<1. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27837638 VI - 1 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Seretis C AU - Seretis F FA - Seretis, Charalampos FA - Seretis, Fotios IN - Seretis, Charalampos. Department of General Surgery, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, United Kingdom. TI - Development of a novel scoring system to potentially avoid completion axillary lymph node clearance after breast cancer excision and positive sentinel lymph node biopsy. SO - Journal of B.U.On.. 21(5):1316-1319, 2016 Sept-Oct AS - J. Balk. Union Oncol.. 21(5):1316-1319, 2016 Sept-Oct NJ - Journal of B.U.ON. : official journal of the Balkan Union of Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - 100883428 IO - J BUON SB - Index Medicus CP - Greece MH - Adult MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Lymph Node Excision/ae [Adverse Effects] MH - *Lymph Node Excision MH - Lymphatic Metastasis MH - Mastectomy/ae [Adverse Effects] MH - *Mastectomy MH - Middle Aged MH - Neoplasm Grading MH - Predictive Value of Tests MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Sentinel Lymph Node/pa [Pathology] MH - *Sentinel Lymph Node/su [Surgery] MH - *Sentinel Lymph Node Biopsy MH - Treatment Outcome MH - Tumor Burden IS - 1107-0625 IL - 1107-0625 PT - Journal Article PP - ppublish LG - English DP - 2016 Sept-Oct DC - 20161112 EZ - 2016/11/13 06:00 DA - 2017/06/09 06:00 DT - 2016/11/13 06:00 YR - 2016 ED - 20170608 RD - 20170608 UP - 20170609 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27837638 <2. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28350657 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mundy LR AU - Homa K AU - Klassen AF AU - Pusic AL AU - Kerrigan CL FA - Mundy, Lily R FA - Homa, Karen FA - Klassen, Anne F FA - Pusic, Andrea L FA - Kerrigan, Carolyn L IN - Mundy, Lily R. Durham, N.C.; Lebanon, N.H.; Hamilton, Ontario, Canada; and New York, N.Y. From the Division of Plastic and Reconstructive Surgery, Duke University; the Section of Plastic Surgery, Dartmouth Hitchcock Medical Center; McMaster University; and the Plastic and Reconstructive Service, Memorial Sloan Kettering Cancer Center. TI - Normative Data for Interpreting the BREAST-Q: Augmentation. SO - Plastic & Reconstructive Surgery. 139(4):846-853, 2017 Apr AS - Plast Reconstr Surg. 139(4):846-853, 2017 Apr NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Data Interpretation, Statistical MH - Female MH - Humans MH - *Mammaplasty/st [Standards] MH - Middle Aged MH - *Patient Reported Outcome Measures AB - BACKGROUND: The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation. AB - METHODS: Normative data were generated for the BREAST-Q Augmentation module by means of the Army of Women, an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited by means of e-mail; women aged 18 years or older without a history of breast cancer or breast surgery were invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies. AB - RESULTS: The preoperative BREAST-Q Augmentation module was completed by 1211 women. Mean age was 54 +/- 24 years, the mean body mass index was 27 +/- 6 kg/m, and 39 percent (n = 467) had a bra cup size of D or greater. Mean scores were as follows: Satisfaction with Breasts, 54 +/- 19; Psychosocial Well-being, 66 +/- 20; Sexual Well-being, 49 +/- 20; and Physical Well-being, 86 +/- 15. Women with a body mass index of 30 kg/m or greater and bra cup size of D or greater had lower scores. In comparison with Army of Women scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being. AB - CONCLUSIONS: The Army of Women normative data represent breast-related satisfaction and well-being in women not actively seeking breast augmentation. These data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201704000-00013 DO - https://dx.doi.org/10.1097/PRS.0000000000003186 PT - Journal Article ID - 10.1097/PRS.0000000000003186 [doi] ID - 00006534-201704000-00013 [pii] ID - PMC5373485 [pmc] ID - NIHMS830003 [mid] PP - ppublish PH - 2018/04/01 [pmc-release] GI - No: P30 CA008748 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2017 Apr DC - 20170328 EZ - 2017/03/29 06:00 DA - 2017/06/02 06:00 DT - 2017/03/30 06:00 YR - 2017 ED - 20170601 RD - 20170601 UP - 20170605 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=28350657 <3. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26107523 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Harcourt D AU - Griffiths C AU - Baker E AU - Hansen E AU - White P AU - Clarke A FA - Harcourt, Diana FA - Griffiths, Catrin FA - Baker, Elisabeth FA - Hansen, Esther FA - White, Paul FA - Clarke, Alex IN - Harcourt, Diana. a Centre for Appearance Research , University of the West of England , Bristol , UK. IN - Griffiths, Catrin. a Centre for Appearance Research , University of the West of England , Bristol , UK. IN - Baker, Elisabeth. b Department of Plastic and Reconstructive Surgery , Royal Free Hospital , London , UK. IN - Hansen, Esther. b Department of Plastic and Reconstructive Surgery , Royal Free Hospital , London , UK. IN - White, Paul. c Department of Engineering, Design and Mathematics , University of the West of England , Bristol , UK. IN - Clarke, Alex. b Department of Plastic and Reconstructive Surgery , Royal Free Hospital , London , UK. TI - The acceptability of PEGASUS: an intervention to facilitate shared decision-making with women contemplating breast reconstruction. SO - Psychology Health & Medicine. 21(2):248-53, 2016 AS - PSYCHOL HEALTH MED. 21(2):248-53, 2016 NJ - Psychology, health & medicine PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9604099 IO - Psychol Health Med PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720038 SB - Index Medicus CP - England MH - Adult MH - Aged MH - Attitude to Health MH - Breast Neoplasms/su [Surgery] MH - Communication MH - *Decision Making MH - Feasibility Studies MH - Female MH - Humans MH - *Mammaplasty/px [Psychology] MH - Mastectomy MH - Middle Aged MH - *Patient Participation/mt [Methods] MH - Physician-Patient Relations MH - Qualitative Research MH - Referral and Consultation MH - Trust KW - PEGASUS; acceptability; breast reconstruction; intervention; shared decision-making AB - Good practice guidelines recommend that women who undergo mastectomy are offered reconstructive surgery. However, many who choose this option report a degree of decisional regret and dissatisfaction because their pre-surgical expectations were not met. This paper reports an acceptability study of a new intervention (PEGASUS) that aims to support shared decision-making by eliciting women's pre-surgical expectations and setting patient-centred goals. Eighteen women contemplating breast reconstruction completed the PEGASUS intervention. Semi-structured interviews were conducted with 12 women and 3 health professionals to explore their experiences of using PEGASUS. Interview transcripts were subjected to a thematic analysis, and a content analysis was conducted on 79 goals that the 18 women identified. Feedback was extremely positive--women found that completing PEGASUS alongside a discussion with a specially trained health professional helped them prepare for the surgical consultation and increased their trust in their surgeon. Staff reported that PEGASUS facilitated patient-centred discussions and informed the decisions made about potential surgery. This preliminary study suggests that this novel intervention is acceptable to patients and health professionals alike. Further work is needed to evaluate its efficacy and then its effectiveness with a larger sample of women, and its potential use with other patient groups. ES - 1465-3966 IL - 1354-8506 DO - https://dx.doi.org/10.1080/13548506.2015.1051059 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10.1080/13548506.2015.1051059 [doi] ID - PMC4720038 [pmc] PP - ppublish LG - English EP - 20150624 DP - 2016 DC - 20160119 EZ - 2015/06/25 06:00 DA - 2017/05/31 06:00 DT - 2015/06/25 06:00 YR - 2016 ED - 20170530 RD - 20170530 UP - 20170601 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26107523 <4. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27782983 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mohan AT AU - Zhu L AU - Wang Z AU - Vijayasekaran A AU - Saint-Cyr M FA - Mohan, Anita T FA - Zhu, Lin FA - Wang, Zhen FA - Vijayasekaran, Aparna FA - Saint-Cyr, Michel IN - Mohan, Anita T. Rochester, Minn.; and London and Cambridge, UnitedKingdom From the Division of Plastic Surgery and the Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic; the Restoration of Appearance and Function Charitable Trust; and the Department of Surgery, University of Cambridge. TI - Techniques and Perforator Selection in Single, Dominant DIEP Flap Breast Reconstruction: Algorithmic Approach to Maximize Efficiency and Safety. SO - Plastic & Reconstructive Surgery. 138(5):790e-803e, 2016 Nov AS - Plast Reconstr Surg. 138(5):790e-803e, 2016 Nov NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Algorithms MH - Decision Support Techniques MH - *Epigastric Arteries/su [Surgery] MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Middle Aged MH - Outcome Assessment (Health Care) MH - Patient Safety MH - *Perforator Flap/bs [Blood Supply] MH - Perforator Flap/su [Surgery] MH - Retrospective Studies AB - BACKGROUND: Perforator selection is critical to deep inferior epigastric perforator (DIEP) flap harvest. Commitment to a single perforator has the potential benefit of a simpler dissection, but may increase fat necrosis or perfusion-related complications compared with multiple perforator harvest. AB - METHODS: A 3-year retrospective study was carried out of all patients who underwent DIEP flap breast reconstruction performed by the senior author (M.S.-C). Data were collected on patient demographics and surgical outcomes. AB - RESULTS: One hundred eighty-three flaps were performed (105 patients) over 3 years. One hundred fifty-six bilateral (78 patients) and 24 unilateral flaps were included in the final study. Mean age was 47.8 +/- 8.4 years and mean body mass index was 29.1 +/- 5.3 kg/m. Seventy-five percent of flaps were based on single dominant perforators. Single perforators were used in 33.3 percent of flaps weighing over 1000 g, 80 and 74 percent of flaps weighing 500 to 1000 g and less than 500 g, respectively (p = 0.01). There were no differences in overall complications between single- versus multiple-perforator DIEP flaps. Neither body mass index nor flap weight posed additional risk to overall complications. Conversion to a muscle-sparing flap was 9.4 percent. AB - CONCLUSIONS: The authors present an algorithm for perforator selection, stepwise approach to flap harvest, and considerations for intraoperative decision-making in DIEP flap reconstruction. Single-dominant perforator flaps can be safely performed, but inclusion of the largest perforator is critical to flap perfusion. Additional perforators must be weighed against the associated tradeoff with donor-site morbidity. The threshold for conversion to a muscle-sparing flap is reduced with increased clinical experience. AB - CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201611000-00003 DO - https://dx.doi.org/10.1097/PRS.0000000000002716 PT - Journal Article PT - Video-Audio Media ID - 10.1097/PRS.0000000000002716 [doi] ID - 00006534-201611000-00003 [pii] PP - ppublish LG - English DP - 2016 Nov DC - 20161026 EZ - 2016/10/27 06:00 DA - 2017/05/18 06:00 DT - 2016/10/27 06:00 YR - 2016 ED - 20170517 RD - 20170517 UP - 20170519 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27782983 <5. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27556599 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Krishnan NM AU - Fischer JP AU - Basta MN AU - Nahabedian MY FA - Krishnan, Naveen M FA - Fischer, John P FA - Basta, Marten N FA - Nahabedian, Maurice Y IN - Krishnan, Naveen M. Washington, D.C.; and Philadelphia, Pa. From the Department of Plastic Surgery, Georgetown University Hospital; and the Division of Plastic Surgery, Perleman School of Medicine, University of Pennsylvania. TI - Is Single-Stage Prosthetic Reconstruction Cost Effective? A Cost-Utility Analysis for the Use of Direct-to-Implant Breast Reconstruction Relative to Expander-Implant Reconstruction in Postmastectomy Patients. [Review] SO - Plastic & Reconstructive Surgery. 138(3):537-47, 2016 Sep AS - Plast Reconstr Surg. 138(3):537-47, 2016 Sep NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Implantation MH - *Cost-Benefit Analysis MH - Decision Trees MH - Female MH - Humans MH - *Mammaplasty/ec [Economics] MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Postoperative Complications MH - Quality of Life MH - Tissue Expansion Devices AB - BACKGROUND: Prosthetic breast reconstruction is most commonly performed using the two-stage (expander-implant) technique. However, with the advent of skin-sparing mastectomy and the use of acellular dermal matrices, one-stage prosthetic reconstruction has become more feasible. Prior studies have suggested that one-stage reconstruction has economic advantages relative to two-stage reconstruction despite a higher revision rate. This is the first cost-utility analysis to compare the cost and quality of life of both procedures to guide patient care. AB - METHODS: A comprehensive literature review was conducted using the MEDLINE, EMBASE, and Cochrane databases to include studies directly comparing matched patient cohorts undergoing single-stage or staged prosthetic reconstruction. Six studies were selected examining 791 direct-to-implant reconstructions and 1142 expander-implant reconstructions. Costs were derived adopting both patient and third-party payer perspectives. Utilities were derived by surveying an expert panel. Probabilities of clinically relevant complications were combined with cost and utility estimates to fit into a decision tree analysis. AB - RESULTS: The overall complication rate was 35 percent for single-stage reconstruction and 34 percent for expander-implant reconstruction. The authors' baseline analysis using Medicare reimbursement revealed a cost decrease of $525.25 and a clinical benefit of 0.89 quality-adjusted life-year when performing single-stage reconstructions, yielding a negative incremental cost-utility ratio. When using national billing, the incremental cost-utility further decreased, indicating that direct-to-implant breast reconstruction was the dominant strategy. Sensitivity analysis confirmed the robustness of the authors' conclusions. AB - CONCLUSIONS: Direct-to-implant breast reconstruction is the dominant strategy when used appropriately. Surgeons are encouraged to consider single-stage reconstruction when feasible in properly selected patients. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201609000-00001 DO - https://dx.doi.org/10.1097/PRS.0000000000002428 PT - Journal Article PT - Review ID - 10.1097/PRS.0000000000002428 [doi] ID - 00006534-201609000-00001 [pii] PP - ppublish LG - English DP - 2016 Sep DC - 20160825 EZ - 2016/08/25 06:00 DA - 2017/05/18 06:00 DT - 2016/08/25 06:00 YR - 2016 ED - 20170517 RD - 20170517 UP - 20170519 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27556599 <6. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27673530 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sherman KA AU - Shaw LK AU - Winch CJ AU - Harcourt D AU - Boyages J AU - Cameron LD AU - Brown P AU - Lam T AU - Elder E AU - French J AU - Spillane A AU - BRECONDA Collaborative Research Group FA - Sherman, Kerry A FA - Shaw, Laura-Kate E FA - Winch, Caleb J FA - Harcourt, Diana FA - Boyages, John FA - Cameron, Linda D FA - Brown, Paul FA - Lam, Thomas FA - Elder, Elisabeth FA - French, James FA - Spillane, Andrew FA - BRECONDA Collaborative Research Group IN - Sherman, Kerry A. Sydney, Australia; Bristol, United Kingdom; and Merced, Calif. From the Centre for Emotional Health, Macquarie University; the Westmead Breast Cancer Institute, Westmead Hospital; the Macquarie University Cancer Institute, Australian School of Advanced Medicine, Macquarie University; The Poche Centre, Mater Hospital; the Centre for Appearance Research, University of West of England; and the University of California, Merced. TI - Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial. SO - Plastic & Reconstructive Surgery. 138(4):592e-602e, 2016 Oct AS - Plast Reconstr Surg. 138(4):592e-602e, 2016 Oct NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Internet MH - *Mammaplasty/px [Psychology] MH - *Mastectomy MH - Middle Aged MH - Outcome Assessment (Health Care) MH - Patient Education as Topic MH - *Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - Single-Blind Method AB - BACKGROUND: Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making. AB - METHODS: Women (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret. AB - RESULTS: Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction. AB - CONCLUSIONS: Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201610000-00007 DO - https://dx.doi.org/10.1097/PRS.0000000000002538 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial ID - 10.1097/PRS.0000000000002538 [doi] ID - 00006534-201610000-00007 [pii] PP - ppublish LG - English DP - 2016 Oct DC - 20160928 EZ - 2016/09/28 06:00 DA - 2016/09/28 06:00 DT - 2016/09/28 06:00 YR - 2016 ED - 20170505 RD - 20170505 UP - 20170508 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27673530 <7. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27673530 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sherman KA AU - Shaw LK AU - Winch CJ AU - Harcourt D AU - Boyages J AU - Cameron LD AU - Brown P AU - Lam T AU - Elder E AU - French J AU - Spillane A AU - BRECONDA Collaborative Research Group FA - Sherman, Kerry A FA - Shaw, Laura-Kate E FA - Winch, Caleb J FA - Harcourt, Diana FA - Boyages, John FA - Cameron, Linda D FA - Brown, Paul FA - Lam, Thomas FA - Elder, Elisabeth FA - French, James FA - Spillane, Andrew FA - BRECONDA Collaborative Research Group IN - Sherman, Kerry A. Sydney, Australia; Bristol, United Kingdom; and Merced, Calif. From the Centre for Emotional Health, Macquarie University; the Westmead Breast Cancer Institute, Westmead Hospital; the Macquarie University Cancer Institute, Australian School of Advanced Medicine, Macquarie University; The Poche Centre, Mater Hospital; the Centre for Appearance Research, University of West of England; and the University of California, Merced. TI - Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial. SO - Plastic & Reconstructive Surgery. 138(4):592e-602e, 2016 Oct AS - Plast Reconstr Surg. 138(4):592e-602e, 2016 Oct NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Internet MH - *Mammaplasty/px [Psychology] MH - *Mastectomy MH - Middle Aged MH - Outcome Assessment (Health Care) MH - Patient Education as Topic MH - *Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - Single-Blind Method AB - BACKGROUND: Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making. AB - METHODS: Women (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret. AB - RESULTS: Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction. AB - CONCLUSIONS: Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201610000-00007 DO - https://dx.doi.org/10.1097/PRS.0000000000002538 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial ID - 10.1097/PRS.0000000000002538 [doi] ID - 00006534-201610000-00007 [pii] PP - ppublish LG - English DP - 2016 Oct DC - 20160928 EZ - 2016/09/28 06:00 DA - 2017/05/06 06:00 DT - 2016/09/28 06:00 YR - 2016 ED - 20170505 RD - 20170505 UP - 20170510 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=27673530 <8. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27348637 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Buchanan PJ AU - Abdulghani M AU - Waljee JF AU - Kozlow JH AU - Sabel MS AU - Newman LA AU - Chung KC AU - Momoh AO FA - Buchanan, Patrick J FA - Abdulghani, Mariam FA - Waljee, Jennifer F FA - Kozlow, Jeffrey H FA - Sabel, Michael S FA - Newman, Lisa A FA - Chung, Kevin C FA - Momoh, Adeyiza O IN - Buchanan, Patrick J. Ann Arbor, Mich. From the Sections of Plastic Surgery and Surgical Oncology, Department of Surgery, University of Michigan Medical School. TI - An Analysis of the Decisions Made for Contralateral Prophylactic Mastectomy and Breast Reconstruction. SO - Plastic & Reconstructive Surgery. 138(1):29-40, 2016 Jul AS - Plast Reconstr Surg. 138(1):29-40, 2016 Jul NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - *Clinical Decision-Making/mt [Methods] MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - Neoplasm Recurrence, Local/pc [Prevention & Control] MH - *Patient Satisfaction MH - *Prophylactic Mastectomy/mt [Methods] MH - *Quality of Life MH - Retrospective Studies MH - *Surgical Flaps MH - Surveys and Questionnaires AB - BACKGROUND: Little is known about the role breast reconstruction plays in decisions made for contralateral prophylactic mastectomy. This study explores factors critical to patient medical decision-making for contralateral prophylactic mastectomy and reconstruction among women with early stage, unilateral breast cancer. AB - METHODS: A mixed methods approach was used to gain an understanding of patients' choices and experiences. Patients with stage 0 to III unilateral breast cancer who underwent reconstruction were recruited, and semistructured interviews were conducted. Patient-reported outcomes were evaluated using the Concerns About Recurrence Scale and the BREAST-Q. AB - RESULTS: Thirty patients were enrolled; 13 (43 percent) underwent unilateral mastectomy and 17 (57 percent) underwent contralateral prophylactic mastectomy. Three broad categories emerged from patient interviews: medical decision-making, quality of life after mastectomy, and breast reconstruction expectations. Patients who chose contralateral prophylactic mastectomy made the decision for mastectomy based primarily on worry about recurrence. Quality of life after mastectomy was characterized by relief of worry, especially in patients who chose contralateral prophylactic mastectomy [n = 14 (82.4 percent)]. Patients' desires for symmetry, although not the primary reason for contralateral prophylactic mastectomy, played a role in supporting decisions made. Levels of worry after treatment were similar in both groups (72.7 percent). Patients with contralateral prophylactic mastectomy had higher mean scores for satisfaction with breast (82.4 versus 70.6) and satisfaction with outcome (89.9 versus 75.2). AB - CONCLUSIONS: The choice for contralateral prophylactic mastectomy is greatly influenced by fear of recurrence, with desires for symmetry playing a secondary role in decisions made. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201607000-00005 DO - https://dx.doi.org/10.1097/PRS.0000000000002263 PT - Journal Article ID - 10.1097/PRS.0000000000002263 [doi] ID - 00006534-201607000-00005 [pii] PP - ppublish LG - English DP - 2016 Jul DC - 20160628 EZ - 2016/06/28 06:00 DA - 2017/04/26 06:00 DT - 2016/06/28 06:00 YR - 2016 ED - 20170425 RD - 20170425 UP - 20170427 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27348637 <9. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26267400 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Knox AD AU - Ho AL AU - Leung L AU - Tashakkor AY AU - Lennox PA AU - Van Laeken N AU - Macadam SA FA - Knox, Aaron D C FA - Ho, Adelyn L FA - Leung, Leslie FA - Tashakkor, A Yashar FA - Lennox, Peter A FA - Van Laeken, Nancy FA - Macadam, Sheina A IN - Knox, Aaron D C. Vancouver, British Columbia, Canada From the Division of Plastic Surgery, University of British Columbia, Vancouver General Hospital, and the Department of Internal Medicine, Faculty of Medicine, University of British Columbia. TI - Comparison of Outcomes following Autologous Breast Reconstruction Using the DIEP and Pedicled TRAM Flaps: A 12-Year Clinical Retrospective Study and Literature Review. [Review] SO - Plastic & Reconstructive Surgery. 138(1):16-28, 2016 Jul AS - Plast Reconstr Surg. 138(1):16-28, 2016 Jul NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Epigastric Arteries/su [Surgery] MH - Female MH - Follow-Up Studies MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Perforator Flap/bs [Blood Supply] MH - *Rectus Abdominis/tr [Transplantation] MH - Retrospective Studies MH - Transplantation, Autologous AB - BACKGROUND: There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery related to abdominal morbidity, operative time, and complications. AB - METHODS: This is a retrospective review of patients undergoing breast reconstruction using the DIEP or pTRAM flap at the University of British Columbia between 2002 and 2013. The authors compared operative time and abdomen- and flap-related complications in both groups. AB - RESULTS: Reconstruction was performed in 507 patients; 25.6 percent received DIEP flaps (n = 183 breasts) and 74.4 percent underwent pTRAM flap surgery (n = 444 breasts). Pedicled TRAM flap patients were more likely to require abdominal closure with mesh (44.2 percent versus 8.1 percent; p < 0.001); 21.2 percent of them had a postoperative bulge and/or hernia versus 3.1 percent of DIEP flap patients; and 12.7 percent of pTRAM flap patients required surgery for hernia/bulge. Controlling for confounders, there were five times the odds of a hernia/bulge in the pTRAM flap group. DIEP flap surgery was 234 minutes longer than pTRAM flap surgery. AB - CONCLUSIONS: The benefits of the pTRAM flap may be offset by the need to correct abdominal wall complications. DIEP flap reconstruction had lower donor complications but increased operative time. A cost analysis is needed to determine the most economical procedure. AB - CLINCIAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. ES - 1529-4242 IL - 0032-1052 DO - https://dx.doi.org/10.1097/PRS.0000000000001747 PT - Journal Article PT - Review ID - 10.1097/PRS.0000000000001747 [doi] PP - ppublish LG - English DP - 2016 Jul DC - 20160628 EZ - 2015/08/13 06:00 DA - 2017/04/26 06:00 DT - 2015/08/13 06:00 YR - 2016 ED - 20170425 RD - 20170425 UP - 20170427 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26267400 <10. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28407998 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eccleston A AU - Bentley A AU - Dyer M AU - Strydom A AU - Vereecken W AU - George A AU - Rahman N FA - Eccleston, Anthony FA - Bentley, Anthony FA - Dyer, Matthew FA - Strydom, Ann FA - Vereecken, Wim FA - George, Angela FA - Rahman, Nazneen IN - Eccleston, Anthony. DRG Abacus, Bicester, Oxfordshire, UK. IN - Bentley, Anthony. DRG Abacus, Bicester, Oxfordshire, UK. IN - Dyer, Matthew. AstraZeneca UK Ltd., Luton, Bedfordshire, UK. Electronic address: matthew.dyer@astrazeneca.com. IN - Strydom, Ann. Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK. IN - Vereecken, Wim. AstraZeneca UK Ltd., Luton, Bedfordshire, UK. IN - George, Angela. Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK; Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK. IN - Rahman, Nazneen. Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK; Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK. TI - A Cost-Effectiveness Evaluation of Germline BRCA1 and BRCA2 Testing in UK Women with Ovarian Cancer. SO - Value in Health. 20(4):567-576, 2017 Apr AS - Value Health. 