Decision-Making Experience Related to Mastectomy Among Women With Breast Cancer

Liu, Jing; Hunter, Sharyn; Zhu, Jiemin; Lee, Regina; Chan, Sally Wai-Chi

doi:10.1097/ncc.0000000000000981

Cited by 11 publications

(21 citation statements)

References 50 publications

(637 reference statements)

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“…As we collected data from medical records, it is possible that we have missed a few important variables that influence surgical choices, such as education level, personal values, and patient involvement in the decision. Furthermore, we did not assess the role and demographic data of the surgeons involved in these choices, which may influence women's decisions regarding which type of surgery to undergo for their breast cancer [ 40 ]. Future studies are warranted to collect more comprehensive data from different regions of China to explore additional predictors of women's choice of surgery, thereby developing strategies to help Chinese women make better-informed decisions regarding which surgery, or surgeries, they want to undergo to treat their breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Predictors of surgery choices in women with early-stage breast cancer in China: a retrospective study

et al. 2023

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Background The breast-conserving surgery and reconstruction rate in China is relatively low when compared with those in Western countries. Moreover, predictors of surgical choices for women with breast cancer in China have not yet been explored. This study aims to explore differences in the surgical choices of women with different demographic and clinical characteristics and the predictors that influence surgical choices of women with early-stage breast cancer. Methods This retrospective study included women with early-stage (0-II) breast cancer who underwent surgeries at one of two Xiamen University-affiliated hospitals between 2009 and 2017. Using medical records, eleven variables were collected: the woman's age, year of diagnosis, hospital, marital status, payment method, cancer stage, presence of positive axillary lymph node, histology, neoadjuvant chemotherapy, radiotherapy, and the type(s) of surgery they chose. Binary logistic regression was used to analyse predictors of surgical choice. Results A total of 1,787 cases were included in this study. Of the total number of women with breast cancer, 61.3% underwent mastectomy without breast reconstruction, 26.4% underwent mastectomy with breast reconstruction, and the remaining 12.2% chose breast-conserving surgery. Women with different demographic and clinical characteristics underwent different types of surgery. Cancer stage, neoadjuvant chemotherapy, radiotherapy, and the choice of hospital were found to be predictors of breast-conserving surgery. Meanwhile, age, year of diagnosis, payment method, neoadjuvant chemotherapy, and the choice of hospital were found to be predictors of reconstruction after mastectomy in women with early-stage breast cancer. Conclusions In China, surgical choices for women with breast cancer have diversified. Healthcare workers should understand the surgical preferences of women of different ages. For early detection of breast cancer, knowledge of breast self-examination and breast cancer screening should be provided. Adequate information about the safety of reconstruction and advocacy for medical insurance coverage of reconstruction should be offer. Breast surgeons need specialised training and standardising protocols towards different types of breast surgery. These actions will help women make better, well-informed decisions about their breast surgeries.

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Section: Discussionmentioning

confidence: 99%

Predictors of surgery choices in women with early-stage breast cancer in China: a retrospective study

et al. 2023

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“…Making treatment decisions to undergo a mastectomy can be challenging for women because they may need to consider not only survival outcomes but also their physical appearance issues (Liu, Hunter, et al., 2021). Research has demonstrated that many women who have had a mastectomy experience decisional conflict (Liu et al., 2023), which is defined as the uncertainty surrounding this treatment decision (O'Connor, 1995). This feeling of uncertainty could lead to dissatisfaction and regret with treatment decisions (Lee & Knobf, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…The evidence regarding women's experiences with making the decision to undergo a mastectomy is limited (Liu, Hunter, et al., 2021). Although many studies have explored women's experiences with making treatment decisions about breast cancer, these studies have covered a variety of treatment approaches, and evidence for mastectomy has been less reported (Abdullah et al., 2013; O'Brien et al., 2008; Schubart et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

Decision‐making experiences related to mastectomy: A descriptive qualitative study

