors.lastname: Schmidt
authors.forename: Almog
authors.initials: A
authors.lastname: Cohen
authors.forename: John
authors.initials: J
authors.lastname: Mandeli
authors.forename: Christina
authors.initials: C
authors.lastname: Weltz
authors.forename: Elisa R
authors.initials: ER
authors.lastname: Port
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D015331:Cohort Studies; D003657:Decision Making; D005260:Female; D066275:Health Information Exchange; D006801:Humans; D008408:Mastectomy / Q000379:methods*; D008490:Medical Informatics / Q000458:organization & administration*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration; D011795:Surveys and Questionnaires; D014481:United States