20(4):567-576, 2017 Apr NJ - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100883818 IO - Value Health SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - *Biomarkers, Tumor/ge [Genetics] MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/ec [Economics] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/th [Therapy] MH - Computer Simulation MH - Cost-Benefit Analysis MH - *DNA Mutational Analysis/ec [Economics] MH - Decision Support Techniques MH - *Early Detection of Cancer/ec [Economics] MH - Early Detection of Cancer/mt [Methods] MH - Female MH - Genetic Predisposition to Disease MH - *Genetic Testing/ec [Economics] MH - Genetic Testing/mt [Methods] MH - *Germ-Line Mutation MH - *Health Care Costs MH - Heredity MH - Humans MH - Middle Aged MH - Models, Economic MH - Neoplasms, Glandular and Epithelial/di [Diagnosis] MH - Neoplasms, Glandular and Epithelial/ec [Economics] MH - *Neoplasms, Glandular and Epithelial/ge [Genetics] MH - Neoplasms, Glandular and Epithelial/th [Therapy] MH - Ovarian Neoplasms/di [Diagnosis] MH - Ovarian Neoplasms/ec [Economics] MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/th [Therapy] MH - Pedigree MH - Phenotype MH - Predictive Value of Tests MH - Prognosis MH - Quality-Adjusted Life Years MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - United Kingdom KW - BRCA gene testing; breast cancer; cost-effectiveness; ovarian cancer AB - OBJECTIVES: To evaluate the long-term cost-effectiveness of germline BRCA1 and BRCA2 (collectively termed "BRCA") testing in women with epithelial ovarian cancer, and testing for the relevant mutation in first- and second-degree relatives of BRCA mutation-positive individuals, compared with no testing. Female BRCA mutation-positive relatives of patients with ovarian cancer could undergo risk-reducing mastectomy and/or bilateral salpingo-oophorectomy. AB - METHODS: A cost-effectiveness model was developed that included the risks of breast and ovarian cancer; the costs, utilities, and effects of risk-reducing surgery on cancer rates; and the costs, utilities, and mortality rates associated with cancer. AB - RESULTS: BRCA testing of all women with epithelial ovarian cancer each year is cost-effective at a UK willingness-to-pay threshold of 20,000/quality-adjusted life-year (QALY) compared with no testing, with an incremental cost-effectiveness ratio of 4,339/QALY. The result was primarily driven by fewer cases of breast cancer (142) and ovarian cancer (141) and associated reductions in mortality (77 fewer deaths) in relatives over the subsequent 50 years. Sensitivity analyses showed that the results were robust to variations in the input parameters. Probabilistic sensitivity analysis showed that the probability of germline BRCA mutation testing being cost-effective at a threshold of 20,000/QALY was 99.9%. AB - CONCLUSIONS: Implementing germline BRCA testing in all patients with ovarian cancer would be cost-effective in the United Kingdom. The consequent reduction in future cases of breast and ovarian cancer in relatives of mutation-positive individuals would ease the burden of cancer treatments in subsequent years and result in significantly better outcomes and reduced mortality rates for these individuals. AB - Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved. RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) RN - 0 (BRCA2 Protein) RN - 0 (BRCA2 protein, human) RN - 0 (Biomarkers, Tumor) RS - Ovarian epithelial cancer ES - 1524-4733 IL - 1098-3015 DI - S1098-3015(17)30064-5 DO - https://dx.doi.org/10.1016/j.jval.2017.01.004 PT - Journal Article ID - S1098-3015(17)30064-5 [pii] ID - 10.1016/j.jval.2017.01.004 [doi] PP - ppublish PH - 2016/06/16 [received] PH - 2017/01/03 [revised] PH - 2017/01/11 [accepted] LG - English EP - 20170303 DP - 2017 Apr DC - 20170414 EZ - 2017/04/15 06:00 DA - 2017/04/25 06:00 DT - 2017/04/15 06:00 YR - 2017 ED - 20170424 RD - 20170424 UP - 20170426 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=28407998 <11. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28407996 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Li Y AU - Arellano AR AU - Bare LA AU - Bender RA AU - Strom CM AU - Devlin JJ FA - Li, Yonghong FA - Arellano, Andre R FA - Bare, Lance A FA - Bender, Richard A FA - Strom, Charles M FA - Devlin, James J IN - Li, Yonghong. Quest Diagnostics, San Juan Capistrano, CA, USA. Electronic address: yonghong.x.li2@questdiagnostics.com. IN - Arellano, Andre R. Quest Diagnostics, San Juan Capistrano, CA, USA. IN - Bare, Lance A. Quest Diagnostics, San Juan Capistrano, CA, USA. IN - Bender, Richard A. Quest Diagnostics, San Juan Capistrano, CA, USA. IN - Strom, Charles M. Quest Diagnostics, San Juan Capistrano, CA, USA. IN - Devlin, James J. Quest Diagnostics, San Juan Capistrano, CA, USA. TI - A Multigene Test Could Cost-Effectively Help Extend Life Expectancy for Women at Risk of Hereditary Breast Cancer. SO - Value in Health. 20(4):547-555, 2017 Apr AS - Value Health. 20(4):547-555, 2017 Apr NJ - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100883818 IO - Value Health SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Aged MH - Aged, 80 and over MH - *Biomarkers, Tumor/ge [Genetics] MH - Breast Neoplasms/ec [Economics] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/th [Therapy] MH - Cost-Benefit Analysis MH - Decision Support Techniques MH - *Early Detection of Cancer/ec [Economics] MH - Early Detection of Cancer/mt [Methods] MH - Female MH - *Gene Expression Profiling/ec [Economics] MH - Genetic Predisposition to Disease MH - *Genetic Testing/ec [Economics] MH - *Health Care Costs MH - Heredity MH - Humans MH - *Life Expectancy MH - Magnetic Resonance Imaging/ec [Economics] MH - Mammography/ec [Economics] MH - Mastectomy/ec [Economics] MH - Middle Aged MH - Models, Economic MH - Patient Selection MH - Phenotype MH - Predictive Value of Tests MH - Prognosis MH - *Quality-Adjusted Life Years MH - Risk Assessment MH - Risk Factors MH - Watchful Waiting/ec [Economics] KW - *BRCA; *breast cancer; *cost-effectiveness; *multigene panel testing AB - BACKGROUND: The National Comprehensive Cancer Network recommends that women who carry gene variants that confer substantial risk for breast cancer consider risk-reduction strategies, that is, enhanced surveillance (breast magnetic resonance imaging and mammography) or prophylactic surgery. Pathogenic variants can be detected in women with a family history of breast or ovarian cancer syndromes by multigene panel testing. AB - OBJECTIVES: To investigate whether using a seven-gene test to identify women who should consider risk-reduction strategies could cost-effectively increase life expectancy. AB - METHODS: We estimated effectiveness and lifetime costs from a payer perspective for two strategies in two hypothetical cohorts of women (40-year-old and 50-year-old cohorts) who meet the National Comprehensive Cancer Network-defined family history criteria for multigene testing. The two strategies were the usual test strategy for variants in BRCA1 and BRCA2 and the seven-gene test strategy for variants in BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, and PALB2. Women found to have a pathogenic variant were assumed to undergo either prophylactic surgery or enhanced surveillance. AB - RESULTS: The incremental cost-effectiveness ratio for the seven-gene test strategy compared with the BRCA1/2 test strategy was $42,067 per life-year gained or $69,920 per quality-adjusted life-year gained for the 50-year-old cohort and $23,734 per life-year gained or $48,328 per quality-adjusted life-year gained for the 40-year-old cohort. In probabilistic sensitivity analysis, the seven-gene test strategy cost less than $100,000 per life-year gained in 95.7% of the trials for the 50-year-old cohort. AB - CONCLUSIONS: Testing seven breast cancer-associated genes, followed by risk-reduction management, could cost-effectively improve life expectancy for women at risk of hereditary breast cancer. AB - Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved. RN - 0 (Biomarkers, Tumor) ES - 1524-4733 IL - 1098-3015 DI - S1098-3015(17)30066-9 DO - https://dx.doi.org/10.1016/j.jval.2017.01.006 PT - Comparative Study PT - Journal Article ID - S1098-3015(17)30066-9 [pii] ID - 10.1016/j.jval.2017.01.006 [doi] PP - ppublish PH - 2016/03/14 [received] PH - 2016/12/08 [revised] PH - 2017/01/13 [accepted] LG - English EP - 20170223 DP - 2017 Apr DC - 20170414 EZ - 2017/04/15 06:00 DA - 2017/04/25 06:00 DT - 2017/04/15 06:00 YR - 2017 ED - 20170424 RD - 20170424 UP - 20170426 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=28407996 <12. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28407998 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eccleston A AU - Bentley A AU - Dyer M AU - Strydom A AU - Vereecken W AU - George A AU - Rahman N FA - Eccleston, Anthony FA - Bentley, Anthony FA - Dyer, Matthew FA - Strydom, Ann FA - Vereecken, Wim FA - George, Angela FA - Rahman, Nazneen IN - Eccleston, Anthony. DRG Abacus, Bicester, Oxfordshire, UK. IN - Bentley, Anthony. DRG Abacus, Bicester, Oxfordshire, UK. IN - Dyer, Matthew. AstraZeneca UK Ltd., Luton, Bedfordshire, UK. Electronic address: matthew.dyer@astrazeneca.com. IN - Strydom, Ann. Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK. IN - Vereecken, Wim. AstraZeneca UK Ltd., Luton, Bedfordshire, UK. IN - George, Angela. Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK; Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK. IN - Rahman, Nazneen. Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK; Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK. TI - A Cost-Effectiveness Evaluation of Germline BRCA1 and BRCA2 Testing in UK Women with Ovarian Cancer. SO - Value in Health. 20(4):567-576, 2017 Apr AS - Value Health. 20(4):567-576, 2017 Apr NJ - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100883818 IO - Value Health SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - *Biomarkers, Tumor/ge [Genetics] MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/ec [Economics] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/th [Therapy] MH - Computer Simulation MH - Cost-Benefit Analysis MH - *DNA Mutational Analysis/ec [Economics] MH - Decision Support Techniques MH - *Early Detection of Cancer/ec [Economics] MH - Early Detection of Cancer/mt [Methods] MH - Female MH - Genetic Predisposition to Disease MH - *Genetic Testing/ec [Economics] MH - Genetic Testing/mt [Methods] MH - *Germ-Line Mutation MH - *Health Care Costs MH - Heredity MH - Humans MH - Middle Aged MH - Models, Economic MH - Neoplasms, Glandular and Epithelial/di [Diagnosis] MH - Neoplasms, Glandular and Epithelial/ec [Economics] MH - *Neoplasms, Glandular and Epithelial/ge [Genetics] MH - Neoplasms, Glandular and Epithelial/th [Therapy] MH - Ovarian Neoplasms/di [Diagnosis] MH - Ovarian Neoplasms/ec [Economics] MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/th [Therapy] MH - Pedigree MH - Phenotype MH - Predictive Value of Tests MH - Prognosis MH - Quality-Adjusted Life Years MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - United Kingdom KW - BRCA gene testing; breast cancer; cost-effectiveness; ovarian cancer AB - OBJECTIVES: To evaluate the long-term cost-effectiveness of germline BRCA1 and BRCA2 (collectively termed "BRCA") testing in women with epithelial ovarian cancer, and testing for the relevant mutation in first- and second-degree relatives of BRCA mutation-positive individuals, compared with no testing. Female BRCA mutation-positive relatives of patients with ovarian cancer could undergo risk-reducing mastectomy and/or bilateral salpingo-oophorectomy. AB - METHODS: A cost-effectiveness model was developed that included the risks of breast and ovarian cancer; the costs, utilities, and effects of risk-reducing surgery on cancer rates; and the costs, utilities, and mortality rates associated with cancer. AB - RESULTS: BRCA testing of all women with epithelial ovarian cancer each year is cost-effective at a UK willingness-to-pay threshold of 20,000/quality-adjusted life-year (QALY) compared with no testing, with an incremental cost-effectiveness ratio of 4,339/QALY. The result was primarily driven by fewer cases of breast cancer (142) and ovarian cancer (141) and associated reductions in mortality (77 fewer deaths) in relatives over the subsequent 50 years. Sensitivity analyses showed that the results were robust to variations in the input parameters. Probabilistic sensitivity analysis showed that the probability of germline BRCA mutation testing being cost-effective at a threshold of 20,000/QALY was 99.9%. AB - CONCLUSIONS: Implementing germline BRCA testing in all patients with ovarian cancer would be cost-effective in the United Kingdom. The consequent reduction in future cases of breast and ovarian cancer in relatives of mutation-positive individuals would ease the burden of cancer treatments in subsequent years and result in significantly better outcomes and reduced mortality rates for these individuals. AB - Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved. RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) RN - 0 (BRCA2 Protein) RN - 0 (BRCA2 protein, human) RN - 0 (Biomarkers, Tumor) RS - Ovarian epithelial cancer ES - 1524-4733 IL - 1098-3015 DI - S1098-3015(17)30064-5 DO - https://dx.doi.org/10.1016/j.jval.2017.01.004 PT - Journal Article ID - S1098-3015(17)30064-5 [pii] ID - 10.1016/j.jval.2017.01.004 [doi] ID - PMC5406158 [pmc] PP - ppublish PH - 2016/06/16 [received] PH - 2017/01/03 [revised] PH - 2017/01/11 [accepted] LG - English EP - 20170303 DP - 2017 Apr DC - 20170414 EZ - 2017/04/15 06:00 DA - 2017/04/25 06:00 DT - 2017/04/15 06:00 YR - 2017 ED - 20170424 RD - 20170507 UP - 20170509 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=28407998 <13. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27550796 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Frisell A AU - Lagergren J AU - de Boniface J FA - Frisell, A FA - Lagergren, J FA - de Boniface, J IN - Frisell, A. Department of Emergency Medicine and Surgery, Karolinska University Hospital Huddinge, Stockholm, Sweden. IN - Lagergren, J. Department of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden. IN - Lagergren, J. Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. IN - de Boniface, J. Department of Breast and Endocrine Surgery, Karolinska University Hospital, Stockholm, Sweden. Jana.De-Boniface@ki.se. IN - de Boniface, J. Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden. Jana.De-Boniface@ki.se. TI - National study of the impact of patient information and involvement in decision-making on immediate breast reconstruction rates. SO - British Journal of Surgery. 103(12):1640-1648, 2016 Nov AS - Br J Surg. 103(12):1640-1648, 2016 Nov NJ - The British journal of surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b34, 0372553 IO - Br J Surg SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Cross-Sectional Studies MH - Decision Making MH - Female MH - Humans MH - Mammaplasty/px [Psychology] MH - *Mammaplasty/sn [Statistics & Numerical Data] MH - Mastectomy/px [Psychology] MH - Mastectomy/sn [Statistics & Numerical Data] MH - Middle Aged MH - *Patient Education as Topic MH - *Patient Participation/px [Psychology] MH - Registries MH - Retrospective Studies MH - Sweden/ep [Epidemiology] MH - Young Adult AB - BACKGROUND: Reconstructive alternatives should be discussed with women facing mastectomy for breast cancer. These include immediate and delayed reconstruction, which both have inherent advantages and disadvantages. Immediate reconstruction rates vary considerably in Swedish healthcare regions, and the aim of the study was to analyse reasons for this disparity. AB - METHODS: All women who underwent mastectomy for primary breast cancer in Sweden in 2013 were included. Tumour data were retrieved from the Swedish National Breast Cancer Registry and from questionnaires regarding patient information and involvement in preoperative decision-making sent to women who were still alive in 2015. AB - RESULTS: Of 2929 women who had undergone 2996 mastectomies, 2906 were still alive. The questionnaire response rate was 76.3 per cent. Immediate reconstruction rates varied regionally, between 3.0 and 26.4 per cent. Tumour characteristics impacted on reconstruction rates but did not explain regional differences. Patient participation in decision-making, availability of plastic surgery services and patient information, however, were independent predictors of immediate breast reconstruction, and varied significantly between regions. Even in younger patients with low-risk tumours, rates of patient information ranged between 34.3 and 83.3 per cent. AB - CONCLUSION: Significant regional differences in immediate reconstruction rates were not explained by differences in tumour characteristics, but by disparities in patient information, availability of plastic surgery services and involvement in decision-making. AB - Copyright © 2016 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd. ES - 1365-2168 IL - 0007-1323 DO - https://dx.doi.org/10.1002/bjs.10286 PT - Journal Article ID - 10.1002/bjs.10286 [doi] ID - PMC5095775 [pmc] PP - ppublish PH - 2016/03/10 [received] PH - 2016/04/07 [revised] PH - 2016/07/01 [accepted] LG - English EP - 20160823 DP - 2016 Nov DC - 20160912 EZ - 2016/08/24 06:00 DA - 2017/04/04 06:00 DT - 2016/11/02 06:00 YR - 2016 ED - 20170403 RD - 20170403 UP - 20170405 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27550796 <14. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27438052 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Guidolin K AU - Lock M AU - Richard L AU - Boldt G AU - Brackstone M FA - Guidolin, Keegan FA - Lock, Michael FA - Richard, Lucie FA - Boldt, Gabriel FA - Brackstone, Muriel IN - Guidolin, Keegan. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Lock, Michael. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Richard, Lucie. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Boldt, Gabriel. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Brackstone, Muriel. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). TI - Predicting which patients actually receive radiation following breast conserving therapy in Canadian populations. SO - Canadian Journal of Surgery. 59(5):358-60, 2016 Sep AS - Can J Surg. 59(5):358-60, 2016 Sep NJ - Canadian journal of surgery. Journal canadien de chirurgie PI - Journal available in: Print PI - Citation processed from: Internet JC - ckj, 0372715 IO - Can J Surg SB - Index Medicus CP - Canada MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Clinical Decision-Making/mt [Methods] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy/st [Standards] MH - *Mastectomy, Segmental/st [Standards] AB - SUMMARY: Canadian women with breast cancer may choose breast conserving therapy as their course of treatment, requiring both breast conserving surgery and adjuvant radiation therapy. However, more than 15% of Canadian women fail to receive the appropriate radiation therapy, putting them at increased risk for recurrence. Age, distance from their radiation therapy centre and stage of disease affect patients' likelihood of receiving prescribed radiation therapy. We propose a nomogram that allows physicians to predict which patients will and will not receive radiation. This nomogram, once validated, could be used to guide decision making when choosing between breast conserving therapy and mastectomy as the treatment course and thereby change the practice of breast cancer management. ES - 1488-2310 IL - 0008-428X DI - 10.1503/cjs.000516 PT - Journal Article ID - PMC5042724 [pmc] ID - 10.1503/cjs.000516 [pii] PP - ppublish LG - English DP - 2016 Sep DC - 20160927 EZ - 2016/07/21 06:00 DA - 2016/07/21 06:00 DT - 2016/07/21 06:00 YR - 2016 ED - 20170329 RD - 20170330 UP - 20170331 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27438052 <15. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27438052 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Guidolin K AU - Lock M AU - Richard L AU - Boldt G AU - Brackstone M FA - Guidolin, Keegan FA - Lock, Michael FA - Richard, Lucie FA - Boldt, Gabriel FA - Brackstone, Muriel IN - Guidolin, Keegan. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Lock, Michael. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Richard, Lucie. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Boldt, Gabriel. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). IN - Brackstone, Muriel. From the Schulich School of Medicine & Dentistry, Western University, London, Ont. (Guidolin, Lock, Brackstone); and the London Health Sciences Centre, London, Ont. (Lock, Richard, Boldt, Brackstone). TI - Predicting which patients actually receive radiation following breast conserving therapy in Canadian populations. SO - Canadian Journal of Surgery. 59(5):358-60, 2016 Sep AS - Can J Surg. 59(5):358-60, 2016 Sep NJ - Canadian journal of surgery. Journal canadien de chirurgie PI - Journal available in: Print PI - Citation processed from: Internet JC - ckj, 0372715 IO - Can J Surg SB - Index Medicus CP - Canada MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Clinical Decision-Making/mt [Methods] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy/st [Standards] MH - *Mastectomy, Segmental/st [Standards] AB - SUMMARY: Canadian women with breast cancer may choose breast conserving therapy as their course of treatment, requiring both breast conserving surgery and adjuvant radiation therapy. However, more than 15% of Canadian women fail to receive the appropriate radiation therapy, putting them at increased risk for recurrence. Age, distance from their radiation therapy centre and stage of disease affect patients' likelihood of receiving prescribed radiation therapy. We propose a nomogram that allows physicians to predict which patients will and will not receive radiation. This nomogram, once validated, could be used to guide decision making when choosing between breast conserving therapy and mastectomy as the treatment course and thereby change the practice of breast cancer management. ES - 1488-2310 IL - 0008-428X DI - 10.1503/cjs.000516 PT - Journal Article ID - PMC5042724 [pmc] ID - 10.1503/cjs.000516 [pii] PP - ppublish LG - English DP - 2016 Sep DC - 20160927 EZ - 2016/07/21 06:00 DA - 2017/03/31 06:00 DT - 2016/07/21 06:00 YR - 2016 ED - 20170329 RD - 20170330 UP - 20170403 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=27438052 <16. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27476081 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Catanuto G AU - Pappalardo F AU - Rocco N AU - Leotta M AU - Ursino V AU - Chiodini P AU - Buggi F AU - Folli S AU - Catalano F AU - Nava MB FA - Catanuto, Giuseppe FA - Pappalardo, Francesco FA - Rocco, Nicola FA - Leotta, Marco FA - Ursino, Venera FA - Chiodini, Paolo FA - Buggi, Federico FA - Folli, Secondo FA - Catalano, Francesca FA - Nava, Maurizio B IN - Catanuto, Giuseppe. U.O. C. Senologia - Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy; Scuola di Oncologia Chirurgica Ricostruttiva - Onlus, Milano, Italy. Electronic address: giuseppecatanuto@gmail.com. IN - Pappalardo, Francesco. Universita degli Studi di Catania, Catania, Italy. IN - Rocco, Nicola. Dipartimento di Medicina Clinica e Chirurgia, Universita di Napoli 'Federico II', Napoli, Italy. IN - Leotta, Marco. Universita degli Studi di Catania, Catania, Italy. IN - Ursino, Venera. U.O. C. Senologia - Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy. IN - Chiodini, Paolo. Unita di Statistica Medica, Seconda Universita di Napoli, Napoli, Italy. IN - Buggi, Federico. U.O.C. Senologia - Ospedale Morgagni-Pierantoni, Forli, Italy. IN - Folli, Secondo. U.O.C. Senologia - Ospedale Morgagni-Pierantoni, Forli, Italy. IN - Catalano, Francesca. U.O. C. Senologia - Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy. IN - Nava, Maurizio B. Scuola di Oncologia Chirurgica Ricostruttiva - Onlus, Milano, Italy. TI - Formal analysis of the surgical pathway and development of a new software tool to assist surgeons in the decision making in primary breast surgery. SO - Breast. 29:74-81, 2016 Oct AS - BREAST. 29:74-81, 2016 Oct NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Breast/pa [Pathology] MH - Breast/su [Surgery] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Endpoint Determination/mt [Methods] MH - Female MH - Humans MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Postoperative Complications/pc [Prevention & Control] MH - Reproducibility of Results MH - *Software MH - Surgeons/px [Psychology] KW - *Breast reconstructive surgery; *Cosmetic outcome; *Decision making in breast surgery; *Oncoplastic surgery; *Prevention of defects AB - BACKGROUND: The increased complexity of the decisional process in breast cancer surgery is well documented. With this study we aimed to create a software tool able to assist patients and surgeons in taking proper decisions. AB - METHODOLOGY: We hypothesized that the endpoints of breast cancer surgery could be addressed combining a set of decisional drivers. We created a decision support system software tool (DSS) and an interactive decision tree. A formal analysis estimated the information gain derived from each feature in the process. We tested the DSS on 52 patients and we analyzed the concordance of decisions obtained by different users and between the DSS suggestions and the actual surgery. We also tested the ability of the system to prevent post breast conservation deformities. AB - RESULTS: The information gain revealed that patients preferences are the root of our decision tree. An observed concordance respectively of 0.98 and 0.88 was reported when the DSS was used twice by an expert operator or by a newly trained operator vs. an expert one. The observed concordance between the DSS suggestion and the actual decision was 0.69. A significantly higher incidence of post breast conservation defects was reported among patients who did not follow the DSS decision (Type III of Fitoussi, N = 4; 33.3%, p = 0.004). AB - CONCLUSION: The DSS decisions can be reproduced by operators with different experience. The concordance between suggestions and actual decision is quite low, however the DSS is able to prevent post- breast conservation deformities. AB - Copyright © 2016 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(16)30078-9 DO - https://dx.doi.org/10.1016/j.breast.2016.06.004 PT - Journal Article PT - Validation Studies ID - S0960-9776(16)30078-9 [pii] ID - 10.1016/j.breast.2016.06.004 [doi] PP - ppublish PH - 2016/02/19 [received] PH - 2016/04/15 [revised] PH - 2016/06/05 [accepted] LG - English EP - 20160728 DP - 2016 Oct DC - 20160907 EZ - 2016/08/01 06:00 DA - 2016/08/01 06:00 DT - 2016/08/01 06:00 YR - 2016 ED - 20170314 RD - 20170314 UP - 20170316 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27476081 <17. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27476081 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Catanuto G AU - Pappalardo F AU - Rocco N AU - Leotta M AU - Ursino V AU - Chiodini P AU - Buggi F AU - Folli S AU - Catalano F AU - Nava MB FA - Catanuto, Giuseppe FA - Pappalardo, Francesco FA - Rocco, Nicola FA - Leotta, Marco FA - Ursino, Venera FA - Chiodini, Paolo FA - Buggi, Federico FA - Folli, Secondo FA - Catalano, Francesca FA - Nava, Maurizio B IN - Catanuto, Giuseppe. U.O. C. Senologia - Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy; Scuola di Oncologia Chirurgica Ricostruttiva - Onlus, Milano, Italy. Electronic address: giuseppecatanuto@gmail.com. IN - Pappalardo, Francesco. Universita degli Studi di Catania, Catania, Italy. IN - Rocco, Nicola. Dipartimento di Medicina Clinica e Chirurgia, Universita di Napoli 'Federico II', Napoli, Italy. IN - Leotta, Marco. Universita degli Studi di Catania, Catania, Italy. IN - Ursino, Venera. U.O. C. Senologia - Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy. IN - Chiodini, Paolo. Unita di Statistica Medica, Seconda Universita di Napoli, Napoli, Italy. IN - Buggi, Federico. U.O.C. Senologia - Ospedale Morgagni-Pierantoni, Forli, Italy. IN - Folli, Secondo. U.O.C. Senologia - Ospedale Morgagni-Pierantoni, Forli, Italy. IN - Catalano, Francesca. U.O. C. Senologia - Azienda Ospedaliera Cannizzaro, Via Messina 829, Catania, Italy. IN - Nava, Maurizio B. Scuola di Oncologia Chirurgica Ricostruttiva - Onlus, Milano, Italy. TI - Formal analysis of the surgical pathway and development of a new software tool to assist surgeons in the decision making in primary breast surgery. SO - Breast. 29:74-81, 2016 Oct AS - BREAST. 