Breast Cancer Surgical Treatment Choices in Newfoundland and Labrador, Canada: Patient and Surgeon Perspectives

Abstract

BackgroundBreast cancer remains the second-leading cause of cancer death among Canadian women. Treatment for breast cancer often includes surgery. Many women have a choice between mastectomy (MT; removal of the entire breast) or breast conserving surgery (BCS; removal of the tumour and some noncancerous breast tissue) followed by radiation. However, Newfoundland and Labrador consistently has a higher rate of mastectomies than the rest of Canada. In this project, we aim to better understand that trend.Design and methods.A multi-method design was chosen. Surgical treatment data kept by the province will be examined to describe the number and types of breast cancer surgeries over time. Second, we will hold focus groups with women around the province who have made surgical treatment choices to explore influences on their decisions. Finally, semi-structured interviews with breast cancer surgeons and surgical residents will explore their opinions on surgical treatment choices.Expected impact for public health.Cancer treatment choices are complex decisions, affected by clinical, demographic and social variables. Understanding why women from Newfoundland and Labrador have the highest rate of mastectomy in Canada is critical to ensure they are receiving appropriate screening and care. Greater understanding of the influences on women’s surgical choices may encourage informed decisions amongst women and physicians and promote active communication about treatment, benefits relevant to all jurisdictions and health authorities. Further, if factors such as geographic proximity to treatment facilities are associated with treatment decisions, this information is important for public health screening and service planners.Significance for public healthCancer treatment choices are complex decisions, affected by numerous clinical, demographic and social variables. Research is needed to understand why women from Newfoundland and Labrador have the highest rate of mastectomy in Canada. Greater understanding of the influences on women’s surgical choices may help encourage informed decisions amongst women and physicians and promote active communication about treatment, benefits relevant to all jurisdictions and health authorities. Further, if factors such as geographic proximity to treatment facilities are associated with treatment decisions, this information is important for public healthcare spending and service planners. Finally, it is our hope the findings from this project could help improve the screening process and surgical care of breast cancer patients in Newfoundland and Labrador.

Surgical treatment choices for breast cancer in Newfoundland and Labrador: a retrospective cohort study

“…The full study protocol is described elsewhere. 22 Research questions were both descriptive ("What is the rate of BCS and mastectomy in Newfoundland and Labrador over a 5-year period?") and inferential ("What demographic, geographic and clinical factors are associated with surgery type?").…”

Surgical method of treatment and level of satisfaction with life among women diagnosed with breast cancer, according to time elapsed since performance of surgery

“…Mastectomy is removal of the whole breast, often with the surrounding lymph nodes, and is performed when a woman is not qualified for conserving surgery, or does not express consent for this type of treatment. The types of amputation may be: simple mastectomy (removal of the breast without dissection of the axillary lymph nodes), modified radical mastectomy by Madden, Patey or Halsted, according to the grade of advancement of the breast cancer [5,9]. When advanced cancer is diagnosed, the treatment consists in radiotherapy, chemotherapy and/or hormonal therapy [8].…”

Anesthetic effect of ultrasound-guided multiple-nerve blockade in modified radical mastectomy in patients with breast cancer

“…Breast cancer is the most prevalent malignancy among women, with an incidence of over 1.5 million worldwide per annum, [ 1 , 2 ] and ranks as the second leading cause of cancer-related mortality, with breast cancer alone responsible for the death of 626,679 female patients. Surgery is by far the primary and most effective treatment for breast cancer and over 40% female patients with breast cancer underwent the neoplasm resection.…”