Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

Roder, David; Zorbas, Helen; Kollias, James; Pyke, Chris; Walters, Donald L.; Campbell, Ian; Taylor, Corey; Webster, Fleur

doi:10.7314/apjcp.2013.14.1.539

Cited by 40 publications

(52 citation statements)

References 30 publications

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“…These findings support the literature that has found tumour pathology is an influencing factor behind a patient's decision for surgery, specifically larger tumour size, higher-grade tumours and positive axillary staging (3,6,7,22). Importantly, the published studies do not make it clear whether the tumour data relates to pre-operative or post-operative findings.…”

Section: Discussionsupporting

confidence: 57%

“…Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation women choosing mastectomy rather than BCS including larger tumour size (6), residing in a rural or remote setting (4,7,8) and wish to avoid radiotherapy (9)(10)(11)(12)(13)(14). The Highland Breast Centre provides both screening and symptomatic breast services to the Highlands and Western Isles of Scotland, a population of approximately 310,000 living within approximately 40% of the land mass of the country.…”

Section: Original Articlementioning

confidence: 99%

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Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation

et al. 2016

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Background: Despite being suitable for breast conservation surgery (BCS) a proportion of women choose mastectomy. This study aimed to assess the pre-operative pathological and geographic factors associated with choosing mastectomy rather than BCS in a single centre that serves a large geographical area encompassing urban, rural and remote island populations.Methods: A retrospective analysis of all patients suitable for BCS between January 2011 and December 2013 was undertaken. Pre-operative pathological features were compared using the Pearson chi squared test as was distance to the treatment centre from the patient's home. A questionnaire was sent to all those who chose mastectomy to identify the factors that influenced their decision. Patients choosing mastectomy were more likely to live remotely (P=0.051). Those patients who chose mastectomy felt this gave a better long-term outcome (18 patients, 44%) and peace of mind (14 patients, 34%).Conclusions: Adverse pre-operative pathological features were associated with patients choosing mastectomy rather than BCS. There was a trend for patients who chose mastectomy to live remotely from the treatment centre. Patients choosing mastectomy most commonly cited a better long-term outcome and peace of mind as the reason behind their decision. Understanding what influences a patient's surgical choice will allow clinicians and patients to engage in a fully informed pre-operative decision making process.

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Section: Discussionsupporting

confidence: 57%

Section: Original Articlementioning

confidence: 99%

Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation

et al. 2016

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“…The safety of breast-conserving surgery (BCS) and radiotherapy in comparison to modified radical mastectomy (MRM) for the treatment of early breast cancer has been proven in randomized controlled trials with long-term follow-up (Fisher et al, 2002;Veronesi et al, 2002;Yang et al, 2008;Roder et al, 2013). Despite that, western data show persistent high rates of mastectomy and wide geographic variation in surgical treatment for early breast (Morrow et al, 2001).…”

Section: Introductionmentioning

confidence: 98%

Determinants of Choice of Surgery in Asian Patients with Early Breast Cancer in A Middle Income Country

Teh

Shaari²,

Taib³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Breast-conserving surgery (BCS) plus radiotherapy is equivalent to modified radical mastectomy (MRM) in terms of outcome. However there is wide variation in mastectomy rates dependent both on tumour and patient characteristics. Objective: This study aimed to assess the determinants of surgery choice in Asian patients with early breast cancer in a middle-income country. Materials and Methods: 184 patients with early breast cancer treated between Jan 2008 and Dec 2010 were recruited to complete a questionnaire. Chi-square test was used to analyze the association between surgery choice and demographic and tumour factors, surgeon recommendation, family member and partner opinions, fear of recurrence, avoidance of second surgery, fear of disfigurement, interference with sex life, fear of radiation and loss of femininity. Results: 85 (46%) had BCS while 99 (54%) had mastectomy. Age >60, Chinese ethnicity, lower education level, and larger tumour size were significantly associated with mastectomy. Surgeon recommendation was important in surgery choice. Although both groups did not place much importance on interference with sex life, 14.1% of the BCS group felt it was very important compared to 5.1% in the mastectomy group and this was statistically significant. There was no statistical difference between the two groups in terms of the other factors. When analyzed by ethnicity, significantly more Malay and Indian women considered partner and family member opinions very important and were more concerned about loss of femininity compared to Chinese women. There were no statistical differences between the three ethnic groups in terms of the other factors. Conclusions: When counseling on surgical options, the surgeon has to take into account the ethnicity, social background and education level, age and reliance on partner and family members. Decision-making is usually a collective effort rather than just between the patient and surgeon, and involving the whole family into the process early is important.

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“…Approximately 30% -40% of those diagnosed are treated with a mastectomy [26]. Each vial of Glubran-2 cost approximately AUD $300.00.…”

Section: Resultsmentioning

confidence: 99%

A Double-Blinded Prospective Randomised Controlled Trial to Assess the Efficacy of Glubran-2 in Reducing Seroma Formation after a Mastectomy with or without Axillary Dissection

Clement¹,

Shin²,

Hoffmann³

et al. 2017

ABCR

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Background and Purpose: Seroma formation is a common complication following a mastectomy and axillary surgery. Decreasing the dead space is believed to decrease seroma formation. The aim of this study is to compare the incidence of seroma formation with the use of Glubran-2 versus normal saline during the wound closure in participants undergoing mastectomy with or without axillary dissection. Methods: This multicentre, prospective, double-blinded, randomised controlled trial, enrolled women 18 years of age or older with breast cancer, who were underwent total or partial mastectomy, with or without axillary dissection. Participants were randomised to Glubran-2 or Saline arm. The primary outcome was the volume and duration of wound seroma. Secondary outcome was post-operative wound infection. Results: A total of 76 women were randomised and there was no loss to follow-up or mortality. The total seroma volume was higher in the Glubran-2 arm. The duration of seroma was higher in the mastectomy and axillary dissection group in the Glubran-2 arm (P = 0.69). Elderly and participants with higher BMI had a higher volume of seroma. Post-operative infection rate was higher in the Glubran-2 arm (13.2% vs. 5.6%; P = 0.26). There was no statistically significant difference between the groups. Conclusion: Our study did not show any benefit with the use of Glubran-2 in mastectomy and axillary surgery in reducing the risk of seroma formation. In elderly and obese participants the use of Glubran-2 showed an increase in seroma formation and post-operative wound infection.How to cite this paper:

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Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

Cited by 40 publications

References 30 publications

Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation

Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation

Determinants of Choice of Surgery in Asian Patients with Early Breast Cancer in A Middle Income Country

A Double-Blinded Prospective Randomised Controlled Trial to Assess the Efficacy of Glubran-2 in Reducing Seroma Formation after a Mastectomy with or without Axillary Dissection

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