29:74-81, 2016 Oct NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Breast/pa [Pathology] MH - Breast/su [Surgery] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Endpoint Determination/mt [Methods] MH - Female MH - Humans MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Postoperative Complications/pc [Prevention & Control] MH - Reproducibility of Results MH - *Software MH - Surgeons/px [Psychology] KW - *Breast reconstructive surgery; *Cosmetic outcome; *Decision making in breast surgery; *Oncoplastic surgery; *Prevention of defects AB - BACKGROUND: The increased complexity of the decisional process in breast cancer surgery is well documented. With this study we aimed to create a software tool able to assist patients and surgeons in taking proper decisions. AB - METHODOLOGY: We hypothesized that the endpoints of breast cancer surgery could be addressed combining a set of decisional drivers. We created a decision support system software tool (DSS) and an interactive decision tree. A formal analysis estimated the information gain derived from each feature in the process. We tested the DSS on 52 patients and we analyzed the concordance of decisions obtained by different users and between the DSS suggestions and the actual surgery. We also tested the ability of the system to prevent post breast conservation deformities. AB - RESULTS: The information gain revealed that patients preferences are the root of our decision tree. An observed concordance respectively of 0.98 and 0.88 was reported when the DSS was used twice by an expert operator or by a newly trained operator vs. an expert one. The observed concordance between the DSS suggestion and the actual decision was 0.69. A significantly higher incidence of post breast conservation defects was reported among patients who did not follow the DSS decision (Type III of Fitoussi, N = 4; 33.3%, p = 0.004). AB - CONCLUSION: The DSS decisions can be reproduced by operators with different experience. The concordance between suggestions and actual decision is quite low, however the DSS is able to prevent post- breast conservation deformities. AB - Copyright © 2016 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(16)30078-9 DO - https://dx.doi.org/10.1016/j.breast.2016.06.004 PT - Journal Article PT - Validation Studies ID - S0960-9776(16)30078-9 [pii] ID - 10.1016/j.breast.2016.06.004 [doi] PP - ppublish PH - 2016/02/19 [received] PH - 2016/04/15 [revised] PH - 2016/06/05 [accepted] LG - English EP - 20160728 DP - 2016 Oct DC - 20160907 EZ - 2016/08/01 06:00 DA - 2017/03/16 06:00 DT - 2016/08/01 06:00 YR - 2016 ED - 20170314 RD - 20170314 UP - 20170317 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=27476081 <18. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27318167 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Glassey R AU - Ives A AU - Saunders C AU - Musiello T FA - Glassey, Rachael FA - Ives, Angela FA - Saunders, Christobel FA - Musiello, Toni IN - Glassey, Rachael. School of Surgery, The University of Western Australia, M507, 35 Stirling Highway, Crawley, Perth, WA, Australia. Electronic address: rachael.glassey@research.uwa.edu.au. IN - Ives, Angela. School of Surgery, The University of Western Australia, M507, 35 Stirling Highway, Crawley, Perth, WA, Australia. IN - Saunders, Christobel. School of Surgery, The University of Western Australia, M507, 35 Stirling Highway, Crawley, Perth, WA, Australia. IN - Musiello, Toni. School of Surgery, The University of Western Australia, M507, 35 Stirling Highway, Crawley, Perth, WA, Australia. TI - Decision making, psychological wellbeing and psychosocial outcomes for high risk women who choose to undergo bilateral prophylactic mastectomy - A review of the literature. [Review] SO - Breast. 28:130-5, 2016 Aug AS - BREAST. 28:130-5, 2016 Aug NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Age Factors MH - Anxiety/et [Etiology] MH - Body Image MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Testing MH - Humans MH - Patient Education as Topic MH - Patient Satisfaction MH - *Prophylactic Mastectomy/px [Psychology] MH - Sexuality KW - Anxiety; Body image; Familial cancer; Prophylactic mastectomy; Psychological wellbeing; Young women AB - A bilateral prophylactic, or preventative, mastectomy (BPM) for women at high risk of developing breast cancer (BC) can reduce their risk of developing the disease by up to 90% (relative risk reduction). An increasing number of women, including young women, are taking up this option. However, there is a dearth of information for younger women (under 40 years) choosing preventative mastectomy. In fact, no studies to date have specifically focused on younger women's experiences of a BPM and investigated their informational needs. The purpose of this review is to report on the current literature surrounding the psychological experience of a BPM and the informational needs for women at high risk of developing BC with a particular emphasis on younger women. Research has highlighted a range of psychological outcomes linked to preventative mastectomy, including positives such as reduced anxiety and negatives including impaired body image and sexuality. The literature strongly suggests women want more information surrounding BPM, particularly related to the after effects of the surgery, and the impact on their psychological wellbeing. Research method limitations and reporting has resulted in conflicting conclusions, making it difficult for women to be well informed. In particular, there has been little focus on the experiences and needs of younger women opting for BPM. Due to the unique needs of younger women and an increase in BPM rates for younger women, it is imperative that the needs of this group are addressed. Together these findings provide justification and recommendation for further research in this area. AB - Copyright © 2016 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(16)30071-6 DO - https://dx.doi.org/10.1016/j.breast.2016.05.012 PT - Journal Article PT - Review ID - S0960-9776(16)30071-6 [pii] ID - 10.1016/j.breast.2016.05.012 [doi] PP - ppublish PH - 2016/02/02 [received] PH - 2016/05/23 [revised] PH - 2016/05/26 [accepted] LG - English EP - 20160615 DP - 2016 Aug DC - 20160712 EZ - 2016/06/19 06:00 DA - 2017/03/14 06:00 DT - 2016/06/19 06:00 YR - 2016 ED - 20170313 RD - 20170313 UP - 20170315 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27318167 <19. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27290619 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ager B AU - Butow P AU - Jansen J AU - Phillips KA AU - Porter D AU - CPM DA Advisory Group FA - Ager, Brittany FA - Butow, Phyllis FA - Jansen, Jesse FA - Phillips, Kelly-Anne FA - Porter, David FA - CPM DA Advisory Group IN - Ager, Brittany. School of Psychology, The University of Sydney, Australia. Electronic address: bage4508@uni.sydney.edu.au. IN - Butow, Phyllis. Centre for Medical Psychology and Evidence Based Decision-Making, The University of Sydney, Australia; Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Australia. IN - Jansen, Jesse. Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Australia; Sydney Medical School, The University of Sydney, Australia. IN - Phillips, Kelly-Anne. Division of Cancer Medicine, Peter MacCallum Cancer Centre, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia. IN - Porter, David. Dept of Medical Oncology, Auckland Hospital, Auckland, New Zealand; Faculty of Medical and Health Sciences, The University of Auckland, New Zealand. TI - Contralateral prophylactic mastectomy (CPM): A systematic review of patient reported factors and psychological predictors influencing choice and satisfaction. [Review] SO - Breast. 28:107-20, 2016 Aug AS - BREAST. 28:107-20, 2016 Aug NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Body Image/px [Psychology] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Emotions MH - Fear MH - Female MH - Humans MH - Patient Education as Topic MH - *Patient Satisfaction MH - Prophylactic Mastectomy/ae [Adverse Effects] MH - *Prophylactic Mastectomy/px [Psychology] MH - Sexuality/px [Psychology] KW - Contralateral prophylactic mastectomy; Patient attitudes; Systematic review AB - OBJECTIVE: Conduct a systematic review of quantitative and qualitative studies exploring patient reported factors and psychological variables influencing the decision to have contralateral prophylactic mastectomy (CPM), and satisfaction with CPM, in women with early stage breast cancer. AB - METHODS: Studies were identified via databases: Medline, CINAHL, Embase and PsycINFO. Data were extracted by one author and crosschecked by two additional authors for accuracy. The quality of included articles was assessed using standardised criteria by three authors. AB - RESULTS: Of the 1346 unique citations identified, 17 were studies that met the inclusion criteria. Studies included were primarily cross-sectional and retrospective. No study utilised a theoretical framework to guide research and few studies considered psychological predictors of CPM. Fear of breast cancer was the most commonly cited reason for CPM, followed by cosmetic reasons such as desire for symmetry. Overall, women appeared satisfied with CPM, however, adverse/diminished body image, poor cosmetic result, complications, diminished sense of sexuality, emotional issues and perceived lack of education regarding alternative surveillance/CPM efficacy were cited as reasons for dissatisfaction. AB - CONCLUSION: Current literature has begun to identify patient-reported reasons for CPM; however, the relative importance of different factors and how these factors relate to the process underlying the decision to have CPM are unknown. Of women who considered CPM, limited information is available regarding differences between those who proceed with or ultimately decline CPM. AB - Copyright © 2016 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(16)30035-2 DO - https://dx.doi.org/10.1016/j.breast.2016.04.005 PT - Journal Article PT - Review ID - S0960-9776(16)30035-2 [pii] ID - 10.1016/j.breast.2016.04.005 [doi] PP - ppublish PH - 2015/09/17 [received] PH - 2016/03/19 [revised] PH - 2016/04/12 [accepted] LG - English EP - 20160609 DP - 2016 Aug DC - 20160712 EZ - 2016/06/13 06:00 DA - 2017/03/14 06:00 DT - 2016/06/13 06:00 YR - 2016 ED - 20170313 RD - 20170313 UP - 20170315 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27290619 <20. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26574936 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Dean M FA - Dean, Marleah IN - Dean, Marleah. a Department of Communication , University of South Florida. TI - Celebrity Health Announcements and Online Health Information Seeking: An Analysis of Angelina Jolie's Preventative Health Decision. SO - Health Communication. 31(6):752-61, 2016 AS - Health Commun. 31(6):752-61, 2016 NJ - Health communication PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dr9, 8908762 IO - Health Commun SB - Index Medicus CP - England MH - BRCA1 Protein/ge [Genetics] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Consumer Health Information/mt [Methods] MH - *Consumer Health Information/sn [Statistics & Numerical Data] MH - Decision Making MH - Disclosure MH - *Famous Persons MH - Genetic Predisposition to Disease MH - Genetic Testing MH - Health Knowledge, Attitudes, Practice MH - Humans MH - *Information Seeking Behavior MH - Internet/sn [Statistics & Numerical Data] MH - Internet/ut [Utilization] MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Risk Assessment AB - On May 14, 2013, Angelina Jolie disclosed she carries BRCA1, which means she has an 87% risk of developing breast cancer during her lifetime. Jolie decided to undergo a preventative bilateral mastectomy (PBM), reducing her risk to 5%. The purpose of this study was to analyze the type of information individuals are exposed to when using the Internet to search health information regarding Jolie's decision. Qualitative content analysis revealed four main themes--information about genetics, information about a PBM, information about health care, and information about Jolie's gender identity. Broadly, the identified websites mention Jolie's high risk for developing cancer due to the genetic mutation BRCA1, describe a PBM occasionally noting reasons why she had this surgery and providing alternatives to the surgery, discuss issues related to health care services, costs, and insurances about Jolie's health decision, and portray Jolie as a sexual icon, a partner to Brad Pitt, a mother of six children, and an inspirational humanitarian. The websites also depict Jolie's health decision in positive, negative, and/or both ways. Discussion centers on how this actress' health decision impacts the public. RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) ES - 1532-7027 IL - 1041-0236 DO - https://dx.doi.org/10.1080/10410236.2014.995866 PT - Journal Article ID - 26574936 [pubmed] ID - 10.1080/10410236.2014.995866 [doi] PP - ppublish LG - English EP - 20151117 DP - 2016 DC - 20160223 EZ - 2015/11/18 06:00 DA - 2017/03/01 06:00 DT - 2015/11/18 06:00 YR - 2016 ED - 20170228 RD - 20170228 UP - 20170302 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26574936 <21. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27215718 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schmidt H AU - Cohen A AU - Mandeli J AU - Weltz C AU - Port ER FA - Schmidt, Hank FA - Cohen, Almog FA - Mandeli, John FA - Weltz, Christina FA - Port, Elisa R IN - Schmidt, Hank. Department of Surgery, Dubin Breast Center/Mount Sinai Medical Center, New York, New York, USA. TI - Decision-Making in Breast Cancer Surgery: Where Do Patients Go for Information?. SO - American Surgeon. 82(5):397-402, 2016 May AS - Am Surg. 82(5):397-402, 2016 May NJ - The American surgeon PI - Journal available in: Print PI - Citation processed from: Internet JC - 43e, 0370522 IO - Am Surg SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/su [Surgery] MH - Cohort Studies MH - *Decision Making MH - Female MH - Health Information Exchange MH - Humans MH - *Mastectomy/mt [Methods] MH - *Medical Informatics/og [Organization & Administration] MH - Middle Aged MH - Patient Education as Topic/og [Organization & Administration] MH - *Surveys and Questionnaires MH - United States AB - Patient decision-making regarding breast cancer surgery is multifactorial, and patients derive information on surgical treatment options from a variety of sources which may have an impact on choice of surgery. We investigated the role of different information sources in patient decision-making regarding breast cancer surgery. Two hundred and sixty-eight patients with breast cancer, eligible for breast-conserving therapy were surveyed in the immediate preoperative period, and clinical data were also collected. This survey evaluated the scope and features of patient-driven research regarding their ultimate choice of surgical treatment. The two most common sources of information used by patients were written material from surgeons (199/268-74%) and the Internet (184/268-69%). There was a trend for women who chose bilateral mastectomy to use the Internet more frequently than those choosing unilateral mastectomy (P = 0.056). Number of surgeons consulted, genetic testing, and MRI were significant predictors of patient choice of mastectomy over breast-conserving therapy. Multivariate analysis showed that the number of surgeons consulted (P < 0.001) and genetic testing (P < 0.001) were independent predictors of choosing mastectomy, whereas MRI was not. In conclusions, understanding factors driving patient decision-making may promote more effective education for patients requiring breast cancer surgery. ES - 1555-9823 IL - 0003-1348 PT - Journal Article ID - 27215718 [pubmed] PP - ppublish LG - English DP - 2016 May DC - 20160524 EZ - 2016/05/25 06:00 DA - 2017/01/25 06:00 DT - 2016/05/25 06:00 YR - 2016 ED - 20170124 RD - 20170124 UP - 20170126 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27215718 <22. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26178202 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hawley ST AU - Newman L AU - Griggs JJ AU - Kosir MA AU - Katz SJ FA - Hawley, Sarah T FA - Newman, Lisa FA - Griggs, Jennifer J FA - Kosir, Mary Ann FA - Katz, Steven J IN - Hawley, Sarah T. Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. sarahawl@umich.edu. IN - Hawley, Sarah T. Ann Arbor VA Healthcare System, Ann Arbor, MI, USA. sarahawl@umich.edu. IN - Newman, Lisa. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. IN - Griggs, Jennifer J. Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. IN - Kosir, Mary Ann. Karmanos Cancer Institute, Detroit, MI, USA. IN - Katz, Steven J. Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. TI - Evaluating a Decision Aid for Improving Decision Making in Patients with Early-stage Breast Cancer. SO - The Patient: Patient-Centered Outcomes Research. 9(2):161-9, 2016 Apr AS - Patient. 9(2):161-9, 2016 Apr NJ - The patient PI - Journal available in: Print PI - Citation processed from: Internet JC - 101309314 IO - Patient PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715777 OI - Source: NLM. NIHMS708502 [Available on 04/01/17] SB - Index Medicus CP - New Zealand MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Mammaplasty/px [Psychology] MH - Mammaplasty/sn [Statistics & Numerical Data] MH - Mastectomy/cl [Classification] MH - Mastectomy/mt [Methods] MH - *Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - Patient Participation MH - *Patient Preference/px [Psychology] MH - Patient Preference/sn [Statistics & Numerical Data] AB - BACKGROUND: Early-stage breast cancer patients face a series of complex treatment decisions, with the first typically being choice of locoregional treatment. There is a need for tools to support patients in this decision-making process. AB - METHODS: We developed an innovative, online locoregional treatment tool based on International Patient Decision Aids Standards criteria. We evaluated its impact on patient knowledge about treatment and appraisal of decision making in a pilot study using a clinical sample of newly diagnosed, breast cancer patients who were randomized to view the decision aid website first or complete a survey prior to viewing the decision aid. Differences in knowledge and decision appraisal between the two groups were compared using t-tests and chi-square tests. Computer-generated preferences for treatment were compared with patients' stated preferences using chi-square tests. AB - RESULTS: One hundred and one newly diagnosed patients were randomized to view the website first or take a survey first. Women who viewed the website first had slightly higher, though not significantly, knowledge about surgery (p = 0.29) and reconstruction (p = 0.10) than the survey-first group. Those who viewed the website first also appraised their decision process significantly more favorably than did those who took the survey first (p < 0.05 for most decision outcomes). There was very good concordance between computer-suggested and stated treatment preferences. AB - CONCLUSION: This pilot study suggests that an interactive decision tool shows promise for supporting early-stage breast cancer patients with complicated treatment decision making. ES - 1178-1661 IL - 1178-1653 DI - 10.1007/s40271-015-0135-y DO - https://dx.doi.org/10.1007/s40271-015-0135-y PT - Evaluation Studies PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 26178202 [pubmed] ID - 10.1007/s40271-015-0135-y [doi] ID - 10.1007/s40271-015-0135-y [pii] ID - PMC4715777 [pmc] ID - NIHMS708502 [mid] PP - ppublish PH - 2017/04/01 [pmc-release] GI - No: R21 CA129859 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2016 Apr DC - 20160318 EZ - 2015/07/17 06:00 DA - 2017/01/12 06:00 DT - 2015/07/17 06:00 YR - 2016 ED - 20170111 RD - 20170112 UP - 20170113 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26178202 <23. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26178202 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hawley ST AU - Newman L AU - Griggs JJ AU - Kosir MA AU - Katz SJ FA - Hawley, Sarah T FA - Newman, Lisa FA - Griggs, Jennifer J FA - Kosir, Mary Ann FA - Katz, Steven J IN - Hawley, Sarah T. Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. sarahawl@umich.edu. IN - Hawley, Sarah T. Ann Arbor VA Healthcare System, Ann Arbor, MI, USA. sarahawl@umich.edu. IN - Newman, Lisa. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. IN - Griggs, Jennifer J. Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. IN - Kosir, Mary Ann. Karmanos Cancer Institute, Detroit, MI, USA. IN - Katz, Steven J. Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, 4th Floor, Ann Arbor, MI, 48109, USA. TI - Evaluating a Decision Aid for Improving Decision Making in Patients with Early-stage Breast Cancer. SO - The Patient: Patient-Centered Outcomes Research. 9(2):161-9, 2016 Apr AS - Patient. 9(2):161-9, 2016 Apr NJ - The patient PI - Journal available in: Print PI - Citation processed from: Internet JC - 101309314 IO - Patient PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715777 OI - Source: NLM. NIHMS708502 [Available on 04/01/17] SB - Index Medicus CP - New Zealand MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Mammaplasty/px [Psychology] MH - Mammaplasty/sn [Statistics & Numerical Data] MH - Mastectomy/cl [Classification] MH - Mastectomy/mt [Methods] MH - *Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - Patient Participation MH - *Patient Preference/px [Psychology] MH - Patient Preference/sn [Statistics & Numerical Data] AB - BACKGROUND: Early-stage breast cancer patients face a series of complex treatment decisions, with the first typically being choice of locoregional treatment. There is a need for tools to support patients in this decision-making process. AB - METHODS: We developed an innovative, online locoregional treatment tool based on International Patient Decision Aids Standards criteria. We evaluated its impact on patient knowledge about treatment and appraisal of decision making in a pilot study using a clinical sample of newly diagnosed, breast cancer patients who were randomized to view the decision aid website first or complete a survey prior to viewing the decision aid. Differences in knowledge and decision appraisal between the two groups were compared using t-tests and chi-square tests. Computer-generated preferences for treatment were compared with patients' stated preferences using chi-square tests. AB - RESULTS: One hundred and one newly diagnosed patients were randomized to view the website first or take a survey first. Women who viewed the website first had slightly higher, though not significantly, knowledge about surgery (p = 0.29) and reconstruction (p = 0.10) than the survey-first group. Those who viewed the website first also appraised their decision process significantly more favorably than did those who took the survey first (p < 0.05 for most decision outcomes). There was very good concordance between computer-suggested and stated treatment preferences. AB - CONCLUSION: This pilot study suggests that an interactive decision tool shows promise for supporting early-stage breast cancer patients with complicated treatment decision making. ES - 1178-1661 IL - 1178-1653 DI - 10.1007/s40271-015-0135-y DO - https://dx.doi.org/10.1007/s40271-015-0135-y PT - Evaluation Studies PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 10.1007/s40271-015-0135-y [doi] ID - 10.1007/s40271-015-0135-y [pii] ID - PMC4715777 [pmc] ID - NIHMS708502 [mid] PP - ppublish GI - No: R21 CA129859 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2016 Apr DC - 20160318 EZ - 2015/07/17 06:00 DA - 2017/01/12 06:00 DT - 2015/07/17 06:00 YR - 2016 ED - 20170111 RD - 20170403 UP - 20170404 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=26178202 <24. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26511607 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mortimer JW AU - McLachlan CS AU - Hansen CJ AU - Assareh H AU - Last A AU - McKay MJ AU - Shakespeare TP FA - Mortimer, Joshua W FA - McLachlan, Craig S FA - Hansen, Carmen J FA - Assareh, Hassan FA - Last, Andrew FA - McKay, Michael J FA - Shakespeare, Thomas P IN - Mortimer, Joshua W. Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour, Australia. IN - McLachlan, Craig S. Rural Clinical School Faculty of Medicine, University of New South Wales, Sydney, Australia. IN - Hansen, Carmen J. Department of Radiation Oncology, North Coast Cancer Institute, Port Macquarie, Australia. IN - Assareh, Hassan. Rural Clinical School Faculty of Medicine, University of New South Wales, Sydney, Australia. IN - Assareh, Hassan. Epidemiology, Executive Medical Services, Western Sydney Local Health District, Sydney, Australia. IN - Last, Andrew. Department of Radiation Oncology, North Coast Cancer Institute, Port Macquarie, Australia. IN - McKay, Michael J. Department of Radiation Oncology, North Coast Cancer Institute, Lismore, Australia. IN - Shakespeare, Thomas P. Rural Clinical School Faculty of Medicine, University of New South Wales, Coffs Harbour, Australia. IN - Shakespeare, Thomas P. Department of Radiation Oncology, North Coast Cancer Institute, Coffs Harbour, Australia. TI - Use of hypofractionated post-mastectomy radiotherapy reduces health costs by over $2000 per patient: An Australian perspective. SO - Journal of Medical Imaging & Radiation Oncology. 60(1):146-53, 2016 Feb AS - J Med Imaging Radiat Oncol. 60(1):146-53, 2016 Feb NJ - Journal of medical imaging and radiation oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101469340 IO - J Med Imaging Radiat Oncol SB - Index Medicus CP - Australia MH - Adult MH - Aged MH - Aged, 80 and over MH - Australia/ep [Epidemiology] MH - *Breast Neoplasms/ec [Economics] MH - Breast Neoplasms/ep [Epidemiology] MH - *Breast Neoplasms/th [Therapy] MH - *Cost Savings/ec [Economics] MH - Cost Savings/ut [Utilization] MH - *Dose Hypofractionation MH - Female MH - Health Care Costs/sn [Statistics & Numerical Data] MH - Humans MH - Middle Aged MH - Prevalence MH - *Prostatectomy/ec [Economics] MH - Prostatectomy/ut [Utilization] MH - *Radiotherapy, Adjuvant/ec [Economics] MH - Radiotherapy, Adjuvant/ut [Utilization] MH - Retrospective Studies MH - Treatment Outcome KW - breast neoplasms; dose fractionation; health care costs; intensity-modulated; mastectomy; radiotherapy AB - INTRODUCTION: The most recent clinical practice guidelines released by Cancer Australia draw attention to unanswered questions concerning the health economic considerations associated with hypofractionated radiotherapy. This study aimed to quantify and compare the healthcare costs at a regional Australian radiotherapy institute with respect to conventionally fractionated post-mastectomy radiotherapy (Cf-PMRT) versus hypofractionated post-mastectomy radiotherapy (Hf-PMRT) administration. AB - METHODS: Medical records of 196 patients treated with post-mastectomy radiotherapy at the NSW North Coast Cancer Institute from February 2008 to June 2014 were retrospectively reviewed. Australian Medicare item numbers billed for patients receiving either Cf-PMRT of 50 Gy in 25 daily fractions or Hf-PMRT of 40.05 Gy in 15 daily fractions were calculated. Decision tree analysis was used to model costs. Independent-samples t-tests and Mann-Whitney U-tests were used to compare crude average costs for Cf-PMRT and Hf-PMRT and determine which treatment components accounted for any differences. AB - RESULTS: Hf-PMRT, with or without irradiation to the regional lymph nodes, was associated with significantly reduced Medicare costs ($5613 AUD per patient for Hf-PMRT vs $8272 AUD per patient for Cf-PMRT; P < 0.001). Savings associated with Hf-PMRT ranged from $1353 (22.1%) for patients receiving no regional irradiation to $2898 (32.0%) for patients receiving both axillary and supraclavicular therapy. AB - CONCLUSIONS: Hf-PMRT results in a significant reduction in the financial costs associated with treating breast cancer patients in a regional Australian setting when compared with Cf-PMRT. AB - Copyright © 2015 The Royal Australian and New Zealand College of Radiologists. ES - 1754-9485 IL - 1754-9477 DO - https://dx.doi.org/10.1111/1754-9485.12405 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26511607 [pubmed] ID - 10.1111/1754-9485.12405 [doi] PP - ppublish PH - 2015/03/20 [received] PH - 2015/09/17 [accepted] SI - GENBANK SA - GENBANK/CD003860 LG - English EP - 20151029 DP - 2016 Feb DC - 20160127 EZ - 2015/10/30 06:00 DA - 2017/01/10 06:00 DT - 2015/10/30 06:00 YR - 2016 ED - 20170109 RD - 20170110 UP - 20170111 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26511607 <25. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26952679 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Richards I AU - Tesson S AU - Porter D AU - Phillips KA AU - Rankin N AU - Musiello T AU - Marven M AU - Butow P FA - Richards, Imogen FA - Tesson, Stephanie FA - Porter, David FA - Phillips, Kelly-Anne FA - Rankin, Nicole FA - Musiello, Toni FA - Marven, Michelle FA - Butow, Phyllis IN - Richards, Imogen. School of Psychology, Griffith Taylor Building (A19), The University of Sydney, NSW 2006, Australia. Electronic address: iric5786@uni.sydney.edu.au. IN - Tesson, Stephanie. School of Psychology, Griffith Taylor Building (A19), The University of Sydney, NSW 2006, Australia. IN - Porter, David. Department of Oncology, Auckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand. IN - Phillips, Kelly-Anne. Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Dept. of Oncology, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population and Global Health, Locked Bag 1, A'Beckett Street, VIC 8006, Australia; Department of Medicine, St Vincent's Hospital, The University of Melbourne, Level 4, Clinical Sciences Building, 29 Regent St, Fitzroy, VIC 3065, Australia. IN - Rankin, Nicole. Sydney Catalyst, Level 6, Chris O'Brien Lifehouse Building (C39Z), Sydney, NSW 2006, Australia. IN - Musiello, Toni. University of Western Australia (M507), 35 Stirling Highway, Crawley, WA 6009, Australia. IN - Marven, Michelle. Breast Cancer Network Australia, 293 Camberwell Rd, Camberwell, VIC 3124, Australia. IN - Butow, Phyllis. School of Psychology, Griffith Taylor Building (A19), The University of Sydney, NSW 2006, Australia; Centre for Medical Psychology & Evidence-based Decision Making/Psycho-oncology Co-operative Research Group, Level 6, Chris O'Brien Lifehouse Building (C39Z), Sydney, NSW 2006, Australia. TI - Predicting women's intentions for contralateral prophylactic mastectomy: An application of an extended theory of planned behaviour. SO - European Journal of Oncology Nursing. 21:57-65, 2016 Apr AS - EUR J ONCOL NURS. 21:57-65, 2016 Apr NJ - European journal of oncology nursing : the official journal of European Oncology Nursing Society PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100885136 IO - Eur J Oncol Nurs SB - Index Medicus SB - Nursing Journal CP - Scotland MH - Adult MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Cross-Sectional Studies MH - *Decision Making MH - Emotions MH - Female MH - Humans MH - *Intention MH - Middle Aged MH - *Prophylactic Mastectomy MH - Self Efficacy MH - Socioeconomic Factors KW - Breast cancer; Contralateral breast cancer; Contralateral prophylactic mastectomy; Decision-making; Theory of planned behaviour AB - PURPOSE: Most women with unilateral breast cancer (BC) without BRCA1/2 gene mutations are at low risk of contralateral breast cancer (CBC). One CBC risk-management option is contralateral prophylactic mastectomy (CPM). While there is no evidence that CPM increases life-expectancy, its uptake is increasing. This study aimed to assess the validity of an extended social-cognition model, the Theory of Planned Behaviour (TPB), in predicting women's intentions to undergo CPM. AB - METHOD: Four hundred women previously treated for BC completed an online survey exploring demographic and disease factors, attitude, subjective norm, perceived behavioural control, anticipated regret, uncertainty avoidance, self-efficacy to not have CPM and intentions to undergo CPM in a common hypothetical decision-making scenario. AB - RESULTS: The TPB uniquely explained 25.7% of intention variance. Greater anticipated regret, uncertainty avoidance and lower self-efficacy to cope with not having CPM were associated with stronger CPM intentions, explaining an additional 7.7%, 10.6% and 2.9% respectively, of variance over and above the TPB. Women who had undergone CPM, had not attended university, and had children reported stronger CPM intentions. AB - CONCLUSIONS: A holistic understanding of CPM decision-making appears to require consideration beyond CBC risk, demographics and disease characteristics, exploring women's expectations about CPM outcomes, others' opinions, and avoidance of emotionality and difficulties associated with not undergoing surgery. This study provides a theoretical basis from which the complexity of CPM decision-making may be understood, and from which resources for patients and treating staff may be developed to support women's informed decision-making aligning with their personal values. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. ES - 1532-2122 IL - 1462-3889 DI - S1462-3889(15)30049-1 DO - https://dx.doi.org/10.1016/j.ejon.2015.12.002 PT - Journal Article ID - 26952679 [pubmed] ID - S1462-3889(15)30049-1 [pii] ID - 10.1016/j.ejon.2015.12.002 [doi] PP - ppublish PH - 2015/08/24 [received] PH - 2015/11/14 [revised] PH - 2015/12/07 [accepted] LG - English EP - 20160202 DP - 2016 Apr DC - 20160308 EZ - 2016/03/09 06:00 DA - 2017/01/10 06:00 DT - 2016/03/10 06:00 YR - 2016 ED - 20170109 RD - 20170110 UP - 20170111 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26952679 <26. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27070681 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Luan A AU - Hui KJ AU - Remington AC AU - Liu X AU - Lee GK FA - Luan, Anna FA - Hui, Kenneth J FA - Remington, Austin C FA - Liu, Xiangxia FA - Lee, Gordon K IN - Luan, Anna. From the *Division of Plastic Surgery, Department of Surgery, Stanford University Medical Center, Stanford, CA; and +Division of Plastic and Reconstructive Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. TI - Effects of A Novel Decision Aid for Breast Reconstruction: A Randomized Prospective Trial. SO - Annals of Plastic Surgery. 76 Suppl 3:S249-54, 2016 May AS - Ann Plast Surg. 76 Suppl 3:S249-54, 2016 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Adult MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Mammaplasty/mt [Methods] MH - *Mammaplasty/px [Psychology] MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Outcome and Process Assessment (Health Care) MH - *Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - *Patient-Centered Care/mt [Methods] MH - Prospective Studies AB - INTRODUCTION: The choice to undergo mastectomy and breast reconstruction is a highly personal decision with profound psychosocial effects, and ultimately, the decision between implant- and autologous tissue-based reconstruction should be made based on a combination of factual information and the patient's personal values and preferences. Unfortunately, patients undergoing breast reconstruction surgery may experience decision regret. Decision aids promote patient involvement in decision making by not only providing standard information about options, but also emphasizing comparative risks, benefits, and alternatives, and most importantly by providing clarification exercises regarding personal values to guide patients toward an individualized decision. AB - METHODS: We developed a novel decision aid to provide decision support and structured guidance for prosthetic, autologous, and combined prosthetic-autologous breast reconstruction surgery. New breast reconstruction patients of one surgeon at our institution were randomized by week to either receive the decision aid or standard preconsultation material. Immediately preceding their new patient consultation clinic visit, patients were asked to complete the validated Decisional Conflict Scale and the BREAST-Q Preoperative survey. After 3 to 5 months following breast mound reconstruction, patients were asked to complete the Decision Regret Scale, BREAST-Q Postoperative survey, and the Hospital Anxiety and Depression Scale. AB - RESULTS: Patients who received the decision aid demonstrated a trend toward decreased preoperative decisional conflict (mean of 13.3 +/- 5.5, compared to 26.2 +/- 4.2; n = 8 per group, P = 0.069), with similar preoperative BREAST-Q scores. Most patients desired to know "everything" regarding their reconstruction surgery (75%), and to be "very involved" in the decisions in their care (81%), with remaining patients wanting to know "as much as I need to be prepared" and to be "somewhat involved." Postoperatively, patients who received the decision aid demonstrated significantly less decision regret (P < 0.001), although there was no significant difference in anxiety, depression, or quality of life-related outcomes as measured by the BREAST-Q. AB - CONCLUSIONS: The use of decision aids in breast reconstruction surgery may help decrease decisional conflict and regret through promoting improved information sharing and shared decision making, which are highly important in this particular setting, patient population, and in our move toward greater patient-centered care. ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/SAP.0000000000000722 PT - Journal Article PT - Randomized Controlled Trial ID - 27070681 [pubmed] ID - 10.1097/SAP.0000000000000722 [doi] PP - ppublish LG - English DP - 2016 May DC - 20160415 EZ - 2016/04/13 06:00 DA - 2017/01/07 06:00 DT - 2016/04/14 06:00 YR - 2016 ED - 20170106 RD - 20170107 UP - 20170109 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27070681 <27. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27017240 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Nicholas Zdenkowski AU - Butow P AU - Tesson S AU - Boyle F FA - Nicholas Zdenkowski FA - Butow, Phyllis FA - Tesson, Stephanie FA - Boyle, Frances IN - Nicholas Zdenkowski, . Faculty of Medicine, University of Sydney, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Newcastle, NSW, Australia. Electronic address: nicholas.zdenkowski@anzbctg.org. IN - Butow, Phyllis. Psycho-oncology Co-operative Research Group (PoCoG) and Centre for Medical Psychology and Evidence-based Medicine (CeMPED), School of Psychology, University of Sydney, NSW, Australia. IN - Tesson, Stephanie. Psycho-oncology Co-operative Research Group (PoCoG) and Centre for Medical Psychology and Evidence-based Medicine (CeMPED), School of Psychology, University of Sydney, NSW, Australia. IN - Boyle, Frances. Faculty of Medicine, University of Sydney, NSW, Australia; Australia and New Zealand Breast Cancer Trials Group, Newcastle, NSW, Australia; Patricia Ritchie Centre for Cancer Care and Research, Mater Hospital, Sydney, NSW, Australia. TI - A systematic review of decision aids for patients making a decision about treatment for early breast cancer. [Review] SO - Breast. 26:31-45, 2016 Apr AS - BREAST. 26:31-45, 2016 Apr NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - Cross-Sectional Studies MH - *Decision Making MH - *Decision Support Techniques MH - Drug Therapy/px [Psychology] MH - *Early Detection of Cancer/px [Psychology] MH - Female MH - Fertility Preservation/px [Psychology] MH - Humans MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Radiotherapy/px [Psychology] MH - Randomized Controlled Trials as Topic KW - Breast neoplasms; Chemotherapy; Decision aid; Decision making; Systematic review; Treatment AB - Several complex treatment decisions may be offered to women with early stage breast cancer, about a range of treatments from different modalities including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids can facilitate shared decision-making and improve decision-related outcomes. We aimed to systematically identify, describe and appraise the literature on treatment decision aids for women with early breast cancer, synthesise the data and identify breast cancer decisions that lack a decision aid. A prospectively developed search strategy was applied to MEDLINE, the Cochrane databases, EMBASE, PsycINFO, Web of Science and abstract databases from major conferences. Data were extracted into a pre-piloted form. Quality and risk of bias were measured using Qualsyst criteria. Results were synthesised into narrative format. Thirty-three eligible articles were identified, evaluating 23 individual treatment decision aids, comprising 13 randomised controlled trial reports, seven non-randomised comparative studies, eight single-arm pre-post studies and five cross-sectional studies. The decisions addressed by these decision aids were: breast conserving surgery versus mastectomy (+/- reconstruction); use of chemotherapy and/or endocrine therapy; radiotherapy; and fertility preservation. Outcome measures were heterogeneous, precluding meta-analysis. Decisional conflict decreased, and knowledge and satisfaction increased, without any change in anxiety or depression, in most studies. No studies were identified that evaluated decision aids for neoadjuvant systemic therapy, or contralateral prophylactic mastectomy. Decision aids are available and improved decision-related outcomes for many breast cancer treatment decisions including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids for neoadjuvant systemic therapy and contralateral prophylactic mastectomy could not be found, and may be warranted. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(15)00265-9 DO - https://dx.doi.org/10.1016/j.breast.2015.12.007 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 27017240 [pubmed] ID - S0960-9776(15)00265-9 [pii] ID - 10.1016/j.breast.2015.12.007 [doi] PP - ppublish PH - 2015/07/08 [received] PH - 2015/12/12 [revised] PH - 2015/12/15 [accepted] LG - English EP - 20160108 DP - 2016 Apr DC - 20160328 EZ - 2016/03/28 06:00 DA - 2017/01/05 06:00 DT - 2016/03/29 06:00 YR - 2016 ED - 20170104 RD - 20170105 UP - 20170106 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27017240 <28. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25959986 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wong IO AU - Lam WW AU - Wong CN AU - Cowling BJ AU - Leung GM AU - Fielding R FA - Wong, Irene O L FA - Lam, Wendy W T FA - Wong, Cheuk Nam FA - Cowling, Benjamin J FA - Leung, Gabriel M FA - Fielding, Richard IN - Wong, Irene O L. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Electronic address: iolwong@hku.hk. IN - Lam, Wendy W T. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. IN - Wong, Cheuk Nam. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. IN - Cowling, Benjamin J. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. IN - Leung, Gabriel M. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. IN - Fielding, Richard. School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. TI - Towards informed decisions on breast cancer screening: Development and pilot testing of a decision aid for Chinese women. SO - Patient Education & Counseling. 98(8):961-9, 2015 Aug AS - Patient Educ Couns. 98(8):961-9, 2015 Aug NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Aged, 80 and over MH - *Asian Continental Ancestry Group/sn [Statistics & Numerical Data] MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Decision Making MH - *Decision Support Techniques MH - Early Detection of Cancer MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Hong Kong MH - Humans MH - Middle Aged MH - Patient Acceptance of Health Care/eh [Ethnology] MH - *Patient Acceptance of Health Care/px [Psychology] MH - Patient Participation MH - Pilot Projects MH - Population Surveillance MH - Surveys and Questionnaires MH - Telephone KW - Breast cancer screening; Chinese; Decision aid; Informed decision AB - OBJECTIVE: To pilot-test a novel, self-use breast cancer (BC) screening decision aid (DA) targeting Hong Kong (HK) Chinese women at average risk of BC. AB - METHODS: Women were recruited through a population-based telephone survey using random digit dialling between October 2013 and January 2014. Eligible participants completed our baseline survey and then received the DA by post. Participants (n=90) completed follow-up telephone interviews one month later. AB - RESULTS: Most participants thought that all/most DA content was presented clearly (86.7%), and was useful in helping women make screening-related decisions (88.9%). It also achieved its expected impact of improving informed decision-making and increasing shared-participation preference without increasing participants' anxiety levels. Participants showed a modest non-statistical increase in their screening knowledge scores. Older women rated the perceived severity of a BC diagnosis as significantly lower, and more educated women reported significantly lower perceived anxiety about the disease. AB - CONCLUSION: Our DA appears acceptable and feasible for self-use by HK Chinese women who need to make an informed decision about BC screening without increasing overall anxiety levels. AB - PRACTICE IMPLICATIONS: This study supports the potential of self-use DAs for cancer screening-related decision support in a Chinese population. AB - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(15)00194-9 DO - https://dx.doi.org/10.1016/j.pec.2015.04.014 PT - Journal Article ID - 25959986 [pubmed] ID - S0738-3991(15)00194-9 [pii] ID - 10.1016/j.pec.2015.04.014 [doi] PP - ppublish PH - 2014/12/31 [received] PH - 2015/04/08 [revised] PH - 2015/04/18 [accepted] LG - English EP - 20150429 DP - 2015 Aug DC - 20150615 EZ - 2015/05/12 06:00 DA - 2016/12/15 06:00 DT - 2015/05/12 06:00 YR - 2015 ED - 20161213 RD - 20161230 UP - 20161230 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25959986 <29. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26517595 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Harter M AU - Buchholz A AU - Nicolai J AU - Reuter K AU - Komarahadi F AU - Kriston L AU - Kallinowski B AU - Eich W AU - Bieber C FA - Harter, Martin FA - Buchholz, Angela FA - Nicolai, Jennifer FA - Reuter, Katrin FA - Komarahadi, Fely FA - Kriston, Levente FA - Kallinowski, Birgit FA - Eich, Wolfgang FA - Bieber, Christiane IN - Harter, Martin. Department of Medical Psychology at the University Medical Center Hamburg-Eppendorf, Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University of Heidelberg, Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Celenus-Kliniken GmbH, Offenburg, Practice for Gastroenterology & Oncology, Schwetzingen. TI - Shared Decision Making and the Use of Decision Aids. SO - Deutsches Arzteblatt International. 112(40):672-9, 2015 Oct 02 AS - Dtsch. Arztebl. int.. 112(40):672-9, 2015 Oct 02 NJ - Deutsches Arzteblatt international PI - Journal available in: Print PI - Citation processed from: Internet JC - 101475967 IO - Dtsch Arztebl Int PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4640071 SB - Index Medicus CP - Germany MH - Adult MH - *Clinical Decision-Making/mt [Methods] MH - Evidence-Based Medicine MH - Female MH - Germany/ep [Epidemiology] MH - Humans MH - Male MH - Middle Aged MH - *Neoplasms/ep [Epidemiology] MH - Neoplasms/px [Psychology] MH - *Neoplasms/th [Therapy] MH - Patient Participation/px [Psychology] MH - *Patient Participation/sn [Statistics & Numerical Data] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - Patient-Centered Care/sn [Statistics & Numerical Data] MH - Physician-Patient Relations MH - Physicians/px [Psychology] MH - Physicians/sn [Statistics & Numerical Data] MH - Prevalence MH - *Quality Improvement/sn [Statistics & Numerical Data] MH - Quality of Health Care/sn [Statistics & Numerical Data] MH - Treatment Outcome AB - BACKGROUND: In shared decision making (SDM), the patient and the physician reach decisions in partnership. We conducted a trial of SDM training for physicians who treat patients with cancer. AB - METHODS: Physicians who treat patients with cancer were invited to participate in a cluster-randomized trial and carry out SDM together with breast or colon cancer patients who faced decisions about their treatment. Decision-related physician-patient conversations were recorded. The patients filled out questionnaires immediately after the consultations (T1) and three months later (T2). The primary endpoints were the patients' confidence in and satisfaction with the decisions taken. The secondary endpoints were the process of decision making, anxiety, depression, quality of life, and externally assessed physician competence in SDM. The physicians in the intervention group underwent 12 hours of training in SDM, including the use of decision aids. AB - RESULTS: Of the 900 physicians invited to participated in the trial, 105 answered the invitation. 86 were randomly assigned to either the intervention group or the control group (44 and 42 physicians, respectively); 33 of the 86 physicians recruited at least one patient for the trial. A total of 160 patients participated in the trial, of whom 55 were treated by physicians in the intervention group. There were no intergroup differences in the primary endpoints. Trained physicians were more competent in SDM (Cohen's d = 0.56; p<0.05). Patients treated by trained physicians had lower anxiety and depression scores immediately after the consultation (d = -0.12 and -0.14, respectively; p<0.10), and markedly lower anxiety and depression scores three months later (d = -0.94 and -0.67, p<0.01). AB - CONCLUSION: When physicians treating cancer patients improve their competence in SDM by appropriate training, their patients may suffer less anxiety and depression. These effects merit further study. ES - 1866-0452 IL - 1866-0452 DI - arztebl.2015.0672 DO - https://dx.doi.org/10.3238/arztebl.2015.0672 PT - Journal Article PT - Randomized Controlled Trial ID - 26517595 [pubmed] ID - arztebl.2015.0672 [pii] ID - 10.3238/arztebl.2015.0672 [doi] ID - PMC4640071 [pmc] PP - ppublish PH - 2015/03/02 [received] PH - 2015/06/11 [revised] PH - 2015/06/11 [accepted] LG - English DP - 2015 Oct 02 DC - 20151031 EZ - 2015/10/31 06:00 DA - 2016/12/15 06:00 DT - 2015/11/01 06:00 YR - 2015 ED - 20161213 RD - 20161230 UP - 20161230 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26517595 <30. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26420774 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bayram Y AU - Zor F AU - Karagoz H AU - Kulahci Y AU - Afifi AM AU - Ozturk S FA - Bayram, Yalcin FA - Zor, Fatih FA - Karagoz, Huseyin FA - Kulahci, Yalcin FA - Afifi, Ahmed M FA - Ozturk, Serdar IN - Bayram, Yalcin. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Zor, Fatih. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Karagoz, Huseyin. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Kulahci, Yalcin. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Afifi, Ahmed M. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Ozturk, Serdar. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. TI - Challenging Breast Augmentations: The Influence of Preoperative Anatomical Features on the Final Result. CM - Comment in: Aesthet Surg J. 2016 Mar;36(3):321-3; PMID: 26843097 SO - Aesthetic Surgery Journal. 36(3):313-20, 2016 Mar AS - Aesthet. surg. j.. 36(3):313-20, 2016 Mar NJ - Aesthetic surgery journal PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9707469 IO - Aesthet Surg J SB - Index Medicus CP - England MH - Adult MH - Breast/ab [Abnormalities] MH - *Breast/su [Surgery] MH - Breast Implantation/ae [Adverse Effects] MH - Breast Implantation/is [Instrumentation] MH - *Breast Implantation MH - Breast Implants MH - Decision Support Techniques MH - Female MH - Humans MH - Patient Satisfaction MH - Photography MH - Postoperative Complications/et [Etiology] MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome MH - Young Adult AB - BACKGROUND: Achieving satisfactory results may be difficult in augmentation mammaplasty patients in the presence of breast, chest wall, or vertebral deformities. These deformities have not been classified previously, and the impact of each deformity or combination of deformities has not been defined. AB - OBJECTIVES: The aims of this study are to determine the complicating factors in augmentation mammaplasty, to classify these factors according to their influence on surgical outcome, and to develop an identification system for simplifying the recognition of challenging cases. AB - METHODS: We retrospectively analyzed photographs and records of 100 consecutive patients who underwent augmentation mammaplasty. We observed suboptimal results in 18 cases. Preoperative deformities of the breast, chest wall, and vertebra were recorded in order to determine which factor or factors had complicated the surgeries. Eventually, the relationship between suboptimal surgical results and complicating factors was evaluated. AB - RESULTS: We observed that some deformities alone caused suboptimal results, whereas others did not. Deformities that caused suboptimal results alone were called major complicating factors, and any others were called minor complicating factors. We observed that suboptimal results were also obtained in patients who had four minor complicating factors. Patients who had suboptimal results because of major or minor complicating factors were considered challenging cases. AB - CONCLUSIONS: In this study, complicating factors for augmentation mammaplasty were defined and classified as major or minor depending on their effect on the surgical outcome. We suggest an identification system that simplifies the recognition of challenging cases in breast augmentation. AB - Copyright © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com. ES - 1527-330X IL - 1090-820X DI - sjv181 DO - https://dx.doi.org/10.1093/asj/sjv181 PT - Journal Article ID - 26420774 [pubmed] ID - sjv181 [pii] ID - 10.1093/asj/sjv181 [doi] ID - PMC5127479 [pmc] PP - ppublish PH - 2015/08/04 [accepted] PH - 2017/03/01 [pmc-release] LG - English EP - 20150929 DP - 2016 Mar DC - 20160216 EZ - 2015/10/01 06:00 DA - 2016/11/15 06:00 DT - 2015/10/01 06:00 YR - 2016 ED - 20161114 RD - 20161202 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26420774 <31. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26420774 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bayram Y AU - Zor F AU - Karagoz H AU - Kulahci Y AU - Afifi AM AU - Ozturk S FA - Bayram, Yalcin FA - Zor, Fatih FA - Karagoz, Huseyin FA - Kulahci, Yalcin FA - Afifi, Ahmed M FA - Ozturk, Serdar IN - Bayram, Yalcin. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Zor, Fatih. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Karagoz, Huseyin. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Kulahci, Yalcin. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Afifi, Ahmed M. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. IN - Ozturk, Serdar. Drs Bayram and Zor are Associate Professors and Dr Ozturk is a Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Karagoz is an Associate Professor, Department of Plastic, Reconstructive, and Aesthetic Surgery; GATA Haydarpasha Training Hospital, Istanbul, Turkey. Dr Kulahci is an Associate Professor, Department of Hand Surgery, Gulhane Military Medical Academy, Ankara, Turkey. Dr Afifi is an Assistant Professor, Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA. TI - Challenging Breast Augmentations: The Influence of Preoperative Anatomical Features on the Final Result. CM - Comment in: Aesthet Surg J. 2016 Mar;36(3):321-3; PMID: 26843097 SO - Aesthetic Surgery Journal. 