Skip to main content
Erschienen in: World Journal of Surgery 3/2017

20.10.2016 | Original Scientific Report

Patients Undergoing Breast-Conserving Surgery Can Benefit from the Opportunity to Participate in Choosing Their Surgical Technique

verfasst von: Cecilia Dahlbäck, Jonas Manjer, Martin Rehn, Anita Ringberg

Erschienen in: World Journal of Surgery | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Shared decision-making is increasingly advocated in many countries. The aims of this study were to investigate whether patients receiving breast-conserving surgery at Skåne University Hospital Malmö, Sweden, perceived an offered possibility to join in the decision-making process regarding the surgical method; to identify potential determinants for not having perceived such an offer; and to study how this perception of being offered an opportunity to take part in the decision-making process affected satisfaction with the aesthetic outcome.

Methods

Women offered breast-conserving surgery were consecutively recruited over a period of 4 years. In all, 324 women completed a study-specific questionnaire.

Results

A majority of the women (53 %) perceived that they had not, or had only partly, been offered a possibility to take part in the decision-making process. Patients who reported that they had received enough preoperative information regarding the expected aesthetic result were more likely to have perceived such an offer (odds ratio (OR) 5.44; confidence interval (CI) 2.83–10.43). Women who had perceived an opportunity to be involved were more satisfied with the aesthetic result (OR 2.71; CI 1.18–6.25) and more likely to have had their expectations met regarding the aesthetic result (OR 5.91; CI 2.01–17.38).

