Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (12): 1-6.doi: 10.6040/j.issn.1671-7554.0.2022.1143

• Expert Commentary •     Next Articles

Factors related to decision-making of breast-conserving surgery for female breast cancer

Yajie ZHOU,Fei WANG,Lixiang YU,Zhigang YU*()   

  1. Department of Breast Surgery, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2022-10-10 Online:2022-12-10 Published:2022-12-01
  • Contact: Zhigang YU E-mail:yzg@medmail.com.cn

Abstract:

Breast-conserving surgery has become the standard operation for women with early breast cancer. However, the overall rate of the surgery is still low in China, and many patients with indications failed to receive breast-conserving surgery. Factors affecting the decision to receive surgery are complex, involving social and economic factors such as age, family income and education level. In addition, recommendations of doctors, medical services related to radiation therapy, concern of recurrence also have impacts. This article will review related factors influencing the decision-making of breast cancer patients with breast-conserving surgery indications, so as to provide reference for improving the rate of surgery.

Key words: Breast cancer, Breast-conserving surgery, Mammectomy, Decision-making, Related factors

CLC Number: 

  • R655.8
1 Sung H , Ferlay J , Siegel RL , et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71 (3): 209- 249.
doi: 10.3322/caac.21660
2 Veronesi U , Cascinelli N , Mariani L , et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer[J]. N Engl J Med, 2002, 347 (16): 1227- 1232.
doi: 10.1056/NEJMoa020989
3 van Maaren MC , de Munck L , de Bock GH , et al. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands: a population-based study[J]. Lancet Oncol, 2016, 17 (8): 1158- 1170.
doi: 10.1016/S1470-2045(16)30067-5
4 Agarwal S , Pappas L , Neumayer L , et al. Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer[J]. JAMA Surg, 2014, 149 (3): 267- 274.
doi: 10.1001/jamasurg.2013.3049
5 de Boniface J , Szulkin R , Johansson a . Survival after breast conservation vs mastectomy adjusted for comorbidity and socioeconomic status: a Swedish national 6-year follow-up of 48 986 women[J]. JAMA Surg, 2021, 156 (7): 628- 637.
doi: 10.1001/jamasurg.2021.1438
6 Härtl K , Janni W , Kästner R , et al. Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients[J]. Ann Oncol, 2003, 14 (7): 1064- 1071.
doi: 10.1093/annonc/mdg289
7 Chen K , Liu JQ , Wu W , et al. Clinical practice guideline for breast-conserving surgery in patients with early-stage breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021[J]. Chin Med J (Engl), 2021, 134 (18): 2143- 2146.
doi: 10.1097/CM9.0000000000001518
8 Yu LX , Shi P , Tian XS , et al. A multi-center investigation of breast-conserving surgery based on data from the Chinese Society of Breast Surgery (CSBrS-005)[J]. Chin Med J (Engl), 2020, 133 (22): 2660- 2664.
doi: 10.1097/CM9.0000000000001152
9 Kummerow KL , Du L , Penson DF , et al. Nationwide trends in mastectomy for early-stage breast cancer[J]. JAMA Surg, 2015, 150 (1): 9- 16.
doi: 10.1001/jamasurg.2014.2895
10 Suen D , Chow L , Kwong A . Breast-conserving surgery in Hong Kong Chinese women[J]. World J Surg, 2008, 32 (12): 2549- 2553.
doi: 10.1007/s00268-008-9586-9