36(3):313-20, 2016 Mar AS - Aesthet. surg. j.. 36(3):313-20, 2016 Mar NJ - Aesthetic surgery journal PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9707469 IO - Aesthet Surg J SB - Index Medicus CP - England MH - Adult MH - Breast/ab [Abnormalities] MH - *Breast/su [Surgery] MH - Breast Implantation/ae [Adverse Effects] MH - Breast Implantation/is [Instrumentation] MH - *Breast Implantation MH - Breast Implants MH - Decision Support Techniques MH - Female MH - Humans MH - Patient Satisfaction MH - Photography MH - Postoperative Complications/et [Etiology] MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome MH - Young Adult AB - BACKGROUND: Achieving satisfactory results may be difficult in augmentation mammaplasty patients in the presence of breast, chest wall, or vertebral deformities. These deformities have not been classified previously, and the impact of each deformity or combination of deformities has not been defined. AB - OBJECTIVES: The aims of this study are to determine the complicating factors in augmentation mammaplasty, to classify these factors according to their influence on surgical outcome, and to develop an identification system for simplifying the recognition of challenging cases. AB - METHODS: We retrospectively analyzed photographs and records of 100 consecutive patients who underwent augmentation mammaplasty. We observed suboptimal results in 18 cases. Preoperative deformities of the breast, chest wall, and vertebra were recorded in order to determine which factor or factors had complicated the surgeries. Eventually, the relationship between suboptimal surgical results and complicating factors was evaluated. AB - RESULTS: We observed that some deformities alone caused suboptimal results, whereas others did not. Deformities that caused suboptimal results alone were called major complicating factors, and any others were called minor complicating factors. We observed that suboptimal results were also obtained in patients who had four minor complicating factors. Patients who had suboptimal results because of major or minor complicating factors were considered challenging cases. AB - CONCLUSIONS: In this study, complicating factors for augmentation mammaplasty were defined and classified as major or minor depending on their effect on the surgical outcome. We suggest an identification system that simplifies the recognition of challenging cases in breast augmentation. AB - Copyright © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com. ES - 1527-330X IL - 1090-820X DI - sjv181 DO - https://dx.doi.org/10.1093/asj/sjv181 PT - Journal Article ID - 26420774 [pubmed] ID - sjv181 [pii] ID - 10.1093/asj/sjv181 [doi] ID - PMC5127479 [pmc] PP - ppublish PH - 2015/08/04 [accepted] PH - 2017/03/01 [pmc-release] LG - English EP - 20150929 DP - 2016 Mar DC - 20160216 EZ - 2015/10/01 06:00 DA - 2016/11/15 06:00 DT - 2015/10/01 06:00 YR - 2016 ED - 20161114 RD - 20170301 UP - 20170302 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=26420774 <32. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25749023 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tokes T AU - Torgyik L AU - Szentmartoni G AU - Somlai K AU - Toth A AU - Kulka J AU - Dank M FA - Tokes, Timea FA - Torgyik, Laszlo FA - Szentmartoni, Gyongyver FA - Somlai, Krisztian FA - Toth, Andrea FA - Kulka, Janina FA - Dank, Magdolna IN - Tokes, Timea. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. Electronic address: tokes.timea@med.semmelweis-univ.hu. IN - Torgyik, Laszlo. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. IN - Szentmartoni, Gyongyver. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. IN - Somlai, Krisztian. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary; St. Margaret Hospital, Surgical Division, Budapest, Hungary. IN - Toth, Andrea. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. IN - Kulka, Janina. Semmelweis University, 2nd Department of Pathology, Budapest, Hungary. IN - Dank, Magdolna. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. TI - Primary systemic therapy for breast cancer: Does the patient's involvement in decision-making create a new future?. [Review] SO - Patient Education & Counseling. 98(6):695-703, 2015 Jun AS - Patient Educ Couns. 98(6):695-703, 2015 Jun NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - Mastectomy MH - *Outcome and Process Assessment (Health Care)/td [Trends] MH - *Patient Participation KW - Breast cancer; Breast-conserving surgery; Decision making; Decision-aid; Primary systemic therapy AB - OBJECTIVE: Primary systemic therapy (PST) followed by surgery is the standard initial treatment for locally advanced breast cancer (LABC). However, some patients are averse to mastectomy or breast-conserving surgery and do not consent to these procedures. The reasons for this controversial decision, the factors influencing the decision-making and optimal solutions for decision aiding need to be investigated. AB - METHODS: We addressed these questions by a review of literature on the possibilities associated with different patient choices and subsequent treatment options in relation to LABC. AB - RESULTS: A total of 5 reviews and 22 clinical studies were summarized in relation to decision making and the most successful decision aids. A discussion is given of the issues of those few patients who cannot be convinced to undergo surgery. AB - CONCLUSION: Currently there is no guideline for the treatment of patients who reject the surgical procedures after PST. Medical oncologists should be able to apply decision aid modalities in a personalized manner to give all needed information to their patients thereby ensuring a deliberate decision-making process, facilitating acceptance of a need for surgery, and thus improving the chances of prolonged survival. AB - PRACTICE IMPLICATIONS: Currently multidisciplinary tumor boards are the most suitable decision aids in oncological practice. AB - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved. RN - 0 (Antineoplastic Agents) ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(15)00082-8 DO - https://dx.doi.org/10.1016/j.pec.2015.02.012 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 25749023 [pubmed] ID - S0738-3991(15)00082-8 [pii] ID - 10.1016/j.pec.2015.02.012 [doi] PP - ppublish PH - 2014/08/21 [received] PH - 2015/02/05 [revised] PH - 2015/02/15 [accepted] LG - English EP - 20150225 DP - 2015 Jun DC - 20150430 EZ - 2015/03/10 06:00 DA - 2016/11/01 06:00 DT - 2015/03/10 06:00 YR - 2015 ED - 20161031 RD - 20161110 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25749023 <33. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25749023 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tokes T AU - Torgyik L AU - Szentmartoni G AU - Somlai K AU - Toth A AU - Kulka J AU - Dank M FA - Tokes, Timea FA - Torgyik, Laszlo FA - Szentmartoni, Gyongyver FA - Somlai, Krisztian FA - Toth, Andrea FA - Kulka, Janina FA - Dank, Magdolna IN - Tokes, Timea. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. Electronic address: tokes.timea@med.semmelweis-univ.hu. IN - Torgyik, Laszlo. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. IN - Szentmartoni, Gyongyver. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. IN - Somlai, Krisztian. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary; St. Margaret Hospital, Surgical Division, Budapest, Hungary. IN - Toth, Andrea. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. IN - Kulka, Janina. Semmelweis University, 2nd Department of Pathology, Budapest, Hungary. IN - Dank, Magdolna. Semmelweis University, 1st Department of Internal Medicine, Oncology Division, Budapest, Hungary. TI - Primary systemic therapy for breast cancer: Does the patient's involvement in decision-making create a new future?. [Review] SO - Patient Education & Counseling. 98(6):695-703, 2015 Jun AS - Patient Educ Couns. 98(6):695-703, 2015 Jun NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - Mastectomy MH - *Outcome and Process Assessment (Health Care)/td [Trends] MH - *Patient Participation KW - Breast cancer; Breast-conserving surgery; Decision making; Decision-aid; Primary systemic therapy AB - OBJECTIVE: Primary systemic therapy (PST) followed by surgery is the standard initial treatment for locally advanced breast cancer (LABC). However, some patients are averse to mastectomy or breast-conserving surgery and do not consent to these procedures. The reasons for this controversial decision, the factors influencing the decision-making and optimal solutions for decision aiding need to be investigated. AB - METHODS: We addressed these questions by a review of literature on the possibilities associated with different patient choices and subsequent treatment options in relation to LABC. AB - RESULTS: A total of 5 reviews and 22 clinical studies were summarized in relation to decision making and the most successful decision aids. A discussion is given of the issues of those few patients who cannot be convinced to undergo surgery. AB - CONCLUSION: Currently there is no guideline for the treatment of patients who reject the surgical procedures after PST. Medical oncologists should be able to apply decision aid modalities in a personalized manner to give all needed information to their patients thereby ensuring a deliberate decision-making process, facilitating acceptance of a need for surgery, and thus improving the chances of prolonged survival. AB - PRACTICE IMPLICATIONS: Currently multidisciplinary tumor boards are the most suitable decision aids in oncological practice. AB - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved. RN - 0 (Antineoplastic Agents) ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(15)00082-8 DO - https://dx.doi.org/10.1016/j.pec.2015.02.012 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 25749023 [pubmed] ID - S0738-3991(15)00082-8 [pii] ID - 10.1016/j.pec.2015.02.012 [doi] PP - ppublish PH - 2014/08/21 [received] PH - 2015/02/05 [revised] PH - 2015/02/15 [accepted] LG - English EP - 20150225 DP - 2015 Jun DC - 20150430 EZ - 2015/03/10 06:00 DA - 2016/11/01 06:00 DT - 2015/03/10 06:00 YR - 2015 ED - 20161031 RD - 20161230 UP - 20161230 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=25749023 <34. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25302963 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Oostendorp LJ AU - Ottevanger PB AU - van de Wouw AJ AU - Schoenaker IJ AU - de Graaf H AU - van der Graaf WT AU - Stalmeier PF FA - Oostendorp, Linda J M FA - Ottevanger, Petronella B FA - van de Wouw, Agnes J FA - Schoenaker, Ivonne J H FA - de Graaf, Hiltje FA - van der Graaf, Winette T A FA - Stalmeier, Peep F M IN - Oostendorp, Linda J M. Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands. IN - Ottevanger, Petronella B. Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. IN - van de Wouw, Agnes J. Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands. IN - Schoenaker, Ivonne J H. Department of Internal Medicine, Isala Clinics, Zwolle, The Netherlands. IN - de Graaf, Hiltje. Leeuwarden Oncology Centre, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. IN - van der Graaf, Winette T A. Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. IN - Stalmeier, Peep F M. Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands. TI - Expected survival with and without second-line palliative chemotherapy: who wants to know?. SO - Health Expectations. 18(6):2903-14, 2015 Dec AS - Health Expect. 18(6):2903-14, 2015 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/px [Psychology] MH - Colorectal Neoplasms/dt [Drug Therapy] MH - Colorectal Neoplasms/mo [Mortality] MH - *Colorectal Neoplasms/px [Psychology] MH - Decision Support Techniques MH - Female MH - Humans MH - Male MH - Middle Aged MH - Neoplasms/dt [Drug Therapy] MH - Neoplasms/mo [Mortality] MH - *Neoplasms/px [Psychology] MH - *Palliative Care/px [Psychology] MH - *Patient Preference/px [Psychology] MH - Prospective Studies MH - Psychology KW - decision aids; information desire; palliative chemotherapy; predictors; survival information; treatment decision AB - BACKGROUND: According to surveys, many patients with advanced cancer wish to receive survival information. AB - OBJECTIVE: This study investigated information preferences by offering patients a decision aid (DA) with information on expected survival for two treatment options: supportive care with or without second-line palliative chemotherapy. Predictors of accepting survival information were explored. AB - DESIGN: Eligible patients in this multicentre prospective study were offered second-line chemotherapy for advanced breast or colorectal cancer. A nurse presented a DA on second-line treatment and asked patients whether they desired information on (i) adverse events, (ii) tumour response and (iii) survival. Data on 50 clinical and psychosocial patient characteristics were collected from inclusion forms and patient questionnaires. AB - RESULTS: Seventy-seven patients received a DA; median age 62 years (range 32-80), 61% female, 77% colorectal cancer. Fifty-seven patients (74%; 95% CI 64-84) desired survival information. Four psychosocial characteristics (e.g. deliberative decision style) independently predicted information desire. However, the use of these characteristics to predict information desire hardly outperformed a simple prediction rule. AB - CONCLUSIONS: Many patients desired information on expected survival when deciding about second-line treatment. However, our exploratory analysis indicated that patients desiring this information could not be identified based on their clinical or psychosocial characteristics. These findings can help encourage candid discussions about expected survival. Health professionals should be careful not to make implicit assumptions of information desire based on patient characteristics, but to explicitly ask patients if survival information is desired, and act accordingly. AB - Copyright © 2014 John Wiley & Sons Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/hex.12275 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 25302963 [pubmed] ID - 10.1111/hex.12275 [doi] PP - ppublish PH - 2014/09/04 [accepted] LG - English EP - 20141010 DP - 2015 Dec DC - 20160115 EZ - 2014/10/11 06:00 DA - 2016/10/14 06:00 DT - 2014/10/11 06:00 YR - 2015 ED - 20161013 RD - 20161110 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25302963 <35. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25186806 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hanoch Y AU - Miron-Shatz T AU - Rolison JJ AU - Omer Z AU - Ozanne E FA - Hanoch, Yaniv FA - Miron-Shatz, Talya FA - Rolison, Jonathan J FA - Omer, Zehra FA - Ozanne, Elisa IN - Hanoch, Yaniv. School of Psychology, Cognition Institute, University of Plymouth, Drake Circus, Plymouth, UK. IN - Miron-Shatz, Talya. Center for Medical Decision Making, Ono Academic College, Kiryat Ono, Israel. IN - Rolison, Jonathan J. School of Psychology, Queen's University Belfast, Belfast, UK. IN - Omer, Zehra. Massachusetts General Hospital-Institute for Technology Assessment, Boston, MA, USA. IN - Ozanne, Elisa. The Dartmouth Institute Geisel School of Medicine at Dartmouth, Centerra Parkway, Lebanon, NH, USA. TI - Shared decision making in patients at risk of cancer: the role of domain and numeracy. SO - Health Expectations. 18(6):2799-810, 2015 Dec AS - Health Expect. 18(6):2799-810, 2015 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Breast Neoplasms/et [Etiology] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - *Decision Making MH - Female MH - Genetic Predisposition to Disease/px [Psychology] MH - Humans MH - Middle Aged MH - Neoplasms/et [Etiology] MH - Neoplasms/ge [Genetics] MH - *Neoplasms/px [Psychology] MH - Patient Preference MH - Risk Factors MH - Surveys and Questionnaires KW - cancer; objective numeracy and subjective numeracy; shared decision making AB - BACKGROUND: Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy. AB - OBJECTIVE: To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities. AB - METHODS: Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales. AB - RESULTS: Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer. AB - CONCLUSION: Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer. AB - PRACTICE IMPLICATIONS: Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills. AB - Copyright © 2014 John Wiley & Sons Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/hex.12257 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 25186806 [pubmed] ID - 10.1111/hex.12257 [doi] PP - ppublish PH - 2014/08/06 [accepted] GI - No: CA-97-004 Organization: (CA) *NCI NIH HHS* Country: United States No: CA-97-019 Organization: (CA) *NCI NIH HHS* Country: United States No: N01-PC-55049-40 Organization: (PC) *NCI NIH HHS* Country: United States LG - English EP - 20140904 DP - 2015 Dec DC - 20160115 EZ - 2014/09/05 06:00 DA - 2016/10/14 06:00 DT - 2014/09/05 06:00 YR - 2015 ED - 20161013 RD - 20161110 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25186806 <36. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25302963 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Oostendorp LJ AU - Ottevanger PB AU - van de Wouw AJ AU - Schoenaker IJ AU - de Graaf H AU - van der Graaf WT AU - Stalmeier PF FA - Oostendorp, Linda J M FA - Ottevanger, Petronella B FA - van de Wouw, Agnes J FA - Schoenaker, Ivonne J H FA - de Graaf, Hiltje FA - van der Graaf, Winette T A FA - Stalmeier, Peep F M IN - Oostendorp, Linda J M. Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands. IN - Ottevanger, Petronella B. Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. IN - van de Wouw, Agnes J. Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands. IN - Schoenaker, Ivonne J H. Department of Internal Medicine, Isala Clinics, Zwolle, The Netherlands. IN - de Graaf, Hiltje. Leeuwarden Oncology Centre, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. IN - van der Graaf, Winette T A. Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. IN - Stalmeier, Peep F M. Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands. TI - Expected survival with and without second-line palliative chemotherapy: who wants to know?. SO - Health Expectations. 18(6):2903-14, 2015 Dec AS - Health Expect. 18(6):2903-14, 2015 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/px [Psychology] MH - Colorectal Neoplasms/dt [Drug Therapy] MH - Colorectal Neoplasms/mo [Mortality] MH - *Colorectal Neoplasms/px [Psychology] MH - Decision Support Techniques MH - Female MH - Humans MH - Male MH - Middle Aged MH - Neoplasms/dt [Drug Therapy] MH - Neoplasms/mo [Mortality] MH - *Neoplasms/px [Psychology] MH - *Palliative Care/px [Psychology] MH - *Patient Preference/px [Psychology] MH - Prospective Studies MH - Psychology KW - decision aids; information desire; palliative chemotherapy; predictors; survival information; treatment decision AB - BACKGROUND: According to surveys, many patients with advanced cancer wish to receive survival information. AB - OBJECTIVE: This study investigated information preferences by offering patients a decision aid (DA) with information on expected survival for two treatment options: supportive care with or without second-line palliative chemotherapy. Predictors of accepting survival information were explored. AB - DESIGN: Eligible patients in this multicentre prospective study were offered second-line chemotherapy for advanced breast or colorectal cancer. A nurse presented a DA on second-line treatment and asked patients whether they desired information on (i) adverse events, (ii) tumour response and (iii) survival. Data on 50 clinical and psychosocial patient characteristics were collected from inclusion forms and patient questionnaires. AB - RESULTS: Seventy-seven patients received a DA; median age 62 years (range 32-80), 61% female, 77% colorectal cancer. Fifty-seven patients (74%; 95% CI 64-84) desired survival information. Four psychosocial characteristics (e.g. deliberative decision style) independently predicted information desire. However, the use of these characteristics to predict information desire hardly outperformed a simple prediction rule. AB - CONCLUSIONS: Many patients desired information on expected survival when deciding about second-line treatment. However, our exploratory analysis indicated that patients desiring this information could not be identified based on their clinical or psychosocial characteristics. These findings can help encourage candid discussions about expected survival. Health professionals should be careful not to make implicit assumptions of information desire based on patient characteristics, but to explicitly ask patients if survival information is desired, and act accordingly. AB - Copyright © 2014 John Wiley & Sons Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/hex.12275 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 25302963 [pubmed] ID - 10.1111/hex.12275 [doi] PP - ppublish PH - 2014/09/04 [accepted] LG - English EP - 20141010 DP - 2015 Dec DC - 20160115 EZ - 2014/10/11 06:00 DA - 2016/10/14 06:00 DT - 2014/10/11 06:00 YR - 2015 ED - 20161013 RD - 20161230 UP - 20161230 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=25302963 <37. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25186806 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hanoch Y AU - Miron-Shatz T AU - Rolison JJ AU - Omer Z AU - Ozanne E FA - Hanoch, Yaniv FA - Miron-Shatz, Talya FA - Rolison, Jonathan J FA - Omer, Zehra FA - Ozanne, Elisa IN - Hanoch, Yaniv. School of Psychology, Cognition Institute, University of Plymouth, Drake Circus, Plymouth, UK. IN - Miron-Shatz, Talya. Center for Medical Decision Making, Ono Academic College, Kiryat Ono, Israel. IN - Rolison, Jonathan J. School of Psychology, Queen's University Belfast, Belfast, UK. IN - Omer, Zehra. Massachusetts General Hospital-Institute for Technology Assessment, Boston, MA, USA. IN - Ozanne, Elisa. The Dartmouth Institute Geisel School of Medicine at Dartmouth, Centerra Parkway, Lebanon, NH, USA. TI - Shared decision making in patients at risk of cancer: the role of domain and numeracy. SO - Health Expectations. 18(6):2799-810, 2015 Dec AS - Health Expect. 18(6):2799-810, 2015 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Breast Neoplasms/et [Etiology] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - *Decision Making MH - Female MH - Genetic Predisposition to Disease/px [Psychology] MH - Humans MH - Middle Aged MH - Neoplasms/et [Etiology] MH - Neoplasms/ge [Genetics] MH - *Neoplasms/px [Psychology] MH - Patient Preference MH - Risk Factors MH - Surveys and Questionnaires KW - cancer; objective numeracy and subjective numeracy; shared decision making AB - BACKGROUND: Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy. AB - OBJECTIVE: To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities. AB - METHODS: Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales. AB - RESULTS: Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer. AB - CONCLUSION: Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer. AB - PRACTICE IMPLICATIONS: Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills. AB - Copyright © 2014 John Wiley & Sons Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/hex.12257 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 25186806 [pubmed] ID - 10.1111/hex.12257 [doi] PP - ppublish PH - 2014/08/06 [accepted] GI - No: CA-97-004 Organization: (CA) *NCI NIH HHS* Country: United States No: CA-97-019 Organization: (CA) *NCI NIH HHS* Country: United States No: N01-PC-55049-40 Organization: (PC) *NCI NIH HHS* Country: United States LG - English EP - 20140904 DP - 2015 Dec DC - 20160115 EZ - 2014/09/05 06:00 DA - 2016/10/14 06:00 DT - 2014/09/05 06:00 YR - 2015 ED - 20161013 RD - 20161230 UP - 20161230 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=25186806 <38. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26801410 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Recio-Saucedo A AU - Gerty S AU - Foster C AU - Eccles D AU - Cutress RI FA - Recio-Saucedo, Alejandra FA - Gerty, Sue FA - Foster, Claire FA - Eccles, Diana FA - Cutress, Ramsey I IN - Recio-Saucedo, Alejandra. University of Southampton, Faculty of Health Sciences, Southampton SO17 1BJ, UK. Electronic address: A.Recio-Saucedo@soton.ac.uk. IN - Gerty, Sue. Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK. IN - Foster, Claire. University of Southampton, Faculty of Health Sciences, Southampton SO17 1BJ, UK. IN - Eccles, Diana. Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK. IN - Cutress, Ramsey I. Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK. TI - Information requirements of young women with breast cancer treated with mastectomy or breast conserving surgery: A systematic review. [Review] SO - Breast. 25:1-13, 2016 Feb AS - BREAST. 25:1-13, 2016 Feb NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Age Factors MH - Age of Onset MH - Body Image MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - *Decision Making MH - Female MH - Humans MH - *Information Seeking Behavior MH - *Mastectomy/px [Psychology] MH - *Mastectomy, Segmental/px [Psychology] MH - *Needs Assessment MH - Risk Assessment MH - Young Adult KW - Breast cancer; Decision-making; Surgery; Young women AB - OBJECTIVES: Young women with breast cancer have poorer prognosis, greater lifetime risk of local recurrence, contralateral recurrence, and distant disease, regardless of surgery received. Here we systematically review published evidence relating to the information requirements and preferences of young women diagnosed with early-stage breast cancer offered a choice between mastectomy and Breast Conservation Surgery (BCS). Findings will inform the development of a surgical decision aid for young women. AB - METHODS: Eight databases were searched to identify research examining information requirements of young women facing breast oncological surgery treatment decisions (MESH headings). Twelve studies met the inclusion criteria. Data were extracted and summarised in a narrative synthesis. AB - RESULTS: Findings indicate that young women prefer greater and more detailed information regarding treatment side effects, sexuality, and body image. Younger age of diagnosis leads to an increased risk perception of developing a second breast cancer. Young women's choices are influenced by factors associated with family and career. Information is required in a continuum throughout the treatment experience and not only at diagnosis when treatment decisions are made. Young women show differing levels of participation preferences. AB - CONCLUSION: Young women find decision-making challenging when the characteristics of diagnosis provide a surgical choice between mastectomy and breast conservation surgery. Efforts should be made to provide information regarding sexuality, body image, reconstruction, fertility and likelihood of familial predisposition. Further research is needed to identify the specific level and information requirements of this young-onset group. The low number of studies indicate a need to design studies targeting specifically this age group of breast cancer patients. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(15)00251-9 DO - https://dx.doi.org/10.1016/j.breast.2015.11.001 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 26801410 [pubmed] ID - S0960-9776(15)00251-9 [pii] ID - 10.1016/j.breast.2015.11.001 [doi] PP - ppublish PH - 2014/10/06 [received] PH - 2015/04/28 [revised] PH - 2015/11/01 [accepted] LG - English EP - 20151130 DP - 2016 Feb DC - 20160123 EZ - 2016/01/24 06:00 DA - 2016/10/12 06:00 DT - 2016/01/24 06:00 YR - 2016 ED - 20161011 RD - 20161110 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26801410 <39. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26801410 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Recio-Saucedo A AU - Gerty S AU - Foster C AU - Eccles D AU - Cutress RI FA - Recio-Saucedo, Alejandra FA - Gerty, Sue FA - Foster, Claire FA - Eccles, Diana FA - Cutress, Ramsey I IN - Recio-Saucedo, Alejandra. University of Southampton, Faculty of Health Sciences, Southampton SO17 1BJ, UK. Electronic address: A.Recio-Saucedo@soton.ac.uk. IN - Gerty, Sue. Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK. IN - Foster, Claire. University of Southampton, Faculty of Health Sciences, Southampton SO17 1BJ, UK. IN - Eccles, Diana. Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK. IN - Cutress, Ramsey I. Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK. TI - Information requirements of young women with breast cancer treated with mastectomy or breast conserving surgery: A systematic review. [Review] SO - Breast. 25:1-13, 2016 Feb AS - BREAST. 