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Determinants of Breast-Conserving Therapy in the Asian Population: A Systematic Review

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Abstract

Background

Treatment guidelines recommend breast-conserving therapy (BCT) for patients with early-stage breast cancer. However, Asian patients choose mastectomy over BCT, and the factors influencing this choice are unknown. This review aimed to identify the factors most frequently reported in the Eastern and Southeastern Asian population influencing the choice of BCT for treatment of early-stage breast cancer.

Methods

PRISMA guidelines were followed, and PubMed and EMBASE databases were used. The literature search initially identified 4619 articles; abstract screening and full-text screening were performed on 150 and 19 articles, respectively, and 9 articles were finally included in the study.

Results

Selection of BCT was associated with sociodemographic factors, such as high socioeconomic status and education level and young age at diagnosis; clinicopathological factors, such as small tumor size and mammographically detected tumors; and healthcare provider factors, such as treatment from a female doctor or from a breast specialist. However, not selecting BCT was associated with personal factors, such as fear of recurrence and avoidance of further treatment.

Conclusions

The process of making a treatment decision is complicated and involves many factors influencing patients’ choice of surgery type. Exploring these factors helps to elucidate why patients do not choose BCT as their treatment option.

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Funding

This study is funded by The Health and Welfare surcharge of Tobacco Products; Grant title: From Value-Based Cancer Care to Precision Medicine in Oncology (MOHW108-TDU-B-212–124021).

Author information

Authors and Affiliations

  1. Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, 125 Lih-Der Rd, Pei-Tou District, Taipei, Taiwan

    Maria Paz Galeano Machuca & Chih-Tao Cheng

  2. Department of Medicine, National Taiwan University, Taipei, Taiwan

    Shelly Chien-Chien Cheng

  3. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Tony Hong-Ting Jou

  4. Department of Psychology and Social Work, National Defense University, Taipei, Taiwan

    Chih-Tao Cheng

Authors
  1. Maria Paz Galeano Machuca
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  2. Shelly Chien-Chien Cheng
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  3. Tony Hong-Ting Jou
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  4. Chih-Tao Cheng
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Correspondence to Chih-Tao Cheng.

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Appendix 1

Appendix 1

Search Strategy PubMed.

((((((((((((Breast neoplasm*[MeSH Terms]) OR Breast cancer[Title/Abstract]) OR neoplasm*[Title/Abstract]) OR tumor[Title/Abstract]) OR tumors[Title/Abstract]) OR tumour[Title/Abstract]) OR cancer*[Title/Abstract]) OR carcinoma[Title/Abstract]) OR mammary[Title/Abstract]) OR breast[Title/Abstract])) AND ((("mastectomy, segmental"[MeSH Terms]) OR breast conserv*[Title/Abstract]) OR lumpect*[Title/Abstract])) AND (((((((Predictors[Title/Abstract]) OR determinants[Title/Abstract]) OR Associated factors[Title/Abstract]) OR factors[Title/Abstract]) OR Predict*[Title/Abstract]) OR related factors[Title/Abstract]) OR factors associated[Title/Abstract]) AND (("1990/01/01"[PDat]: "2019/12/31"[PDat]) AND Humans[Mesh] AND English[lang]).

Search Strategy EMBASE.

'breast cancer'/de OR 'breast tumor'/de OR neoplasm:ab,ti OR 'malignant neoplasm':ab,ti OR carcinoma:ab,ti OR 'breast tumor':ab,ti OR 'breast cancer':ab,ti) AND ('partial mastectomy'/de OR 'partial mastectomy':ab,ti OR 'breast conserving therapy':ab,ti OR 'breast conserv*':ab,ti) AND (predictors:ab,ti OR determinant:ab,ti OR determinants:ab,ti OR 'associated factors':ab,ti OR 'related factors':ab,ti OR 'factors associated':ab,ti) AND [humans]/lim AND [english]/lim AND [1990–2019]/py.

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Galeano Machuca, M.P., Cheng, S.CC., Jou, T.HT. et al. Determinants of Breast-Conserving Therapy in the Asian Population: A Systematic Review. World J Surg 45, 799–807 (2021). https://doi.org/10.1007/s00268-020-05814-6

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  • DOI: https://doi.org/10.1007/s00268-020-05814-6

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