Charlotte Davies
Understanding women’s decision making for and against oncoplastic breast conserving surgery as an alternative to mastectomy in early breast cancer: UK ANTHEM qualitative study
Davies, Charlotte; Conefrey, Carmel; Mills, Nicola; Fairbrother, Patricia; Holcombe, Chris; Whisker, Lisa; Skillman, Joanna; White, Paul; Macmillan, Douglas; Comins, Charles; Hollingworth, William; Potter, Shelley
Authors
Carmel Conefrey
Nicola Mills
Patricia Fairbrother
Chris Holcombe
Lisa Whisker
Joanna Skillman
Paul White Paul.White@uwe.ac.uk
Professor in Applied Statistics
Douglas Macmillan
Charles Comins
William Hollingworth
Shelley Potter
Abstract
ABSTRACT
Background: Oncoplastic breast conserving surgery (OPBCS) may allow women with early breast cancer to avoid mastectomy, but many women choose more extensive surgery even when breast conserving options are offered. Reasons for this are unclear. The ANTHEM qualitative study aimed to explore factors influencing women’s surgical decision-making for and against OPBCS.
Methods: Semi-structured interviews were conducted with a purposive sample of women who had received either OPBCS or mastectomy +/- immediate breast reconstruction (IBR) to explore their rationale for procedure choice. Interviews were transcribed verbatim and analysed thematically.
Results: Twenty-seven women from 12 centres were interviewed; 12 who had chosen OPBCS and 15 mastectomy +/- IBR respectively. Overwhelmingly, women’s decisions were guided by their surgical teams with women’s decision-making for and against OPBCS influenced by three key inter-related factors: i) perceptions of oncological safety; ii) maintenance/restoration of femininity and iii) practical issues. Oncological safety was paramount. Women who felt reassured that OPBCS was oncologically safe were happy to accept this option. Those who were not were more likely to opt for mastectomy as a ‘safer’ option. Most women wished to maintain/restore femininity with the offer of IBR essential to make mastectomy an acceptable option. Practical issues such as the perceived magnitude of the surgery were a lesser concern.
Conclusions: Women’s decision-making is complex and heavily influenced by the surgical team. High-quality, accurate information about surgical options including appropriate reassurance about short- and long-term oncological safety of OPBCS is vital if women are to make fully informed decisions.
Trial registration number: ISRCTN18238549
Citation
Davies, C., Conefrey, C., Mills, N., Fairbrother, P., Holcombe, C., Whisker, L., …Potter, S. (in press). Understanding women’s decision making for and against oncoplastic breast conserving surgery as an alternative to mastectomy in early breast cancer: UK ANTHEM qualitative study. British Journal of Surgery,
Journal Article Type | Article |
---|---|
Acceptance Date | May 4, 2024 |
Deposit Date | May 5, 2024 |
Journal | British Journal of Surgery |
Print ISSN | 0007-1323 |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Public URL | https://uwe-repository.worktribe.com/output/11977509 |
You might also like
Disclosure control issues in complex medical data
(2023)
Presentation / Conference
Towards a comprehensive theory and practice of output SDC
(2023)
Presentation / Conference
Downloadable Citations
About UWE Bristol Research Repository
Administrator e-mail: repository@uwe.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search