25:1-13, 2016 Feb NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Age Factors MH - Age of Onset MH - Body Image MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - *Decision Making MH - Female MH - Humans MH - *Information Seeking Behavior MH - *Mastectomy/px [Psychology] MH - *Mastectomy, Segmental/px [Psychology] MH - *Needs Assessment MH - Risk Assessment MH - Young Adult KW - Breast cancer; Decision-making; Surgery; Young women AB - OBJECTIVES: Young women with breast cancer have poorer prognosis, greater lifetime risk of local recurrence, contralateral recurrence, and distant disease, regardless of surgery received. Here we systematically review published evidence relating to the information requirements and preferences of young women diagnosed with early-stage breast cancer offered a choice between mastectomy and Breast Conservation Surgery (BCS). Findings will inform the development of a surgical decision aid for young women. AB - METHODS: Eight databases were searched to identify research examining information requirements of young women facing breast oncological surgery treatment decisions (MESH headings). Twelve studies met the inclusion criteria. Data were extracted and summarised in a narrative synthesis. AB - RESULTS: Findings indicate that young women prefer greater and more detailed information regarding treatment side effects, sexuality, and body image. Younger age of diagnosis leads to an increased risk perception of developing a second breast cancer. Young women's choices are influenced by factors associated with family and career. Information is required in a continuum throughout the treatment experience and not only at diagnosis when treatment decisions are made. Young women show differing levels of participation preferences. AB - CONCLUSION: Young women find decision-making challenging when the characteristics of diagnosis provide a surgical choice between mastectomy and breast conservation surgery. Efforts should be made to provide information regarding sexuality, body image, reconstruction, fertility and likelihood of familial predisposition. Further research is needed to identify the specific level and information requirements of this young-onset group. The low number of studies indicate a need to design studies targeting specifically this age group of breast cancer patients. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(15)00251-9 DO - https://dx.doi.org/10.1016/j.breast.2015.11.001 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 26801410 [pubmed] ID - S0960-9776(15)00251-9 [pii] ID - 10.1016/j.breast.2015.11.001 [doi] PP - ppublish PH - 2014/10/06 [received] PH - 2015/04/28 [revised] PH - 2015/11/01 [accepted] LG - English EP - 20151130 DP - 2016 Feb DC - 20160123 EZ - 2016/01/24 06:00 DA - 2016/10/12 06:00 DT - 2016/01/24 06:00 YR - 2016 ED - 20161011 RD - 20161230 UP - 20161230 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=26801410 <40. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27557300 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cardoso F AU - van't Veer LJ AU - Bogaerts J AU - Slaets L AU - Viale G AU - Delaloge S AU - Pierga JY AU - Brain E AU - Causeret S AU - DeLorenzi M AU - Glas AM AU - Golfinopoulos V AU - Goulioti T AU - Knox S AU - Matos E AU - Meulemans B AU - Neijenhuis PA AU - Nitz U AU - Passalacqua R AU - Ravdin P AU - Rubio IT AU - Saghatchian M AU - Smilde TJ AU - Sotiriou C AU - Stork L AU - Straehle C AU - Thomas G AU - Thompson AM AU - van der Hoeven JM AU - Vuylsteke P AU - Bernards R AU - Tryfonidis K AU - Rutgers E AU - Piccart M AU - MINDACT Investigators FA - Cardoso, Fatima FA - van't Veer, Laura J FA - Bogaerts, Jan FA - Slaets, Leen FA - Viale, Giuseppe FA - Delaloge, Suzette FA - Pierga, Jean-Yves FA - Brain, Etienne FA - Causeret, Sylvain FA - DeLorenzi, Mauro FA - Glas, Annuska M FA - Golfinopoulos, Vassilis FA - Goulioti, Theodora FA - Knox, Susan FA - Matos, Erika FA - Meulemans, Bart FA - Neijenhuis, Peter A FA - Nitz, Ulrike FA - Passalacqua, Rodolfo FA - Ravdin, Peter FA - Rubio, Isabel T FA - Saghatchian, Mahasti FA - Smilde, Tineke J FA - Sotiriou, Christos FA - Stork, Lisette FA - Straehle, Carolyn FA - Thomas, Geraldine FA - Thompson, Alastair M FA - van der Hoeven, Jacobus M FA - Vuylsteke, Peter FA - Bernards, Rene FA - Tryfonidis, Konstantinos FA - Rutgers, Emiel FA - Piccart, Martine FA - MINDACT Investigators IN - Cardoso, Fatima. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - van't Veer, Laura J. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Bogaerts, Jan. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Slaets, Leen. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Viale, Giuseppe. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Delaloge, Suzette. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Pierga, Jean-Yves. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Brain, Etienne. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Causeret, Sylvain. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - DeLorenzi, Mauro. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Glas, Annuska M. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Golfinopoulos, Vassilis. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Goulioti, Theodora. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Knox, Susan. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Matos, Erika. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Meulemans, Bart. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Neijenhuis, Peter A. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Nitz, Ulrike. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Passalacqua, Rodolfo. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Ravdin, Peter. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Rubio, Isabel T. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Saghatchian, Mahasti. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Smilde, Tineke J. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Sotiriou, Christos. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Stork, Lisette. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Straehle, Carolyn. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Thomas, Geraldine. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Thompson, Alastair M. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - van der Hoeven, Jacobus M. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Vuylsteke, Peter. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Bernards, Rene. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Tryfonidis, Konstantinos. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Rutgers, Emiel. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Piccart, Martine. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IR - Benn K IR - Bogaerts J IR - Cardoso F IR - Ciruelos E IR - Corochan S IR - Cuny J IR - de la Pena L IR - Delaloge S IR - DeLorenzi M IR - Dudek-Peric A IR - Eekhout I IR - Gluz O IR - Golfinopoulos V IR - Goulioti T IR - Harbeck N IR - Hilal V IR - Knox S IR - Lemonnier J IR - Lawniczak M IR - Marini L IR - Matos E IR - Morales P IR - Murray K IR - Nitz U IR - Passalaqua R IR - Piccart M IR - Remmelzwaal J IR - Rubio I IR - Rutgers E IR - Saghatchian M IR - Slaets L IR - Sotiriou C IR - Straehle C IR - Straley M IR - Theron N IR - Thompson A IR - Tryfonidis K IR - Todeschini R IR - Urunkar M IR - van 't Veer L IR - Viale G IR - Aalders K IR - Bines J IR - Bedard P IR - Bozovic I IR - Braga S IR - Castaneda C IR - Celebic A IR - Colichi C IR - Criscitiello C IR - Dal Lago L IR - Demonty G IR - Drukker C IR - Fei F IR - Lia M IR - Loi S IR - Messina C IR - Mook S IR - Moulin C IR - Sreseli R IR - Therasse P IR - Werutsky G IR - Corachan S IR - Dudek-Peric A IR - Wheeler L IR - Dif N IR - Rizzetto G IR - Beauvois M IR - Meirsman L IR - Breyssens H IR - Decker N IR - Engelen K IR - Akropovic A IR - Harrison J IR - Henot F IR - Celis M IR - De Jongh B IR - Delmotte I IR - Daubie V IR - Goossens R IR - Helsen N IR - Hourt L IR - Janssen S IR - Soete V IR - Vansevenant K IR - Hermans C IR - Hart G IR - Brink G IR - Floore A IR - Sixt B IR - Buyse M TI - 70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer. CM - Comment in: N Engl J Med. 2016 Aug 25;375(8):790-1; PMID: 27557306 SO - New England Journal of Medicine. 375(8):717-29, 2016 Aug 25 AS - N Engl J Med. 375(8):717-29, 2016 Aug 25 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Internet JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/su [Surgery] MH - *Chemotherapy, Adjuvant MH - Disease-Free Survival MH - Female MH - Gene Expression MH - *Gene Expression Profiling MH - *Genetic Predisposition to Disease MH - Genetic Testing MH - Humans MH - Kaplan-Meier Estimate MH - Mastectomy MH - Middle Aged MH - *Neoplasm Metastasis/pc [Prevention & Control] MH - Neoplasm Staging MH - Oligonucleotide Array Sequence Analysis MH - Prospective Studies MH - Risk MH - Risk Assessment AB - BACKGROUND: The 70-gene signature test (MammaPrint) has been shown to improve prediction of clinical outcome in women with early-stage breast cancer. We sought to provide prospective evidence of the clinical utility of the addition of the 70-gene signature to standard clinical-pathological criteria in selecting patients for adjuvant chemotherapy. AB - METHODS: In this randomized, phase 3 study, we enrolled 6693 women with early-stage breast cancer and determined their genomic risk (using the 70-gene signature) and their clinical risk (using a modified version of Adjuvant! Online). Women at low clinical and genomic risk did not receive chemotherapy, whereas those at high clinical and genomic risk did receive such therapy. In patients with discordant risk results, either the genomic risk or the clinical risk was used to determine the use of chemotherapy. The primary goal was to assess whether, among patients with high-risk clinical features and a low-risk gene-expression profile who did not receive chemotherapy, the lower boundary of the 95% confidence interval for the rate of 5-year survival without distant metastasis would be 92% (i.e., the noninferiority boundary) or higher. AB - RESULTS: A total of 1550 patients (23.2%) were deemed to be at high clinical risk and low genomic risk. At 5 years, the rate of survival without distant metastasis in this group was 94.7% (95% confidence interval, 92.5 to 96.2) among those not receiving chemotherapy. The absolute difference in this survival rate between these patients and those who received chemotherapy was 1.5 percentage points, with the rate being lower without chemotherapy. Similar rates of survival without distant metastasis were reported in the subgroup of patients who had estrogen-receptor-positive, human epidermal growth factor receptor 2-negative, and either node-negative or node-positive disease. AB - CONCLUSIONS: Among women with early-stage breast cancer who were at high clinical risk and low genomic risk for recurrence, the receipt of no chemotherapy on the basis of the 70-gene signature led to a 5-year rate of survival without distant metastasis that was 1.5 percentage points lower than the rate with chemotherapy. Given these findings, approximately 46% of women with breast cancer who are at high clinical risk might not require chemotherapy. (Funded by the European Commission Sixth Framework Program and others; ClinicalTrials.gov number, NCT00433589; EudraCT number, 2005-002625-31.). RN - 0 (Antineoplastic Agents) ES - 1533-4406 IL - 0028-4793 DO - https://dx.doi.org/10.1056/NEJMoa1602253 PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 27557300 [pubmed] ID - 10.1056/NEJMoa1602253 [doi] PP - ppublish SI - ClinicalTrials.gov SI - EudraCT SA - ClinicalTrials.gov/NCT00433589 SA - EudraCT/2005-002625-31 SL - https://clinicaltrials.gov/search/term=NCT00433589 GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English DP - 2016 Aug 25 DC - 20160825 EZ - 2016/08/25 06:00 DA - 2016/09/02 06:00 DT - 2016/08/25 06:00 YR - 2016 ED - 20160901 RD - 20160825 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27557300 <41. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26422125 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Potter S AU - Mills N AU - Cawthorn S AU - Wilson S AU - Blazeby J FA - Potter, Shelley FA - Mills, Nicola FA - Cawthorn, Simon FA - Wilson, Sherif FA - Blazeby, Jane IN - Potter, Shelley. Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom; Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, United Kingdom. Electronic address: Shelley.Potter@bristol.ac.uk. IN - Mills, Nicola. Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom. IN - Cawthorn, Simon. Breast Care Centre, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, United Kingdom. IN - Wilson, Sherif. Department of Plastic Surgery, North Bristol NHS Trust, Bristol BS16 1LE, United Kingdom. IN - Blazeby, Jane. Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom; Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, United Kingdom. TI - Exploring information provision in reconstructive breast surgery: A qualitative study. SO - Breast. 24(6):732-8, 2015 Dec AS - BREAST. 24(6):732-8, 2015 Dec NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - *Attitude of Health Personnel MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Consumer Health Information/mt [Methods] MH - Decision Making MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Male MH - *Mammaplasty/px [Psychology] MH - Middle Aged MH - Patient Education as Topic/st [Standards] MH - Qualitative Research KW - Breast cancer; Breast reconstruction; Decision-making; Information; Oncology; Qualitative study AB - OBJECTIVE: Women considering reconstructive breast surgery (RBS) require adequate information to make informed treatment decisions. This study explored patients' and health professionals' (HPs) perceptions of the adequacy of information provided for decision-making in RBS. AB - METHODS: Semi-structured interviews with a purposive sample of patients who had undergone RBS and HPs providing specialist care explored participants' experiences of information provision prior to RBS. AB - RESULTS: Professionals reported providing standardised verbal, written and photographic information about the process and outcomes of surgery. Women, by contrast, reported varying levels of information provision. Some felt fully-informed but others perceived they had received insufficient information about available treatment options or possible outcomes of surgery to make an informed decision. AB - CONCLUSIONS: Women need adequate information to make informed decisions about RBS and current practice may not meet women's needs. Minimum agreed standards of information provision, especially about alternative types of reconstruction, are recommended to improve decision-making in RBS. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(15)00192-7 DO - https://dx.doi.org/10.1016/j.breast.2015.09.003 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26422125 [pubmed] ID - S0960-9776(15)00192-7 [pii] ID - 10.1016/j.breast.2015.09.003 [doi] PP - ppublish PH - 2014/07/31 [received] PH - 2015/02/12 [revised] PH - 2015/09/07 [accepted] GI - No: MR/K025643/1 Organization: *Medical Research Council* Country: United Kingdom LG - English EP - 20150928 DP - 2015 Dec DC - 20151120 EZ - 2015/10/01 06:00 DA - 2016/09/02 06:00 DT - 2015/10/01 06:00 YR - 2015 ED - 20160901 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26422125 <42. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27557300 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cardoso F AU - van't Veer LJ AU - Bogaerts J AU - Slaets L AU - Viale G AU - Delaloge S AU - Pierga JY AU - Brain E AU - Causeret S AU - DeLorenzi M AU - Glas AM AU - Golfinopoulos V AU - Goulioti T AU - Knox S AU - Matos E AU - Meulemans B AU - Neijenhuis PA AU - Nitz U AU - Passalacqua R AU - Ravdin P AU - Rubio IT AU - Saghatchian M AU - Smilde TJ AU - Sotiriou C AU - Stork L AU - Straehle C AU - Thomas G AU - Thompson AM AU - van der Hoeven JM AU - Vuylsteke P AU - Bernards R AU - Tryfonidis K AU - Rutgers E AU - Piccart M AU - MINDACT Investigators FA - Cardoso, Fatima FA - van't Veer, Laura J FA - Bogaerts, Jan FA - Slaets, Leen FA - Viale, Giuseppe FA - Delaloge, Suzette FA - Pierga, Jean-Yves FA - Brain, Etienne FA - Causeret, Sylvain FA - DeLorenzi, Mauro FA - Glas, Annuska M FA - Golfinopoulos, Vassilis FA - Goulioti, Theodora FA - Knox, Susan FA - Matos, Erika FA - Meulemans, Bart FA - Neijenhuis, Peter A FA - Nitz, Ulrike FA - Passalacqua, Rodolfo FA - Ravdin, Peter FA - Rubio, Isabel T FA - Saghatchian, Mahasti FA - Smilde, Tineke J FA - Sotiriou, Christos FA - Stork, Lisette FA - Straehle, Carolyn FA - Thomas, Geraldine FA - Thompson, Alastair M FA - van der Hoeven, Jacobus M FA - Vuylsteke, Peter FA - Bernards, Rene FA - Tryfonidis, Konstantinos FA - Rutgers, Emiel FA - Piccart, Martine FA - MINDACT Investigators IN - Cardoso, Fatima. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - van't Veer, Laura J. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Bogaerts, Jan. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Slaets, Leen. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Viale, Giuseppe. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Delaloge, Suzette. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Pierga, Jean-Yves. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Brain, Etienne. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Causeret, Sylvain. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - DeLorenzi, Mauro. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Glas, Annuska M. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Golfinopoulos, Vassilis. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Goulioti, Theodora. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Knox, Susan. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Matos, Erika. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Meulemans, Bart. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Neijenhuis, Peter A. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Nitz, Ulrike. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Passalacqua, Rodolfo. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Ravdin, Peter. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Rubio, Isabel T. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Saghatchian, Mahasti. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Smilde, Tineke J. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Sotiriou, Christos. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Stork, Lisette. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Straehle, Carolyn. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Thomas, Geraldine. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Thompson, Alastair M. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - van der Hoeven, Jacobus M. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Vuylsteke, Peter. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Bernards, Rene. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Tryfonidis, Konstantinos. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Rutgers, Emiel. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IN - Piccart, Martine. From Champalimaud Clinical Center-Champalimaud Foundation, Lisbon, Portugal (F.C.); Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (L.J.V.); European Organization for Research and Treatment of Cancer Headquarters (J.B., L. Slaets, V.G., B.M., K.T.), Breast International Group Headquarters (T.G., C. Straehle), and Institut Jules Bordet, Universite Libre de Bruxelles (C. Sotiriou, M.P.), Brussels, and Centre Hospitalier Universitaire Universite Catholique de Louvain, Namur (P.V.) - both in Belgium; University of Milan and Istituto Europeo di Oncologia (G.V.) and Europa Donna-European Breast Cancer Coalition (S.K.), Milan, and Azienda Istituti Ospitalieri di Cremona, Cremona (R.P.) - both in Italy; Gustave Roussy, Villejuif (S.D., M.S.), Institut Curie Paris Sciences et Lettres, Universite Paris Descartes, Sorbonne Paris Cite, Paris (J.-Y.P.). Institut Curie-Hopital Rene Huguenin, Saint-Cloud (E.B.), and Centre Georges-Francois-Leclerc, Dijon (S.C.) - all in France; Swiss Institute of Bioinformatics and University of Lausanne, Lausanne, Switzerland (M.D.); Agendia (A.M.G., L. Stork) and the Netherlands Cancer Institute (R.B., E.R.), Amsterdam, Alrijne Ziekenhuis, Rijnland Leiderdorp (P.A.N.), Jeroen Bosch Hospital, 's-Hertogenbosch (T.J.S.), and Medisch Centrum Alkmaar, Alkmaar (J.M.H.) - all in the Netherlands; Institute of Oncology, Ljubljana, Slovenia (E.M.); Evangelisches Krankenhaus Bethesda, Duisburg, Germany (U.N.); University of Texas Health Sciences Center, San Antonio (P.R.); Hospital Universitario Vall d'Hebron, Barcelona (I.T.R.); Imperial College London, London (G.T.); and University of Texas M.D. Anderson Cancer Center, Houston (A.M.T.). IR - Benn K IR - Bogaerts J IR - Cardoso F IR - Ciruelos E IR - Corochan S IR - Cuny J IR - de la Pena L IR - Delaloge S IR - DeLorenzi M IR - Dudek-Peric A IR - Eekhout I IR - Gluz O IR - Golfinopoulos V IR - Goulioti T IR - Harbeck N IR - Hilal V IR - Knox S IR - Lemonnier J IR - Lawniczak M IR - Marini L IR - Matos E IR - Morales P IR - Murray K IR - Nitz U IR - Passalaqua R IR - Piccart M IR - Remmelzwaal J IR - Rubio I IR - Rutgers E IR - Saghatchian M IR - Slaets L IR - Sotiriou C IR - Straehle C IR - Straley M IR - Theron N IR - Thompson A IR - Tryfonidis K IR - Todeschini R IR - Urunkar M IR - van 't Veer L IR - Viale G IR - Aalders K IR - Bines J IR - Bedard P IR - Bozovic I IR - Braga S IR - Castaneda C IR - Celebic A IR - Colichi C IR - Criscitiello C IR - Dal Lago L IR - Demonty G IR - Drukker C IR - Fei F IR - Lia M IR - Loi S IR - Messina C IR - Mook S IR - Moulin C IR - Sreseli R IR - Therasse P IR - Werutsky G IR - Corachan S IR - Dudek-Peric A IR - Wheeler L IR - Dif N IR - Rizzetto G IR - Beauvois M IR - Meirsman L IR - Breyssens H IR - Decker N IR - Engelen K IR - Akropovic A IR - Harrison J IR - Henot F IR - Celis M IR - De Jongh B IR - Delmotte I IR - Daubie V IR - Goossens R IR - Helsen N IR - Hourt L IR - Janssen S IR - Soete V IR - Vansevenant K IR - Hermans C IR - Hart G IR - Brink G IR - Floore A IR - Sixt B IR - Buyse M TI - 70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer. CM - Comment in: N Engl J Med. 2016 Aug 25;375(8):790-1; PMID: 27557306 CM - Comment in: N Engl J Med. 2016 Dec;375(22):2199-2201; PMID: 27959762 CM - Comment in: N Engl J Med. 2016 Dec;375(22):2199; PMID: 27959763 CM - Comment in: BMJ. 2016 Aug 24;354:i4635; PMID: 27561820 SO - New England Journal of Medicine. 375(8):717-29, 2016 Aug 25 AS - N Engl J Med. 375(8):717-29, 2016 Aug 25 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Internet JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/su [Surgery] MH - *Chemotherapy, Adjuvant MH - Disease-Free Survival MH - Female MH - Gene Expression MH - *Gene Expression Profiling MH - *Genetic Predisposition to Disease MH - Genetic Testing MH - Humans MH - Kaplan-Meier Estimate MH - Mastectomy MH - Middle Aged MH - *Neoplasm Metastasis/pc [Prevention & Control] MH - Neoplasm Staging MH - Oligonucleotide Array Sequence Analysis MH - Prospective Studies MH - Risk MH - Risk Assessment AB - BACKGROUND: The 70-gene signature test (MammaPrint) has been shown to improve prediction of clinical outcome in women with early-stage breast cancer. We sought to provide prospective evidence of the clinical utility of the addition of the 70-gene signature to standard clinical-pathological criteria in selecting patients for adjuvant chemotherapy. AB - METHODS: In this randomized, phase 3 study, we enrolled 6693 women with early-stage breast cancer and determined their genomic risk (using the 70-gene signature) and their clinical risk (using a modified version of Adjuvant! Online). Women at low clinical and genomic risk did not receive chemotherapy, whereas those at high clinical and genomic risk did receive such therapy. In patients with discordant risk results, either the genomic risk or the clinical risk was used to determine the use of chemotherapy. The primary goal was to assess whether, among patients with high-risk clinical features and a low-risk gene-expression profile who did not receive chemotherapy, the lower boundary of the 95% confidence interval for the rate of 5-year survival without distant metastasis would be 92% (i.e., the noninferiority boundary) or higher. AB - RESULTS: A total of 1550 patients (23.2%) were deemed to be at high clinical risk and low genomic risk. At 5 years, the rate of survival without distant metastasis in this group was 94.7% (95% confidence interval, 92.5 to 96.2) among those not receiving chemotherapy. The absolute difference in this survival rate between these patients and those who received chemotherapy was 1.5 percentage points, with the rate being lower without chemotherapy. Similar rates of survival without distant metastasis were reported in the subgroup of patients who had estrogen-receptor-positive, human epidermal growth factor receptor 2-negative, and either node-negative or node-positive disease. AB - CONCLUSIONS: Among women with early-stage breast cancer who were at high clinical risk and low genomic risk for recurrence, the receipt of no chemotherapy on the basis of the 70-gene signature led to a 5-year rate of survival without distant metastasis that was 1.5 percentage points lower than the rate with chemotherapy. Given these findings, approximately 46% of women with breast cancer who are at high clinical risk might not require chemotherapy. (Funded by the European Commission Sixth Framework Program and others; ClinicalTrials.gov number, NCT00433589; EudraCT number, 2005-002625-31.). RN - 0 (Antineoplastic Agents) ES - 1533-4406 IL - 0028-4793 DO - https://dx.doi.org/10.1056/NEJMoa1602253 PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 10.1056/NEJMoa1602253 [doi] PP - ppublish SI - ClinicalTrials.gov SI - EudraCT SA - ClinicalTrials.gov/NCT00433589 SA - EudraCT/2005-002625-31 SL - https://clinicaltrials.gov/search/term=NCT00433589 GI - No: 7714 Organization: *Cancer Research UK* Country: United Kingdom Organization: *Cancer Research UK* Country: United Kingdom LG - English DP - 2016 Aug 25 DC - 20160825 EZ - 2016/08/25 06:00 DA - 2016/09/02 06:00 DT - 2016/08/25 06:00 YR - 2016 ED - 20160901 RD - 20170425 UP - 20170426 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=27557300 <43. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26264902 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - van der Aa JE AU - Hoogendam JP AU - Butter ES AU - Ausems MG AU - Verheijen RH AU - Zweemer RP FA - van der Aa, Jessica E FA - Hoogendam, Jacob P FA - Butter, Els S F FA - Ausems, Margreet G E M FA - Verheijen, Rene H M FA - Zweemer, Ronald P IN - van der Aa, Jessica E. Department of Gynaecological Oncology, UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. IN - Hoogendam, Jacob P. Department of Gynaecological Oncology, UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. IN - Butter, Els S F. Department of Gynaecological Oncology, UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. IN - Ausems, Margreet G E M. Department of Medical Genetics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. IN - Verheijen, Rene H M. Department of Gynaecological Oncology, UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. IN - Zweemer, Ronald P. Department of Gynaecological Oncology, UMC Utrecht Cancer Center, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. r.zweemer@umcutrecht.nl. TI - The effect of personal medical history and family history of cancer on the uptake of risk-reducing salpingo-oophorectomy. SO - Familial Cancer. 14(4):539-44, 2015 Dec AS - Fam Cancer. 14(4):539-44, 2015 Dec NJ - Familial cancer PI - Journal available in: Print PI - Citation processed from: Internet JC - 100898211 IO - Fam. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630248 SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - BRCA1 Protein/ge [Genetics] MH - BRCA2 Protein/ge [Genetics] MH - Female MH - Follow-Up Studies MH - *Genetic Predisposition to Disease MH - Germ-Line Mutation/ge [Genetics] MH - Heterozygote MH - Humans MH - Middle Aged MH - Neoplasm Staging MH - Netherlands MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/px [Psychology] MH - *Ovarian Neoplasms/su [Surgery] MH - Ovariectomy/px [Psychology] MH - *Ovariectomy/sn [Statistics & Numerical Data] MH - *Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - Prognosis MH - Retrospective Studies MH - Risk Factors MH - *Risk Reduction Behavior MH - Salpingectomy/px [Psychology] MH - *Salpingectomy/sn [Statistics & Numerical Data] KW - BRCA1; BRCA2; Hereditary ovarian cancer; Prophylactic surgery uptake; Risk-reducing salpingo-oophorectomy AB - Women with an increased lifetime risk of ovarian cancer are advised to undergo risk-reducing salpingo-oophorectomy (RRSO) to reduce risk of adnexal cancer. We investigated the uptake of RRSO and evaluated the influence of personal medical history of (breast) cancer, risk-reducing mastectomy (RRM) and family history of ovarian and/or breast cancer on the RRSO decision. This single center retrospective observational cohort study was performed in a tertiary multidisciplinary clinic for hereditary cancer of the University Medical Centre Utrecht, The Netherlands. Women >=35 years old with an estimated lifetime risk of ovarian cancer >=10%, who had completed childbearing, were eligible for RRSO. Uptake and timing of RRSO were analyzed. Influence of personal medical history and family history on RRSO decision making, were evaluated with logistic regression. The study population consisted of 218 women (45.0% BRCA1 mutation carrier, 28.0% BRCA2 mutation carrier, 27.0% with familial susceptibility) with 87.2% RRSO uptake. The median age at RRSO was 44.5 (range 28-73) years. Of the women undergoing RRSO, 78.3% needed <=3 consultations to reach this decision. Multivariable analysis showed a significant difference in RRSO uptake for women with a history of RRM [OR 3.66 95% CI (1.12-11.98)], but no significant difference in women with a history of breast cancer [OR 1.38 95% CI (0.50-3.79)], nor with a family history of ovarian and/or breast cancer [OR 1.10 95% CI (0.44-2.76)]. We conclude that RRSO counseling, without the alternative of screening, is effective. The uptake is increased in women with a history of RRM. RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) RN - 0 (BRCA2 Protein) RN - 0 (BRCA2 protein, human) ES - 1573-7292 IL - 1389-9600 DI - 10.1007/s10689-015-9827-7 DO - https://dx.doi.org/10.1007/s10689-015-9827-7 PT - Journal Article PT - Observational Study ID - 26264902 [pubmed] ID - 10.1007/s10689-015-9827-7 [doi] ID - 10.1007/s10689-015-9827-7 [pii] ID - PMC4630248 [pmc] PP - ppublish LG - English DP - 2015 Dec DC - 20151103 EZ - 2015/08/13 06:00 DA - 2016/08/27 06:00 DT - 2015/08/13 06:00 YR - 2015 ED - 20160826 RD - 20151107 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26264902 <44. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26954715 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kuchel A AU - Robinson T AU - Comins C AU - Shere M AU - Varughese M AU - Sparrow G AU - Sahu A AU - Saunders L AU - Bahl A AU - Cawthorn SJ AU - Braybrooke JP FA - Kuchel, Anna FA - Robinson, Tim FA - Comins, Charles FA - Shere, Mike FA - Varughese, Mohini FA - Sparrow, Geoff FA - Sahu, Ajay FA - Saunders, Louise FA - Bahl, Amit FA - Cawthorn, Simon J FA - Braybrooke, Jeremy P IN - Kuchel, Anna. Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK. IN - Robinson, Tim. Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK. IN - Comins, Charles. Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK. IN - Shere, Mike. Bristol Breast Care Centre, North Bristol NHS Trust, Bristol BS10 5NB, UK. IN - Varughese, Mohini. The Beacon Centre, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton TA1 5DA, UK. IN - Sparrow, Geoff. Yeovil District Hospital NHS Foundation Trust, Yeovil BA21 4AT, UK. IN - Sahu, Ajay. Bristol Breast Care Centre, North Bristol NHS Trust, Bristol BS10 5NB, UK. IN - Saunders, Louise. Bristol Breast Care Centre, North Bristol NHS Trust, Bristol BS10 5NB, UK. IN - Bahl, Amit. Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK. IN - Cawthorn, Simon J. Bristol Breast Care Centre, North Bristol NHS Trust, Bristol BS10 5NB, UK. IN - Braybrooke, Jeremy P. Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8ED, UK. TI - The impact of the 21-gene assay on adjuvant treatment decisions in oestrogen receptor-positive early breast cancer: a prospective study. SO - British Journal of Cancer. 114(7):731-6, 2016 Mar 29 AS - Br J Cancer. 114(7):731-6, 2016 Mar 29 NJ - British journal of cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984867 SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - *Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - *Biomarkers, Tumor/ge [Genetics] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/pa [Pathology] MH - Chemotherapy, Adjuvant MH - Decision Making MH - Decision Support Techniques MH - Female MH - Follow-Up Studies MH - *Gene Expression Profiling MH - Humans MH - Middle Aged MH - Neoplasm Grading MH - Neoplasm Invasiveness MH - Neoplasm Recurrence, Local/dt [Drug Therapy] MH - *Neoplasm Recurrence, Local/ge [Genetics] MH - Neoplasm Recurrence, Local/me [Metabolism] MH - Neoplasm Recurrence, Local/pa [Pathology] MH - Neoplasm Staging MH - *Patient Care Planning MH - Prognosis MH - Prospective Studies MH - *Receptors, Estrogen/me [Metabolism] MH - United Kingdom AB - BACKGROUND: International guidelines, including NICE, recommend using the 21-gene Recurrence Score assay for guiding adjuvant treatment decisions in ER+, HER2-negative early breast cancer (BC). We investigated the impact of adding this assay to standard pathological tests on clinicians'/patients' treatment decisions and on patients' decisional conflict in the United Kingdom. AB - METHODS: In this prospective multicentre study, eligibility criteria included: ER+ HER2-negative BC (N0/Nmic for patients 50 years; 3 positive lymph nodes for patients >50 years) and being fit for chemotherapy. Physicians'/patients' treatment choices and patients' decisional conflict were recorded pre- and post testing. AB - RESULTS: The analysis included 137 patients. Overall, adjuvant treatment recommendations changed in 40.7% of patients, with the direction of the change consistent with the Recurrence Score results (net decrease in chemotherapy recommendation rate in low Recurrence Score patients and net increase in high Recurrence Score patients). Patients' choices were generally consistent with physicians' recommendations. Post-testing, patients' decisional conflict decreased significantly (P<0.0001). In the 67 patients meeting the NICE criteria for testing, the recommendation change rate was 49.3%. AB - CONCLUSIONS: Recurrence Score testing significantly influenced treatment recommendations overall and in the subgroup of patients meeting the NICE criteria, suggesting that this test could substantially alter treatment patterns in the United Kingdom. RN - 0 (Biomarkers, Tumor) RN - 0 (Receptors, Estrogen) ES - 1532-1827 IL - 0007-0920 DI - bjc201648 DO - https://dx.doi.org/10.1038/bjc.2016.48 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 26954715 [pubmed] ID - bjc201648 [pii] ID - 10.1038/bjc.2016.48 [doi] ID - PMC4984867 [pmc] PP - ppublish PH - 2015/09/21 [received] PH - 2016/01/26 [revised] PH - 2016/02/08 [accepted] LG - English EP - 20160308 DP - 2016 Mar 29 DC - 20160330 EZ - 2016/03/09 06:00 DA - 2016/08/18 06:00 DT - 2016/03/10 06:00 YR - 2016 ED - 20160817 RD - 20161126 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26954715 <45. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26539004 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kim SI AU - Lee Y AU - Son Y AU - Jun SY AU - Yun S AU - Bae HS AU - Lim MC AU - Jung SY AU - Joo J AU - Lee ES FA - Kim, Se Ik FA - Lee, Yumi FA - Son, Yedong FA - Jun, So Yeun FA - Yun, Sooin FA - Bae, Hyo Sook FA - Lim, Myong Cheol FA - Jung, So-Youn FA - Joo, Jungnam FA - Lee, Eun Sook IN - Kim, Se Ik. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea. ; Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Lee, Yumi. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Son, Yedong. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Jun, So Yeun. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Yun, Sooin. Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Bae, Hyo Sook. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Lim, Myong Cheol. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. ; Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Jung, So-Youn. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Joo, Jungnam. Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea. IN - Lee, Eun Sook. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea. TI - Assessment of Breast Cancer Patients' Knowledge and Decisional Conflict Regarding Tamoxifen Use. CM - Comment in: J Korean Med Sci. 2016 Apr;31(4):647; PMID: 27051254 CM - Comment in: J Korean Med Sci. 2016 Apr;31(4):646; PMID: 27051253 SO - Journal of Korean Medical Science. 30(11):1604-10, 2015 Nov AS - J Korean Med Sci. 30(11):1604-10, 2015 Nov NJ - Journal of Korean medical science PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ah4, 8703518 IO - J. Korean Med. Sci. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4630476 SB - Index Medicus CP - Korea (South) MH - Adult MH - Aged MH - Antineoplastic Agents, Hormonal/ae [Adverse Effects] MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/ep [Epidemiology] MH - *Consent Forms/sn [Statistics & Numerical Data] MH - Decision Making MH - *Endometrial Neoplasms/ci [Chemically Induced] MH - Endometrial Neoplasms/ep [Epidemiology] MH - Endometrial Neoplasms/pc [Prevention & Control] MH - Female MH - Health Knowledge, Attitudes, Practice MH - Health Surveys MH - Humans MH - Middle Aged MH - *Patient Education as Topic/sn [Statistics & Numerical Data] MH - Patient Participation/sn [Statistics & Numerical Data] MH - Prevalence MH - Republic of Korea MH - Risk Assessment MH - *Tamoxifen/ae [Adverse Effects] MH - *Tamoxifen/tu [Therapeutic Use] KW - Breast Neoplasms; Conflict; Decision Making; Knowledge; Patient Satisfaction; Tamoxifen AB - Breast cancer is the most common type of female cancer. Tamoxifen, a selective estrogen receptor modulator, is widely used to decrease breast cancer recurrence and mortality among patients. However, it also increases the risk of endometrial cancer. This study aimed to assess knowledge and decisional conflict regarding tamoxifen use. Between June and October 2014, breast cancer patients using tamoxifen were consecutively screened and requested to complete a survey including the EQ-5D, Satisfaction with Decision Scale (SWD), Decisional Conflict Scale (DCS), and a self-developed, 15-item questionnaire measuring tamoxifen-related knowledge. The study sample comprised 299 patients. The mean total knowledge score was 63.4 of a possible 100.0 (range, 13.3-93.3). While 73.9% of the participants knew that tamoxifen reduces the risk of breast cancer recurrence, only 57.9% knew that the drug increases endometrial cancer risk. A higher education level (>= college) was associated with a higher, total knowledge score (beta = 4.291; P = 0.017). A higher knowledge score was associated with a decreased DCS score (beta = -0.366; P < 0.001). A higher SWD score was also associated with decreased decisional conflict (beta = -0.178; P < 0.001). In conclusion, the breast cancer patients with higher levels of tamoxifen-related knowledge showed lower levels of decisional conflict regarding tamoxifen use. Clinicians should provide the exact information about tamoxifen treatment to patients, based on knowledge assessment results, so as to aid patients' decision-making with minimal conflict. RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) ES - 1598-6357 IL - 1011-8934 DO - https://dx.doi.org/10.3346/jkms.2015.30.11.1604 PT - Journal Article ID - 26539004 [pubmed] ID - 10.3346/jkms.2015.30.11.1604 [doi] ID - PMC4630476 [pmc] PP - ppublish PH - 2015/03/31 [received] PH - 2015/07/14 [accepted] LG - English EP - 20151016 DP - 2015 Nov DC - 20151105 EZ - 2015/11/06 06:00 DA - 2016/08/17 06:00 DT - 2015/11/06 06:00 YR - 2015 ED - 20160816 RD - 20151107 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26539004 <46. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27018666 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Clemens MW AU - Miranda RN AU - Butler CE FA - Clemens, Mark W FA - Miranda, Roberto N FA - Butler, Charles E IN - Clemens, Mark W. Houston, Texas From the Departments of Plastic Surgery and Hematopathology, The University of Texas M. D. Anderson Cancer Center. TI - Breast Implant Informed Consent Should Include the Risk of Anaplastic Large Cell Lymphoma. CM - Comment in: Plast Reconstr Surg. 2016 Apr;137(4):1123; PMID: 27018667 SO - Plastic & Reconstructive Surgery. 137(4):1117-22, 2016 Apr AS - Plast Reconstr Surg. 137(4):1117-22, 2016 Apr NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Breast Implantation/ae [Adverse Effects] MH - *Breast Implantation/is [Instrumentation] MH - *Breast Implants/ae [Adverse Effects] MH - *Breast Neoplasms/et [Etiology] MH - Female MH - Follow-Up Studies MH - Humans MH - *Informed Consent MH - *Lymphoma, Large-Cell, Anaplastic/et [Etiology] MH - Risk Assessment MH - Risk Factors MH - *Truth Disclosure AB - Breast implant-associated anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma arising around breast implants. Public awareness has increased following a safety communication warning of the association of breast implant-associated ALCL by the U.S. Food and Drug Administration in 2011. Difficulty with determining an accurate assessment of risk, including diagnosis, or standardized treatment regimen has led surgeons to commonly omit preoperative discussion of this rare and frequently misunderstood cancer. Risk disclosure is a form of respect for patient autonomy, and informed consent has positive practical and moral consequences for the practice of plastic surgery. A model of breast implant-associated ALCL informed consent implementation and health care provider education are reviewed with 1-year process follow-up at a tertiary cancer center. Breast implant-associated ALCL should be included during preoperative counseling on the risks of breast implantation when obtaining informed consent. Pertinent aspects of decision-making include disease awareness, presenting symptoms, and resources for concerned patients. Education of health care professionals and provision of patient-focused materials ensures effectiveness of the informed consent process. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201604000-00006 DO - https://dx.doi.org/10.1097/01.prs.0000481103.45976.b1 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Video-Audio Media ID - 27018666 [pubmed] ID - 10.1097/01.prs.0000481103.45976.b1 [doi] ID - 00006534-201604000-00006 [pii] PP - ppublish GI - No: P30 CA016672 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2016 Apr DC - 20160329 EZ - 2016/03/29 06:00 DA - 2016/08/09 06:00 DT - 2016/03/29 06:00 YR - 2016 ED - 20160808 RD - 20160329 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=27018666 <47. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26475704 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ozanne EM AU - Schneider KH AU - Soeteman D AU - Stout N AU - Schrag D AU - Fordis M AU - Punglia RS FA - Ozanne, Elissa M FA - Schneider, Katharine H FA - Soeteman, Djora FA - Stout, Natasha FA - Schrag, Deborah FA - Fordis, Michael FA - Punglia, Rinaa S TI - onlineDeCISion.org: a web-based decision aid for DCIS treatment. SO - Breast Cancer Research & Treatment. 154(1):181-90, 2015 Nov AS - Breast Cancer Res Treat. 154(1):181-90, 2015 Nov NJ - Breast cancer research and treatment PI - Journal available in: Print PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. SB - Index Medicus CP - Netherlands MH - Adult MH - *Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/th [Therapy] MH - *Carcinoma, Intraductal, Noninfiltrating/ep [Epidemiology] MH - Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - Internet MH - Mammography MH - Middle Aged MH - Patient Education as Topic MH - *Patient Participation AB - Women diagnosed with DCIS face complex treatment decisions and often do so with inaccurate and incomplete understanding of the risks and benefits involved. Our objective was to create a tool to guide these decisions for both providers and patients. We developed a web-based decision aid designed to provide clinicians with tailored information about a patient's recurrence risks and survival outcomes following different treatment strategies for DCIS. A theoretical framework, microsimulation model (Soeteman et al., J Natl Cancer 105:774-781, 2013) and best practices for web-based decision tools guided the development of the decision aid. The development process used semi-structured interviews and usability testing with key stakeholders, including a diverse group of multidisciplinary clinicians and a patient advocate. We developed onlineDeCISion.org to include the following features that were rated as important by the stakeholders: (1) descriptions of each of the standard treatment options available; (2) visual projections of the likelihood of time-specific (10-year and lifetime) breast-preservation, recurrence, and survival outcomes; and (3) side-by-side comparisons of down-stream effects of each treatment choice. All clinicians reviewing the decision aid in usability testing were interested in using it in their clinical practice. The decision aid is available in a web-based format and is planned to be publicly available. To improve treatment decision making in patients with DCIS, we have developed a web-based decision aid onlineDeCISion.org that conforms to best practices and that clinicians are interested in using in their clinics with patients to better inform treatment decisions. ES - 1573-7217 IL - 0167-6806 DI - 10.1007/s10549-015-3605-y DO - https://dx.doi.org/10.1007/s10549-015-3605-y PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 26475704 [pubmed] ID - 10.1007/s10549-015-3605-y [doi] ID - 10.1007/s10549-015-3605-y [pii] PP - ppublish PH - 2015/07/25 [received] PH - 2015/10/12 [accepted] LG - English DP - 2015 Nov DC - 20160120 EZ - 2015/10/18 06:00 DA - 2016/08/09 06:00 DT - 2015/10/18 06:00 YR - 2015 ED - 20160808 RD - 20160120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26475704 <48. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26458964 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Berger-Hoger B AU - Liethmann K AU - Muhlhauser I AU - Haastert B AU - Steckelberg A FA - Berger-Hoger, Birte FA - Liethmann, Katrin FA - Muhlhauser, Ingrid FA - Haastert, Burkhard FA - Steckelberg, Anke IN - Berger-Hoger, Birte. University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany. Birte.Berger-Hoeger@uni-hamburg.de. IN - Liethmann, Katrin. University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany. Katrin.Liethmann@uni-hamburg.de. IN - Muhlhauser, Ingrid. University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany. Ingrid_Muehlhauser@uni-hamburg.de. IN - Haastert, Burkhard. mediStatistica Neuenrade, Lambertusweg 1b, D-58809, Neuenrade, Germany. haastert@medistatistica.de. IN - Steckelberg, Anke. University of Hamburg, MIN-Faculty, Unit of Health Sciences and Education, Martin-Luther-King-Platz 6, D-20146, Hamburg, Germany. ASteckelberg@uni-hamburg.de. TI - Informed shared decision-making supported by decision coaches for women with ductal carcinoma in situ: study protocol for a cluster randomized controlled trial. SO - Trials [Electronic Resource]. 16:452, 2015 Oct 12 AS - Trials. 16:452, 2015 Oct 12 NJ - Trials PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101263253 IO - Trials PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603943 SB - Index Medicus CP - England MH - Attitude of Health Personnel MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma, Intraductal, Noninfiltrating/di [Diagnosis] MH - Carcinoma, Intraductal, Noninfiltrating/px [Psychology] MH - *Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - *Choice Behavior MH - *Communication MH - Decision Support Techniques MH - Female MH - Germany MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Informed Consent MH - *Nurse-Patient Relations MH - Patient Education as Topic MH - *Patient Participation MH - *Physician-Patient Relations MH - Research Design AB - BACKGROUND: Women with breast cancer want to participate in treatment decision-making. Guidelines have confirmed the right of informed shared decision-making. However, previous research has shown that the implementation of informed shared decision-making is suboptimal for reasons of limited resources of physicians, power imbalances between patients and physicians and missing evidence-based patient information. We developed an informed shared decision-making program for women with primary ductal carcinoma in situ (DCIS). The program provides decision coaching for women by specialized nurses and aims at supporting involvement in decision-making and informed choices. In this trial, the informed shared decision-making program will be evaluated in breast care centers. AB - METHODS/DESIGN: A cluster randomized controlled trial will be conducted to compare the informed shared decision-making program with standard care. The program comprises an evidence-based patient decision aid and training of physicians (2 hours) and specialized breast care and oncology nurses (4 days) in informed shared decision-making. Sixteen certified breast care centers will be included, with 192 women with primary DCIS being recruited. Primary outcome is the extent of patients' involvement in shared decision-making as assessed by the MAPPIN-Odyad (Multifocal approach to the 'sharing' in shared decision-making: observer instrument dyad). Secondary endpoints include the sub-measures of the MAPPIN-inventory (MAPPIN-Onurse, MAPPIN-Ophysician, MAPPIN-Opatient, MAPPIN-Qnurse, MAPPIN-Qpatient and MAPPIN-Qphysician), informed choice, decisional conflict and the duration of encounters. It is expected that decision coaching and the provision of evidence-based patient decision aids will increase patients' involvement in decision-making with informed choices and reduce decisional conflicts and duration of physician encounters. Furthermore, an accompanying process evaluation will be conducted. AB - DISCUSSION: To our knowledge, this is the first study investigating the implementation of decision coaches in German breast care centers. AB - TRIAL REGISTRATION: Current Controlled Trials ISRCTN46305518 , date of registration: 5 June 2015. ES - 1745-6215 IL - 1745-6215 DI - 10.1186/s13063-015-0991-8 DO - https://dx.doi.org/10.1186/s13063-015-0991-8 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 26458964 [pubmed] ID - 10.1186/s13063-015-0991-8 [doi] ID - 10.1186/s13063-015-0991-8 [pii] ID - PMC4603943 [pmc] PP - epublish PH - 2015/06/25 [received] PH - 2015/09/30 [accepted] SI - ISRCTN SA - ISRCTN/ISRCTN46305518 SL - https://www.controlled-trials.com/ISRCTN46305518 LG - English EP - 20151012 DP - 2015 Oct 12 DC - 20151013 EZ - 2015/10/14 06:00 DA - 2016/07/19 06:00 DT - 2015/10/16 06:00 YR - 2015 ED - 20160718 RD - 20151017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26458964 <49. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25880673 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Belkora JK AU - Miller MF AU - Dougherty K AU - Gayer C AU - Golant M AU - Buzaglo JS FA - Belkora, Jeffrey K FA - Miller, Melissa F FA - Dougherty, Kasey FA - Gayer, Christopher FA - Golant, Mitch FA - Buzaglo, Joanne S IN - Belkora, Jeffrey K. Institute for Health Policy Studies, University of California, San Francisco, California, USA. IN - Miller, Melissa F. Public Health Research Scientist, Fairfax, Virginia, USA. IN - Dougherty, Kasey. Research Partnership, Horsham, Pennsylvania, USA. IN - Gayer, Christopher. Research & Training Institute, Cancer Support Community, Philadelphia, Pennsylvania, USA. IN - Golant, Mitch. Research & Training Institute, Cancer Support Community, Philadelphia, Pennsylvania, USA. IN - Buzaglo, Joanne S. Research & Training Institute, Cancer Support Community, Philadelphia, Pennsylvania, USA. joanne@cancersupportcommunity.org. TI - The need for decision and communication aids: a survey of breast cancer survivors. SO - The Journal of community and supportive oncology. 13(3):104-12, 2015 Mar AS - J. community support. oncol.. 13(3):104-12, 2015 Mar NJ - The Journal of community and supportive oncology PI - Journal available in: Print PI - Citation processed from: Print JC - 101621609 IO - J Community Support Oncol CP - United States KW - breast cancer; communication aids; decision aids; decision support; office visits; shared decision making; visit preparation AB - BACKGROUND: Qualitative studies have identified barriers to communication and informed decision making among breast cancer survivors making treatment decisions. The prevalence of these barriers is unknown. AB - OBJECTIVE: To quantify the need for decision support among breast cancer survivors. AB - METHODS: We surveyed 2,521 breast cancer survivors participating in an online registry hosted by the Cancer Support Community to find out what proportion of breast cancer patients: made decisions during their first visit with a specialist; received satisfactory information before that visit; asked questions and received responses; and endorsed expanded use of decision support. AB - RESULTS: We received 1,017 (41%) responses and analyzed 917 surveys from women who lived in the United States. Most of the respondents recalled making treatment decisions during their first visit (52%). A minority (14%) received information before the first specialist visit. At least 25% of respondents rated their satisfaction below 7 on a scale of 10 for decision-making, information, and questions asked and answered. Respondents endorsed the need for assistance with obtaining information, listing questions, taking notes, and making audio-recordings of visits. AB - LIMITATIONS: The respondent sample skewed younger and had higher-stage cancer compared with all breast cancer survivors. Responses were subject to recall bias. AB - CONCLUSIONS: Cancer survivors expressed gaps in their care with respect to reviewing information, asking questions, obtaining answers, and making decisions. Implementing decision and communication aids immediately upon diagnosis, when treatment decisions are being made, would address these gaps. AB - Copyright ©2015 Frontline Medical Communications. IS - 2330-7749 IL - 2330-7749 DO - https://dx.doi.org/10.12788/jcso.0116 PT - Journal Article ID - 25880673 [pubmed] ID - 10.12788/jcso.0116 [doi] PP - ppublish PH - 2014/11/05 [accepted] LG - English DP - 2015 Mar DC - 20150417 EZ - 2015/04/17 06:00 DA - 2015/04/17 06:01 DT - 2015/04/17 06:00 YR - 2015 ED - 20160702 RD - 20150417 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=25880673 <50. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26562292 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Clemons M AU - Bouganim N AU - Smith S AU - Mazzarello S AU - Vandermeer L AU - Segal R AU - Dent S AU - Gertler S AU - Song X AU - Wheatley-Price P AU - Dranitsaris G FA - Clemons, Mark FA - Bouganim, Nathaniel FA - Smith, Stephanie FA - Mazzarello, Sasha FA - Vandermeer, Lisa FA - Segal, Roanne FA - Dent, Susan FA - Gertler, Stan FA - Song, Xinni FA - Wheatley-Price, Paul FA - Dranitsaris, George IN - Clemons, Mark. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada2Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. IN - Bouganim, Nathaniel. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. IN - Smith, Stephanie. Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. IN - Mazzarello, Sasha. Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. IN - Vandermeer, Lisa. Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. IN - Segal, Roanne. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. IN - Dent, Susan. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. IN - Gertler, Stan. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. IN - Song, Xinni. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. IN - Wheatley-Price, Paul. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. IN - Dranitsaris, George. Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. TI - Risk Model-Guided Antiemetic Prophylaxis vs Physician's Choice in Patients Receiving Chemotherapy for Early-Stage Breast Cancer: A Randomized Clinical Trial. CM - Comment in: Lancet Oncol. 