Conclusion

When deciding on a suitable surgical approach for women with early breast cancer, physicians could try to more clearly communicate to the women that they can choose whether or not to participate in the decision-making regarding surgical technique. This might improve satisfaction. An important part of patient involvement is sufficient preoperative information.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241CrossRefPubMed Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241CrossRefPubMed
2.
Zurück zum Zitat Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232CrossRefPubMed Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232CrossRefPubMed
3.
Zurück zum Zitat Hansson E, Manjer J, Ringberg A (2014) Reliability of plastic cups to measure breast volume. J Plast Surg Hand Surg 48:254–258CrossRefPubMed Hansson E, Manjer J, Ringberg A (2014) Reliability of plastic cups to measure breast volume. J Plast Surg Hand Surg 48:254–258CrossRefPubMed
4.
Zurück zum Zitat Strombeck JO, Malm M (1986) Priority grouping in a waiting list of patients for reduction mammaplasty. Ann Plast Surg 17:498–502CrossRefPubMed Strombeck JO, Malm M (1986) Priority grouping in a waiting list of patients for reduction mammaplasty. Ann Plast Surg 17:498–502CrossRefPubMed
5.
Zurück zum Zitat Galimberti V, Zurrida S, Zanini V et al (1993) Central small size breast cancer: how to overcome the problem of nipple and areola involvement. Eur J Cancer 29A:1093–1096CrossRefPubMed Galimberti V, Zurrida S, Zanini V et al (1993) Central small size breast cancer: how to overcome the problem of nipple and areola involvement. Eur J Cancer 29A:1093–1096CrossRefPubMed
6.
Zurück zum Zitat McCulley SJ, Macmillan RD (2005) Planning and use of therapeutic mammoplasty—Nottingham approach. Br J Plast Surg 58:889–901CrossRefPubMed McCulley SJ, Macmillan RD (2005) Planning and use of therapeutic mammoplasty—Nottingham approach. Br J Plast Surg 58:889–901CrossRefPubMed
8.
Zurück zum Zitat Cochrane RA, Valasiadou P, Wilson AR et al (2003) Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg 90:1505–1509CrossRefPubMed Cochrane RA, Valasiadou P, Wilson AR et al (2003) Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg 90:1505–1509CrossRefPubMed
9.
Zurück zum Zitat Socialstyrelsen Nationella riktlinjer för bröstcancersjukvård (2007), pp. 20–27 Socialstyrelsen Nationella riktlinjer för bröstcancersjukvård (2007), pp. 20–27
10.
Zurück zum Zitat Hawley ST, Lantz PM, Janz NK et al (2007) Factors associated with patient involvement in surgical treatment decision making for breast cancer. Patient Educ Couns 65:387–395CrossRefPubMed Hawley ST, Lantz PM, Janz NK et al (2007) Factors associated with patient involvement in surgical treatment decision making for breast cancer. Patient Educ Couns 65:387–395CrossRefPubMed
11.
Zurück zum Zitat Keating NL, Guadagnoli E, Landrum MB et al (2002) Treatment decision making in early-stage breast cancer: Should surgeons match patients’ desired level of involvement? J Clin Oncol 20:1473–1479CrossRefPubMed Keating NL, Guadagnoli E, Landrum MB et al (2002) Treatment decision making in early-stage breast cancer: Should surgeons match patients’ desired level of involvement? J Clin Oncol 20:1473–1479CrossRefPubMed
12.
Zurück zum Zitat Lantz PM, Janz NK, Fagerlin A et al (2005) Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Serv Res 40:745–767CrossRefPubMedPubMedCentral Lantz PM, Janz NK, Fagerlin A et al (2005) Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Serv Res 40:745–767CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Wallberg B, Michelson H, Nystedt M et al (2000) Information needs and preferences for participation in treatment decisions among Swedish breast cancer patients. Acta Oncol 39:467–476CrossRefPubMed Wallberg B, Michelson H, Nystedt M et al (2000) Information needs and preferences for participation in treatment decisions among Swedish breast cancer patients. Acta Oncol 39:467–476CrossRefPubMed
14.
Zurück zum Zitat Arora NK, McHorney CA (2000) Patient preferences for medical decision making: Who really wants to participate? Med Care 38:335–341CrossRefPubMed Arora NK, McHorney CA (2000) Patient preferences for medical decision making: Who really wants to participate? Med Care 38:335–341CrossRefPubMed
15.
Zurück zum Zitat Ende J, Kazis L, Ash A et al (1989) Measuring patients’ desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med 4:23–30CrossRefPubMed Ende J, Kazis L, Ash A et al (1989) Measuring patients’ desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med 4:23–30CrossRefPubMed
16.
Zurück zum Zitat Levinson W, Kao A, Kuby A et al (2005) Not all patients want to participate in decision making. A national study of public preferences. J Gen Intern Med 20:531–535CrossRefPubMedPubMedCentral Levinson W, Kao A, Kuby A et al (2005) Not all patients want to participate in decision making. A national study of public preferences. J Gen Intern Med 20:531–535CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Bleicher RJ, Abrahamse P, Hawley ST et al (2008) The influence of age on the breast surgery decision-making process. Ann Surg Oncol 15:854–862CrossRefPubMed Bleicher RJ, Abrahamse P, Hawley ST et al (2008) The influence of age on the breast surgery decision-making process. Ann Surg Oncol 15:854–862CrossRefPubMed
18.
Zurück zum Zitat Degner LF, Sloan JA (1992) Decision making during serious illness: What role do patients really want to play? J Clin Epidemiol 45:941–950CrossRefPubMed Degner LF, Sloan JA (1992) Decision making during serious illness: What role do patients really want to play? J Clin Epidemiol 45:941–950CrossRefPubMed
19.
Zurück zum Zitat Schou I, Ekeberg O, Ruland CM et al (2002) Do women newly diagnosed with breast cancer and consulting surgeon assess decision-making equally? Breast (Edinburgh, Scotland) 11:434–441CrossRef Schou I, Ekeberg O, Ruland CM et al (2002) Do women newly diagnosed with breast cancer and consulting surgeon assess decision-making equally? Breast (Edinburgh, Scotland) 11:434–441CrossRef
20.
Zurück zum Zitat Katz SJ, Lantz PM, Janz NK et al (2005) Patient involvement in surgery treatment decisions for breast cancer. J Clin Oncol 23:5526–5533CrossRefPubMed Katz SJ, Lantz PM, Janz NK et al (2005) Patient involvement in surgery treatment decisions for breast cancer. J Clin Oncol 23:5526–5533CrossRefPubMed
21.
Zurück zum Zitat Collins ED, Moore CP, Clay KF et al (2009) Can women with early-stage breast cancer make an informed decision for mastectomy? J Clin Oncol 27:519–525CrossRefPubMed Collins ED, Moore CP, Clay KF et al (2009) Can women with early-stage breast cancer make an informed decision for mastectomy? J Clin Oncol 27:519–525CrossRefPubMed
22.
Zurück zum Zitat Fallowfield LJ, Hall A, Maguire GP et al (1990) Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. BMJ 301:575–580 (Clinical researched) CrossRefPubMedPubMedCentral Fallowfield LJ, Hall A, Maguire GP et al (1990) Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. BMJ 301:575–580 (Clinical researched) CrossRefPubMedPubMedCentral
Metadaten
Titel
Patients Undergoing Breast-Conserving Surgery Can Benefit from the Opportunity to Participate in Choosing Their Surgical Technique
verfasst von
Cecilia Dahlbäck
Jonas Manjer
Martin Rehn
Anita Ringberg
Publikationsdatum
20.10.2016
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 3/2017
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3768-7

Weitere Artikel der Ausgabe 3/2017

World Journal of Surgery 3/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.