Liu,

Chan,

Guo

et al. 2023

Journal of Advanced Nursing

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AimTo obtain an in‐depth understanding of women's decision‐making experiences related to mastectomy.DesignA descriptive qualitative interview study.MethodsIndividual semi‐structured interviews were conducted face‐to‐face with 27 Chinese women with breast cancer who underwent mastectomy at two tertiary hospitals in mainland China between September 2020 and December 2021 after obtaining the appropriate ethical approvals. Interviews were conducted in Mandarin. Data were analysed using inductive content analysis.ResultsMean age of participants was 48 years (range 31–70). Most participants had low education, low monthly family income, had a partner and health insurance, had been diagnosed with early breast cancer, and had not undergone reconstructive surgery. Six categories related to decision‐making experiences emerged: (1) Emotions affecting decision‐making, (2) Information seeking for decision‐making, (3) Beliefs about mastectomy and the breast, (4) Participation in decision‐making, (5) People who influence decision‐making, and (6) Post‐decision reflection. Participants did not mention the role of nurses in their decision‐making process for mastectomy.ConclusionsThis study adds valuable insights into the limited evidence on women's experience with decision‐making about mastectomy from a Chinese perspective, which is important given the continuing high prevalence of mastectomy in many regions. Future studies from other countries and ethnic groups are recommended to gain diverse knowledge.ImpactThe findings of this study are useful for nurses and other healthcare professionals in the multidisciplinary team to better support women with breast cancer in their decision‐making process regarding mastectomy. The findings could inform future interventions to support treatment decision‐making and may be relevant to women living in similar socio‐medical contexts to those in mainland China.Reporting MethodThe study was reported following the Standards for Reporting Qualitative Research checklist.Patient or Public ContributionNo patient or public contribution.

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Section: Introductionmentioning

confidence: 99%

“…Reviews summarising evidence about patients’ decision-making about breast cancer treatments have been published 22 23. However, they did not specifically address the issue of regret about treatment decisions, and were not able to generalise to the whole population because these reviews only included older women22 and women who had a mastectomy 23. Previous reviews on decision regret related to breast reconstruction24 and risk-reducing treatment25 26 also could not provide a holistic understanding of decision regret regarding EBC treatments because other treatments, such as BCS, chemotherapy and radiotherapy, are also common choices for EBC.…”

Section: Introductionmentioning

confidence: 99%

Decision regret regarding treatments among women with early-stage breast cancer: a systematic review protocol

et al. 2022

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IntroductionWomen with early-stage breast cancer (EBC) are commonly required to make treatment decisions. Decision regret regarding treatments is an adverse outcome that negatively affects women’s psychological well-being and quality of life. A systematic review will be conducted to synthesise evidence about decision regret among women regarding treatments for EBC. The study will focus on levels of decision regret, what is regretted, and the factors associated with decision regret.Methods and analysisA systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 checklist. Electronic databases, including CINAHL Complete, Embase, PubMed, Medline and Web of Science, will be searched for relevant articles published from 2000 to 2021. The reference lists of eligible studies will also be manually searched. All types of quantitative, qualitative and mixed-methods studies that report on decision regret regarding treatments among women with EBC will be included. The primary outcome of this review will be women’s levels of decision regret regarding breast cancer treatments. The secondary outcomes will include the content of their regrets, and the factors contributing to decision regret. The methodological quality of the studies will be assessed using the Joanna Briggs Institute appraisal tools. Meta-analysis and thematic synthesis approaches will be used to synthesise quantitative and qualitative data, respectively. A convergent parallel approach will be used to integrate quantitative and qualitative findings.Ethics and disseminationEthical approval is not required for this systematic review. The findings of this work will be disseminated at international conferences and peer-reviewed journals. The findings of this systematic review will inform the development of decision interventions to improve the decision outcomes of breast cancer treatments.PROSPERO registration numberCRD42021260041.

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Decision-Making Experience Related to Mastectomy Among Women With Breast Cancer

Cited by 11 publications

References 50 publications

Predictors of surgery choices in women with early-stage breast cancer in China: a retrospective study

Predictors of surgery choices in women with early-stage breast cancer in China: a retrospective study

Decision‐making experiences related to mastectomy: A descriptive qualitative study

Decision regret regarding treatments among women with early-stage breast cancer: a systematic review protocol

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