11 Chen R , You S , Yin Z , et al. Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery[J]. World J Surg Oncol, 2019, 17 (1): 189.
doi: 10.1186/s12957-019-1723-4
12 Lam WW , Fielding R , Ho EY , et al. Surgeon's recommendation, perceived operative efficacy and age dictate treatment choice by Chinese women facing breast cancer surgery[J]. Psychooncology, 2005, 14 (7): 585- 593.
doi: 10.1002/pon.877
13 李习, 刘美娜, 张秋菊. 基于多重对应分析的早期乳腺癌保乳手术影响因素研究[J]. 中国医院统计, 2020, 27 (6): 490- 493.
doi: 10.3969/j.issn.1006-5253.2020.06.004
LI Xi , LIU Meina , ZHANG Qiuju . Study on the influencing factors of breast conserving surgery for early breast cancer based on multiple correspondence analysis[J]. Chinese Journal of Hospital Statistics, 2020, 27 (6): 490- 493.
doi: 10.3969/j.issn.1006-5253.2020.06.004
14 Hershman DL , Buono D , Jacobson JS , et al. Surgeon characteristics and use of breast conservation surgery in women with early stage breast cancer[J]. Ann Surg, 2009, 249 (5): 828- 833.
doi: 10.1097/SLA.0b013e3181a38f6f
15 Chan S , Cheung C , Chan A , et al. Surgical options for Chinese patients with early invasive breast cancer: Data from the Hong Kong Breast Cancer Registry[J]. Asian J Surg, 2017, 40 (6): 444- 452.
doi: 10.1016/j.asjsur.2016.02.003
16 Whelan T , Levine M , Willan A , et al. Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial[J]. JAMA, 2004, 292 (4): 435- 441.
doi: 10.1001/jama.292.4.435
17 杨林宁, 杨艳, 胡嘉乐, 等. 决策辅助工具用于乳腺癌患者的研究进展[J]. 护理学杂志, 2020, 35 (2): 110- 113.
doi: 10.3870/j.issn.1001-4152.2020.02.110
YANG Linning , YANG Yan , HU Jiale , et al. Research progress on application of decision aids in breast cancer patients[J]. Journal of Nursing Science, 2020, 35 (2): 110- 113.
doi: 10.3870/j.issn.1001-4152.2020.02.110
18 周露. 乳腺癌保留乳房手术选择影响因素分析[D]. 泸州: 西南医科大学, 2020.
19 Molenaar S , Oort F , Sprangers M , et al. Predictors of patients' choices for breast-conserving therapy or mastectomy: a prospective study[J]. Br J Cancer, 2004, 90 (11): 2123- 2130.
doi: 10.1038/sj.bjc.6601835
20 张景涵. 乳腺癌女性患者乳腺癌根治术和保乳手术选择意愿调查及影响因素分析[J]. 中国妇幼保健, 2020, 35 (20): 3868- 3871.
doi: 10.19829/j.zgfybj.issn.1001-4411.2020.20.050
21 Liu JJ , Zhang S , Hao X , et al. Breast-conserving therapy versus modified radical mastectomy: socioeconomic status determines who receives what--results from case-control study in Tianjin, China[J]. Cancer Epidemiol, 2012, 36 (1): 89- 93.
doi: 10.1016/j.canep.2011.04.005
22 Zhang L , Jiang M , Zhou Y , et al. Survey on breast cancer patients in China toward breast-conserving surgery[J]. Psychooncology, 2012, 21 (5): 488- 495.
doi: 10.1002/pon.1922
23 张佩雯, 张辉, 李明爽, 等. 基于医患双方的女性早期乳腺癌选择保乳手术的影响因素研究[J]. 中华流行病学杂志, 2021, 42 (11): 2044- 2052.
doi: 10.3760/cma.j.cn112338-20210516-00402
ZHANG Peiwen , ZHANG Hui , LI Mingshuang , et al. Factors associated with selection of breast-conserving surgery in early female patients with breast cancer[J]. Chinese Journal of Epidemiology, 2021, 42 (11): 2044- 2052.
doi: 10.3760/cma.j.cn112338-20210516-00402
24 Lautner M , Lin H , Shen Y , et al. Disparities in the use of breast-conserving therapy among patients with early-stage breast cancer[J]. JAMA Surg, 2015, 150 (8): 778- 786.
doi: 10.1001/jamasurg.2015.1102
25 张燕娜, 孙强, 周易冬, 等. 知识宣教对乳腺癌患者保留乳房选择影响的前瞻性队列研究[J]. 中华乳腺病杂志(电子版), 2015, 9 (4): 257- 263.
