title: Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer.
abstract: BACKGROUND
  Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated.
  
  
  OBJECTIVE
  To assess preferences of patients with breast cancer and of healthy women regarding these new techniques, compared with conventional surgical treatments.
  
  
  METHODS
  Six hypothetical breast cancer treatment-outcome scenarios were developed: three standard surgical scenarios (mastectomy, mastectomy with immediate implant-based reconstruction, and breast-conserving therapy [BCT]) and three minimally invasive or noninvasive scenarios (radiofrequency ablation, magnetic resonance-guided high-intensity focused ultrasound ablation, and single-dose ablative radiotherapy). Participants rated treatment-outcome scenarios by visual analogue scale (VAS) and time trade-off (TTO). The Friedman and post hoc Wilcoxon signed-rank tests were used to test whether scores were significantly different from BCT.
  
  
  RESULTS
  Seventy-one patients with breast cancer and 50 healthy volunteers participated. Overall, BCT was rated the highest in terms of VAS (0.80) and TTO (0.90) scores. After stratification, BCT ranked the highest in most subgroups, with the exception of healthy individuals, who had given the highest score to ablative boost (VAS, 0.80; TTO, 0.88). Mastectomy with immediate reconstruction was the least preferred in most subgroups.
  
  
  CONCLUSIONS
  This study showed no significant preference for minimally invasive treatment for breast cancer. Using hypothetical scenarios, breast cancer survivors attributed the highest scores to BCT, whereas healthy volunteers showed a slight preference for minimally invasive treatments.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: fknuttel@gmail.com.
authors.forename: Floortje M
authors.initials: FM
authors.lastname: Knuttel
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Maurice A A J
authors.initials: MA
authors.lastname: van den Bosch
authors.affiliation: Department of Clinical Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Danny A
authors.initials: DA
authors.lastname: Young-Afat
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Marleen J
authors.initials: MJ
authors.lastname: Emaus
authors.affiliation: Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Desirée H J G
authors.initials: DH
authors.lastname: van den Bongard
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Arjen J
authors.initials: AJ
authors.lastname: Witkamp
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Helena M
authors.initials: HM
authors.lastname: Verkooijen
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000523:psychology*; D009367:Neoplasm Staging; D009426:Netherlands; D057240:Patient Preference; D064232:Visual Analog Scale
keywords: breast cancer; minimally invasive treatment; patient preferences; utility scores