Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kotwall, C. A.
Right arrow Articles by Covan, E. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kotwall, C. A.
Right arrow Articles by Covan, E. K.

Annals of Surgical Oncology, Vol 3, Issue 2 169-175, Copyright © 1996 by Society of Surgical Oncology

ARTICLES

Clinicopathologic factors and patient perceptions associated with surgical breast-conserving treatment

C. A. Kotwall, J. G. Maxwell, D. L. Covington, P. Churchill, S. E. Smith and E. K. Covan
Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, USA.

BACKGROUND: Clinical studies have shown equivalent survival rates between breast-conserving surgery (BCS) and mastectomy in early breast cancer; however, rates for BCS remain low. The purpose of this study was to determine (a) the prevalence of BCS in a regional medical center, (b) clinicopathologic factors associated with BCS, and (c) patient perceptions of the treatment decision-making process. METHODS: We retrospectively reviewed 251 consecutive breast cancer cases during January 1990-December 1991; 77 patients were ineligible for BCS because of unfavorable pathology. We then interviewed 118 of the 160 women available for interview. RESULTS: BCS was performed in 31 of the eligible patients (18%). Multivariate analysis revealed that tumor size < 10 mm (p = 0.03) was the only significant predictive variable for BCS. Patient interviews revealed that 93% said their surgeon was the primary source of information regarding treatment options. Among 69% of the women whose surgeons reportedly recommended a particular option, 89% recommended mastectomy with 93% compliance, and 11% recommended BCS with 89% compliance. The BCS group more often obtained a second opinion (p = 0.04) and 60% said they made the decision themselves compared with only 37% of the mastectomy group (p = 0.05). CONCLUSION: Limiting BCS to women whose tumor size is < 10 mm is too restrictive; this excludes a large number of women who are clinically eligible for BCS. The surgical decision-making process for early-stage breast cancer is very much surgeon-driven, with a high degree of patient compliance.


This article has been cited by other articles:


Home page
 JCOHome page
W. J. Temple, M. L. Russell, L. L. Parsons, S. M. Huber, C. A. Jones., J. Bankes, and M. Eliasziw
Conservation Surgery for Breast Cancer As the Preferred Choice: A Prospective Analysis
J. Clin. Oncol., July 20, 2006; 24(21): 3367 - 3373.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
N. L. Keating, M. B. Landrum, J. Z. Ayanian, E. P. Winer, and E. Guadagnoli
Consultation With a Medical Oncologist Before Surgery and Type of Surgery Among Elderly Women With Early-Stage Breast Cancer
J. Clin. Oncol., December 15, 2003; 21(24): 4532 - 4539.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the Society of Surgical Oncology.