ZHANG Yanna , SUN Qiang , ZHOU Yidong , et al. Influence of cancer education on breast-conserving surgery decision-making of breast cancer patients: a prospective cohort study[J]. Chinese Journal of Breast Disease (Electronic Edition), 2015, 9 (4): 257- 263.
26 Cimprich B . Pretreatment symptom distress in women newly diagnosed with breast cancer[J]. Cancer Nurs, 1999, 22 (3): 185- 194.
doi: 10.1097/00002820-199906000-00001
27 Schou I , Ekeberg Ø , Ruland CM , et al. Do women newly diagnosed with breast cancer and consulting surgeon assess decision-making equally?[J]. Breast, 2002, 11 (5): 434- 441.
doi: 10.1054/brst.2002.0454
28 Fisher CS , Martin-Dunlap T , Ruppel MB , et al. Fear of recurrence and perceived survival benefit are primary motivators for choosing mastectomy over breast-conservation therapy regardless of age[J]. Ann Surg Oncol, 2012, 19 (10): 3246- 3250.
doi: 10.1245/s10434-012-2525-x
29 Hawley ST , Griggs JJ , Hamilton AS , et al. Decision involvement and receipt of mastectomy among racially and ethnically diverse breast cancer patients[J]. J Natl Cancer Inst, 2009, 101 (19): 1337- 1347.
doi: 10.1093/jnci/djp271
30 Pham JT , Allen LJ , Gomez SL . Why do Asian-American women have lower rates of breast conserving surgery: results of a survey regarding physician perceptions[J]. BMC Public Health, 2009, 9, 246.
doi: 10.1186/1471-2458-9-246
31 Yau TK , Soong IS , Sze H , et al. Trends and patterns of breast conservation treatment in Hong Kong: 1994-2007[J]. Int J Radiat Oncol Biol Phys, 2009, 74 (1): 98- 103.
doi: 10.1016/j.ijrobp.2008.07.066
32 Zhang L , Zhou Y , Fu R , et al. Survey on Chinese breast cancer patients' husbands toward breast conserving surgery[J]. J BUON, 2014, 19 (4): 887- 894.
33 Zhang L , Gao J , Lin D , et al. Personal factors influencing breast cancer patients' perception of breast conservation surgery in West China[J]. Ann Transl Med, 2019, 7 (14): 313.
doi: 10.21037/atm.2019.06.43
34 Li Y , Ye S , Zhou Y , et al. Web-based medical information searching by chinese patients with breast cancer and its influence on survival: observational study[J]. J Med Internet Res, 2020, 22 (4): e16768.
doi: 10.2196/16768
35 张烨, 易俊林, 姜威, 等. 2019年中国大陆地区放疗人员和设备基本情况调查研究[J]. 中国肿瘤, 2020, 29 (5): 321- 326.
ZHANG Ye , YI Junlin , JIANG Wei , et al. Survey on the basic information of personnel and facilities of radiotherapy in Chinese mainland in 2019[J]. China Cancer, 2020, 29 (5): 321- 326.
36 Fan L , Strasser-Weippl K , Li JJ , et al. Breast cancer in China[J]. Lancet Oncol, 2014, 15 (7): e279- 289.
doi: 10.1016/S1470-2045(13)70567-9
37 Bai Y , Ye M , Cao H , et al. Economic evaluation of radiotherapy for early breast cancer after breast-conserving surgery in a health resource-limited setting[J]. Breast Cancer Res Treat, 2012, 136 (2): 547- 557.
doi: 10.1007/s10549-012-2268-1
38 Zhang B , Song Q , Zhang B , et al. A 10-year (1999~2008) retrospective multi-center study of breast cancer surgical management in various geographic areas of China[J]. Breast, 2013, 22 (5): 676- 681.
doi: 10.1016/j.breast.2013.01.004
39 Yang B , Ren G , Song E , et al. Current status and factors influencing surgical options for breast cancer in China: a nationwide cross-sectional survey of 110 hospitals[J]. Oncologist, 2020, 25 (10): e1473- e1480.
doi: 10.1634/theoncologist.2020-0001
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