Annals of Surgical Oncology

, Volume 3, Issue 2, pp 169–175

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

Authors

  • Cyrus A. Kotwall
    • From the Departments of Surgery, School of MedicineUniversity of North Carolina at Chapel Hill
    • New Hanover Regional Medical Center
    • Coastal Area Health Education Center
  • J. Gary Maxwell
    • From the Departments of Surgery, School of MedicineUniversity of North Carolina at Chapel Hill
    • New Hanover Regional Medical Center
    • Coastal Area Health Education Center
  • Deborah L. Covington
    • New Hanover Regional Medical Center
  • Paige Churchill
    • New Hanover Regional Medical Center
  • Susan E. Smith
    • New Hanover Regional Medical Center
    • Coastal Area Health Education Center
  • Eleanor Krassen Covan
    • University of North Carolina at Wilmington
Original Articles

DOI: 10.1007/BF02305797

Cite this article as:
Kotwall, C.A., Maxwell, J.G., Covington, D.L. et al. Annals of Surgical Oncology (1996) 3: 169. doi:10.1007/BF02305797

Abstract

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.

Key Words

Breast cancerSurgerySegmental mastectomyBreast-conserving surgeryPatient interview

Copyright information

© The Society of Surgical Oncology, Inc. 1996