2016 Jan;17(1):e7; PMID: 26776103 CM - Comment in: JAMA Oncol. 2016 Feb;2(2):232-3; PMID: 26561746 SO - JAMA Oncology. 2(2):225-31, 2016 Feb AS - JAMA Oncol. 2(2):225-31, 2016 Feb NJ - JAMA oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - 101652861 IO - JAMA Oncol SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Anthracyclines/ae [Adverse Effects] MH - *Antiemetics/ad [Administration & Dosage] MH - Antiemetics/ae [Adverse Effects] MH - *Antineoplastic Combined Chemotherapy Protocols/ae [Adverse Effects] MH - Benzodiazepines/ad [Administration & Dosage] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - Choice Behavior MH - Cyclophosphamide/ae [Adverse Effects] MH - *Decision Support Techniques MH - Dexamethasone/ad [Administration & Dosage] MH - Drug Administration Schedule MH - Female MH - Humans MH - Middle Aged MH - Nausea/ci [Chemically Induced] MH - *Nausea/pc [Prevention & Control] MH - Neoplasm Staging MH - Ondansetron/ad [Administration & Dosage] MH - Ontario MH - Patient Selection MH - *Practice Patterns, Physicians' MH - Predictive Value of Tests MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Vomiting/ci [Chemically Induced] MH - *Vomiting/pc [Prevention & Control] AB - IMPORTANCE: Despite multiple patient-centered factors being associated with the risk of chemotherapy-induced nausea and vomiting (CINV), these factors are rarely considered when making antiemetic recommendations. AB - OBJECTIVE: To compare risk model-guided (RMG) antiemetic prophylaxis with physician's choice (PC) in patients receiving chemotherapy for early-stage breast cancer. AB - DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial of 324 patients with early-stage breast cancer undergoing chemotherapy (cyclophosphamide and an anthracycline) for the first time at 2 specialty cancer care centers in Ottawa from April 10, 2012, to September 2, 2014. Patients were randomized to either the RMG arm (n = 154) or the PC control arm (n = 170). Prior to each cycle of chemotherapy patients in the RMG group were categorized as low or high risk for CINV, and their antiemetic treatments were adjusted accordingly. AB - INTERVENTIONS: Patients considered to be at low risk received standard dexamethasone and a 5-HT3 antagonist, while those at high risk also received aprepitant with or without olanzapine, based on their risk level. The PC control group received antiemetic agents according to the treating physician's discretion. AB - MAIN OUTCOMES AND MEASURES: The primary end points were control of both nausea and vomiting in the acute posttreatment period (first 24 hours after therapy) and in the delayed posttreatment period (days 2-5 after therapy). AB - RESULTS: The total numbers of chemotherapy cycles delivered in the RMG and PC control groups were 497 and 551 respectively. In the acute period, significantly more patients in the RMG group reported no nausea (53.7% [95% CI, 49.2%-58.1%] vs 41.6% [95% CI, 37.4%-45.3%]; P <.001) and no vomiting (91.8% [95% CI, 89.0%-94.0%] vs 82.2% [95% CI, 78.8%-85.3%]; P <.001) compared with the PC control group. Similarly, significantly more patients in the RMG group reported no nausea (39.6% [95% CI, 35.3%-44.1%] vs 30.7% [95% CI, 26.8%-34.7%]; P =.01) and no vomiting (87.1% [95% CI, 83.8%-90.0%) vs 78.0% [95% CI, 74.3%-81.4%]; P <.001) in the delayed period respectively. AB - CONCLUSIONS AND RELEVANCE: In this trial, the RMG antiemetic prophylaxis led to improved control of acute and delayed CINV compared with physician's choice of therapy. AB - TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01913990. RN - 0 (Anthracyclines) RN - 0 (Antiemetics) RN - 12794-10-4 (Benzodiazepines) RN - 4AF302ESOS (Ondansetron) RN - 7S5I7G3JQL (Dexamethasone) RN - 8N3DW7272P (Cyclophosphamide) RN - N7U69T4SZR (olanzapine) ES - 2374-2445 IL - 2374-2437 DI - 2469339 DO - https://dx.doi.org/10.1001/jamaoncol.2015.3730 PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 26562292 [pubmed] ID - 2469339 [pii] ID - 10.1001/jamaoncol.2015.3730 [doi] PP - ppublish SI - ClinicalTrials.gov SA - ClinicalTrials.gov/NCT01913990 SL - https://clinicaltrials.gov/search/term=NCT01913990 LG - English DP - 2016 Feb DC - 20160212 EZ - 2015/11/13 06:00 DA - 2016/06/30 06:00 DT - 2015/11/13 06:00 YR - 2016 ED - 20160629 RD - 20161126 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26562292 <51. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27207563 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Zdenkowski N AU - Butow P AU - Hutchings E AU - Douglas C AU - Coll JR AU - Boyle FM AI - Zdenkowski, Nicholas; ORCID: http://orcid.org/0000-0001-8738-8463 AI - Butow, Phyllis; ORCID: http://orcid.org/0000-0003-3562-6954 AI - Hutchings, Elizabeth; ORCID: http://orcid.org/0000-0002-6030-954X AI - Douglas, Charles; ORCID: http://orcid.org/0000-0001-7952-068X AI - Coll, Joseph R; ORCID: http://orcid.org/0000-0002-8928-0656 AI - Boyle, Frances M; ORCID: http://orcid.org/0000-0003-3798-1570 FA - Zdenkowski, Nicholas FA - Butow, Phyllis FA - Hutchings, Elizabeth FA - Douglas, Charles FA - Coll, Joseph R FA - Boyle, Frances M IN - Zdenkowski, Nicholas. Northern Clinical School, Faculty of Medicine, University of Sydney, North Sydney, Australia. nick.zdenkowski@newcastle.edu.au. TI - A Decision Aid for Women Considering Neoadjuvant Systemic Therapy for Operable Invasive Breast Cancer: Development and Protocol of a Phase II Evaluation Study (ANZ1301 DOMINO). SO - JMIR Research Protocols. 5(2):e88, 2016 May 20 AS - JMIR Res Protoc. 5(2):e88, 2016 May 20 NJ - JMIR research protocols PI - Journal available in: Electronic PI - Citation processed from: Print JC - 101599504 IO - JMIR Res Protoc PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893151 CP - Canada KW - breast neoplasm; chemotherapy; decision aid; neoadjuvant; protocol AB - BACKGROUND: Neoadjuvant systemic therapy is offered to selected women with large and/or highly proliferative operable breast cancers. This option adds further complexity to an already complex breast cancer treatment decision tree. Patient decision aids are an established method of increasing patient involvement and knowledge while decreasing decisional conflict. There is currently no decision aid available for women considering neoadjuvant systemic therapy. AB - OBJECTIVE: We aimed to develop a decision aid for women diagnosed with operable breast cancer and considered suitable for neoadjuvant systemic therapy, and the protocol for a multicenter pre-post study evaluating the acceptability and feasibility of the decision aid. AB - METHODS: The decision aid was developed through literature review, expert advisory panel, adherence to the International Patient Decision Aid Standards, and iterative review. The protocol for evaluation of the decision aid consists of the following: eligible women will undertake a series of questionnaires prior to and after using the decision aid. The primary endpoint is decision aid acceptability to patients and investigators and the feasibility of use. Secondary endpoints include change in decisional conflict, participant knowledge, and information involvement preference. Feasibility is defined as the proportion of eligible participants who use the decision aid to help inform their treatment decision. AB - RESULTS: This study has recruited 29 out of a planned 50 participants at four Australian sites. A 12-month recruitment period is expected with a further 12-months follow-up. AB - CONCLUSIONS: The decision aid has the potential to allow patients with operable breast cancer, who have been offered neoadjuvant systemic therapy, decreased decisional conflict, and greater involvement in the decision. If this study finds that an online decision aid is feasible and acceptable, it will be made widely available for routine clinical practice. AB - TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12614001267640; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12614001267640&isBasic=True (Archived by WebCite at http://www.webcitation.org/6gh7BPZdG). IL - 1929-0748 DI - v5i2e88 DO - https://dx.doi.org/10.2196/resprot.5641 PT - Journal Article ID - 27207563 [pubmed] ID - v5i2e88 [pii] ID - 10.2196/resprot.5641 [doi] ID - PMC4893151 [pmc] PP - epublish PH - 2016/02/16 [received] PH - 2016/03/30 [accepted] PH - 2016/03/30 [revised] LG - English EP - 20160520 DP - 2016 May 20 DC - 20160521 EZ - 2016/05/22 06:00 DA - 2016/05/22 06:01 DT - 2016/05/22 06:00 YR - 2016 ED - 20160521 RD - 20160614 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27207563 <52. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26261111 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Msaouel P AU - Kappos T AU - Tasoulis A AU - Apostolopoulos AP AU - Lekkas I AU - Tripodaki ES AU - Keramaris NC FA - Msaouel, Pavlos FA - Kappos, Theocharis FA - Tasoulis, Athanasios FA - Apostolopoulos, Alexandros P FA - Lekkas, Ioannis FA - Tripodaki, Elli-Sophia FA - Keramaris, Nikolaos C IN - Msaouel, Pavlos. Greek Junior Doctors and Health Scientists Society, Athens, Greece. TI - Comparison of resident performance in interpreting mammography results using a probabilistic or a natural frequency presentation: a multi-institutional randomized experimental study. SO - Education for Health. 28(1):29-34, 2015 Jan-Apr AS - EDUC HEALTH. 28(1):29-34, 2015 Jan-Apr NJ - Education for health (Abingdon, England) PI - Journal available in: Print PI - Citation processed from: Internet JC - 9607101 IO - Educ Health (Abingdon) SB - Index Medicus CP - India MH - Adult MH - Bayes Theorem MH - *Breast Neoplasms/di [Diagnosis] MH - Clinical Competence/st [Standards] MH - *Clinical Competence/sn [Statistics & Numerical Data] MH - Data Interpretation, Statistical MH - Decision Making MH - Female MH - Greece MH - Humans MH - Internship and Residency/st [Standards] MH - *Internship and Residency/sn [Statistics & Numerical Data] MH - Logistic Models MH - Male MH - *Mammography/st [Standards] MH - Mammography/sn [Statistics & Numerical Data] MH - Probability AB - BACKGROUND: Residents are being increasingly challenged on how best to integrate diagnostic information in making decisions about patient care. The aim of this study is to assess the ability of residents to accurately integrate statistical data from a screening mammography test in order to estimate breast cancer probability and to investigate whether a simple alteration of the representation mode of probabilities into natural frequencies facilitates these computations. AB - METHODS: A multi-institutional randomized controlled study of residents was performed in eight major hospitals in the city of Athens. Residents were asked to estimate the positive predictive value of the screening mammography test given its sensitivity and 1-specificity as well as the prevalence of breast cancer in the relevant population. One version of the scenario was presented in the single-event probability format that is commonly used in the medical literature, while the other used the natural frequency representation. The two questionnaire versions were randomly assigned to the participants. AB - RESULTS: Out of 200 residents, 153 completed and returned the questionnaire (response rate 76.5%). Although more than one-third of the residents reported excellent or close to excellent familiarity with sensitivity and positive predictive value, the majority of responses (79.1%) were incorrect. However, a significantly higher proportion of residents in the natural frequency group (n = 88) selected the correct response compared with residents (n = 65) in the single-event probability group (28.4% vs 10.8%; 95% confidence intervals of the difference between the two proportions = 5.6-29.7%; P < 0.01). AB - DISCUSSION: Residents more often correctly understand test performance accuracy when test characteristics are presented to them as natural frequency representations than the more common approach of presenting single event probabilities. Educators and journal editors should be aware of this facilitative effect. ES - 1469-5804 IL - 1357-6283 DI - EducHealth_2015_28_1_29_161846 DO - https://dx.doi.org/10.4103/1357-6283.161846 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial ID - 26261111 [pubmed] ID - EducHealth_2015_28_1_29_161846 [pii] ID - 10.4103/1357-6283.161846 [doi] PP - ppublish LG - English DP - 2015 Jan-Apr DC - 20150811 EZ - 2015/08/12 06:00 DA - 2016/05/19 06:00 DT - 2015/08/12 06:00 YR - 2015 ED - 20160518 RD - 20150811 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26261111 <53. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26164840 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fernandes-Taylor S AU - Adesoye T AU - Bloom JR FA - Fernandes-Taylor, Sara FA - Adesoye, Taiwo FA - Bloom, Joan R IN - Fernandes-Taylor, Sara. aWisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin, Madison, Wisconsin bSchool of Public Health, University of California at Berkeley, Berkeley, California, USA. TI - Managing psychosocial issues faced by young women with breast cancer at the time of diagnosis and during active treatment. [Review] SO - Current Opinion in Supportive & Palliative Care. 9(3):279-84, 2015 Sep AS - Curr. opin. support. palliat. care. 9(3):279-84, 2015 Sep NJ - Current opinion in supportive and palliative care PI - Journal available in: Print PI - Citation processed from: Internet JC - 101297402 IO - Curr Opin Support Palliat Care SB - Index Medicus CP - United States MH - Adult MH - Anxiety/px [Psychology] MH - Body Image MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Communication MH - *Decision Making MH - Depression/px [Psychology] MH - Family Relations MH - Fear MH - Female MH - Humans MH - *Mastectomy/px [Psychology] MH - Neoplasm Recurrence, Local/px [Psychology] MH - Physician-Patient Relations MH - Quality of Life MH - Risk Assessment MH - Stress, Psychological/px [Psychology] AB - PURPOSE OF REVIEW: This review examines recent literature on the psychosocial needs of and interventions for young women. We focus on the active treatment period given the toxicity of treatment, the incidence of anxiety, and depressive symptoms in these women during treatment. This review summarizes research relevant to addressing their social and emotional concerns. AB - RECENT FINDINGS: Young women undergoing treatment for breast cancer remain understudied despite unique needs. Psychoeducational interventions help to relieve symptoms and emotional distress during treatment, but effects do not appear to persist over the longer term. In the clinical context, the performance of prognostic-risk prediction models in this population is poor. Surgical decision-making is often driven by fear of recurrence and body image rather than prognosis, and decision aids may help young women to synthesize information to preserve their role in the treatment process. AB - SUMMARY: First, shared decision-making, second, balancing body image, fear of recurrence, and recommended treatment, and third, palliative care for metastasis are essential research priorities for the clinical setting. In the larger social context, unique family/partner dynamics as well as financial and insurance concerns warrant particular attention in this population. ES - 1751-4266 IL - 1751-4258 DO - https://dx.doi.org/10.1097/SPC.0000000000000161 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Review ID - 26164840 [pubmed] ID - 10.1097/SPC.0000000000000161 [doi] PP - ppublish GI - No: R21 HS023395-01 Organization: (HS) *AHRQ HHS* Country: United States LG - English DP - 2015 Sep DC - 20150811 EZ - 2015/07/13 06:00 DA - 2016/05/19 06:00 DT - 2015/07/15 06:00 YR - 2015 ED - 20160518 RD - 20150811 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26164840 <54. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26017564 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Belkora J AU - Volz S AU - Loth M AU - Teng A AU - Zarin-Pass M AU - Moore D AU - Esserman L FA - Belkora, Jeff FA - Volz, Shelley FA - Loth, Meredith FA - Teng, Alexandra FA - Zarin-Pass, Margot FA - Moore, Dan FA - Esserman, Laura IN - Belkora, Jeff. Philip R. Lee Institute For Health Policy Studies, University of California, San Francisco, 3333, California St, Suite 265, San Francisco, CA, 94118, USA. Jeff.belkora@ucsf.edu. IN - Volz, Shelley. Philip R. Lee Institute For Health Policy Studies, University of California, San Francisco, 3333, California St, Suite 265, San Francisco, CA, 94118, USA. Shelley.volz@ucsf.edu. IN - Loth, Meredith. Philip R. Lee Institute For Health Policy Studies, University of California, San Francisco, 3333, California St, Suite 265, San Francisco, CA, 94118, USA. Meredith.Loth@gmail.com. IN - Teng, Alexandra. Philip R. Lee Institute For Health Policy Studies, University of California, San Francisco, 3333, California St, Suite 265, San Francisco, CA, 94118, USA. Alexandra.Teng@ucsf.edu. IN - Zarin-Pass, Margot. Philip R. Lee Institute For Health Policy Studies, University of California, San Francisco, 3333, California St, Suite 265, San Francisco, CA, 94118, USA. Margot.Zarin-Pass@ucsf.edu. IN - Moore, Dan. Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 1600 Divisadero Street, San Francisco, CA, 94115, USA. dmoore@cc.ucsf.edu. IN - Esserman, Laura. Carol Franc Buck Breast Care Center, University of California, San Francisco, 1600 Divisadero Street, 2nd Floor, San Francisco, CA, 94115, USA. Laura.Esserman@ucsf.edu. TI - Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program. SO - BMC Health Services Research. 15:209, 2015 May 28 AS - BMC Health Serv Res. 15:209, 2015 May 28 NJ - BMC health services research PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088677 IO - BMC Health Serv Res PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446845 SB - Index Medicus CP - England MH - Adult MH - *Breast Neoplasms/th [Therapy] MH - California MH - *Communication MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - *Health Personnel/ed [Education] MH - Humans MH - Male MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Program Evaluation MH - Surveys and Questionnaires AB - BACKGROUND: Decision aids educate patients about treatment options and outcomes. Communication aids include question lists, consultation summaries, and audio-recordings. In efficacy studies, decision aids increased patient knowledge, while communication aids increased patient question-asking and information recall. Starting in 2004, we trained successive cohorts of post-baccalaureate, pre-medical interns to coach patients in the use of decision and communication aids at our university-based breast cancer clinic. AB - METHODS: From July 2005 through June 2012, we used the RE-AIM framework to measure Reach, Effectiveness, Adoption, Implementation and Maintenance of our interventions. AB - RESULTS: 1. Reach: Over the study period, our program sent a total of 5,153 decision aids and directly administered 2,004 communication aids. In the most recent program year (2012), out of 1,524 eligible patient appointments, we successfully contacted 1,212 (80%); coached 1,110 (73%) in the self-administered use of decision and communication aids; sent 958 (63%) decision aids; and directly administered communication aids for 419 (27%) patients. In a 2010 survey, coached patients reported self-administering one or more communication aids in 81% of visits 2. Effectiveness: In our pre-post comparisons, decision aids were associated with increased patient knowledge and decreased decisional conflict. Communication aids were associated with increased self-efficacy and number of questions; and with high ratings of patient preparedness and satisfaction 3. Adoption: Among visitors sent decision aids, 82% of survey respondents reviewed some or all; among those administered communication aids, 86% reviewed one or more after the visit 4. AB - IMPLEMENTATION: Through continuous quality adaptations, we increased the proportion of available staff time used for patient support (i.e. exploitation of workforce capacity) from 29% in 2005 to 84% in 2012 5. Maintenance: The main barrier to sustainability was the cost of paid intern labor. We addressed this by testing a service learning model in which student interns work as program coaches in exchange for academic credit rather than salary. The feasibility test succeeded, and we are now expanding the use of unpaid interns. AB - CONCLUSION: We have sustained a clinic-wide implementation of decision and communication aids through a novel staffing model that uses paid and unpaid student interns as coaches. ES - 1472-6963 IL - 1472-6963 DI - 10.1186/s12913-015-0872-6 DO - https://dx.doi.org/10.1186/s12913-015-0872-6 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26017564 [pubmed] ID - 10.1186/s12913-015-0872-6 [doi] ID - 10.1186/s12913-015-0872-6 [pii] ID - PMC4446845 [pmc] PP - epublish PH - 2014/12/02 [received] PH - 2015/05/18 [accepted] LG - English EP - 20150528 DP - 2015 May 28 DC - 20150528 EZ - 2015/05/29 06:00 DA - 2016/05/18 06:00 DT - 2015/05/29 06:00 YR - 2015 ED - 20160516 RD - 20150530 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26017564 <55. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25862439 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fontein DB AU - Klinten Grand M AU - Nortier JW AU - Seynaeve C AU - Meershoek-Klein Kranenbarg E AU - Dirix LY AU - van de Velde CJ AU - Putter H FA - Fontein, D B Y FA - Klinten Grand, M FA - Nortier, J W R FA - Seynaeve, C FA - Meershoek-Klein Kranenbarg, E FA - Dirix, L Y FA - van de Velde, C J H FA - Putter, H IN - Fontein, D B Y. Department of Surgery. IN - Klinten Grand, M. Department of Medical Statistics. IN - Nortier, J W R. Department of Medical Oncology, Leiden University Medical Center, Leiden. IN - Seynaeve, C. Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. IN - Meershoek-Klein Kranenbarg, E. Department of Surgery. IN - Dirix, L Y. Department of Medical Oncology, Academisch Ziekenhuis Sint-Augustinus Antwerp, Antwerp, Belgium. IN - van de Velde, C J H. Department of Surgery. IN - Putter, H. Department of Medical Statistics h.putter@lumc.nl. TI - Dynamic prediction in breast cancer: proving feasibility in clinical practice using the TEAM trial. SO - Annals of Oncology. 26(6):1254-62, 2015 Jun AS - Ann Oncol. 26(6):1254-62, 2015 Jun NJ - Annals of oncology : official journal of the European Society for Medical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ayf, 9007735 IO - Ann. Oncol. SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents, Hormonal/ae [Adverse Effects] MH - *Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - Belgium MH - Biomarkers, Tumor/an [Analysis] MH - Breast Neoplasms/ch [Chemistry] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Humans MH - Mastectomy/ae [Adverse Effects] MH - Mastectomy/mo [Mortality] MH - *Mastectomy MH - Middle Aged MH - Neoplasm Recurrence, Local MH - Neoplasm Staging MH - Netherlands MH - Nomograms MH - Patient Selection MH - Predictive Value of Tests MH - Receptor, ErbB-2/an [Analysis] MH - Risk Assessment MH - Risk Factors MH - Survival Analysis MH - Time Factors MH - Treatment Outcome KW - breast cancer; dynamic prediction; landmark analysis; personalized therapy; survival probability AB - BACKGROUND: Predictive models are an integral part of current clinical practice and help determine optimal treatment strategies for individual patients. A drawback is that covariates are assumed to have constant effects on overall survival (OS), when in fact, these effects may change during follow-up (FU). Furthermore, breast cancer (BC) patients may experience events that alter their prognosis from that time onwards. We investigated the 'dynamic' effects of different covariates on OS and developed a nomogram to calculate 5-year dynamic OS (DOS) probability at different prediction timepoints (tP) during FU. AB - METHODS: Dutch and Belgian postmenopausal, endocrine-sensitive, early BC patients enrolled in the TEAM trial were included. We assessed time-varying effects of specific covariates and obtained 5-year DOS predictions using a proportional baselines landmark supermodel. Covariates included age, histological grade, hormone receptor and HER2 status, T- and N-stage, locoregional recurrence (LRR), distant recurrence, and treatment compliance. A nomogram was designed to calculate 5-year DOS based on individual characteristics. AB - RESULTS: A total of 2602 patients were included (mean FU 6.2 years). N-stage, LRR, and HER2 status demonstrated time-varying effects on 5-year DOS. Hazard ratio (HR) functions for LRR, high-risk N-stage (N2/3), and HER2 positivity were HR = (8.427 x 0.583[Formula: see text], HR = (3.621 x 0.816[Formula: see text], and HR = (1.235 x 0.851[Formula: see text], respectively. Treatment discontinuation was associated with a higher mortality risk, but without a time-varying effect [HR 1.263 (0.867-1.841)]. All other covariates were time-constant. AB - DISCUSSION: The current nomogram accounts for elapsed time since starting adjuvant endocrine treatment and optimizes prediction of individual 5-year DOS during FU for postmenopausal, endocrine-sensitive BC patients. The nomogram can facilitate in determining whether further therapy will benefit an individual patient, although validation in an independent dataset is still needed. AB - Copyright © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com. RN - 0 (Antineoplastic Agents, Hormonal) RN - 0 (Biomarkers, Tumor) RN - EC 2-7-10-1 (ERBB2 protein, human) RN - EC 2-7-10-1 (Receptor, ErbB-2) ES - 1569-8041 IL - 0923-7534 DI - mdv146 DO - https://dx.doi.org/10.1093/annonc/mdv146 PT - Clinical Trial, Phase III PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 25862439 [pubmed] ID - mdv146 [pii] ID - 10.1093/annonc/mdv146 [doi] PP - ppublish PH - 2014/04/16 [received] PH - 2015/03/05 [accepted] SI - NTR SA - NTR/NTR267 LG - English EP - 20150410 DP - 2015 Jun DC - 20150525 EZ - 2015/04/12 06:00 DA - 2016/05/14 06:00 DT - 2015/04/12 06:00 YR - 2015 ED - 20160513 RD - 20161017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25862439 <56. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25858291 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kerruish N AU - McMillan JR FA - Kerruish, Nicola FA - McMillan, John R IN - Kerruish, Nicola. Department of Women's and Children's Health and Bioethics Centre, University of Otago, Dunedin, New Zealand. IN - McMillan, John R. Bioethics Centre, University of Otago, Dunedin, New Zealand. TI - Parental reasoning about growth attenuation therapy: report of a single-case study. SO - Journal of Medical Ethics. 41(9):745-9, 2015 Sep AS - J Med Ethics. 41(9):745-9, 2015 Sep NJ - Journal of medical ethics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - j1d, 7513619 IO - J Med Ethics SB - Bioethics Journals SB - Index Medicus CP - England MH - Adult MH - Child MH - Child, Preschool MH - *Decision Making/es [Ethics] MH - *Developmental Disabilities MH - *Disabled Children MH - Ethical Analysis MH - Ethics Committees MH - *Ethics, Medical MH - Female MH - *Growth/de [Drug Effects] MH - *Hormones/ad [Administration & Dosage] MH - Humans MH - Hysterectomy/es [Ethics] MH - *Intellectual Disability MH - Male MH - Mastectomy/es [Ethics] MH - Parenting/px [Psychology] MH - *Parenting MH - Parents/px [Psychology] MH - *Parents MH - *Quality of Life KW - Decision-making; Disability; Minors/Parental Consent AB - In 2006 a case report was published about a 6-year-old girl, Ashley, who has profound developmental disabilities and was treated with oestrogen patches to limit her final height, along with a hysterectomy and the removal of her breast buds. Ashley's parents claimed that attenuating her growth would make it possible for them to lift and move her more easily, facilitating greater involvement in family activities and making routine care more straightforward. The 'Ashley treatment' provoked public comment and academic debate and remains ethically controversial. As more children are being referred for such treatment, there is an urgent need to clarify how clinicians and ethics committees should respond to such requests. The controversy surrounding the Ashley treatment exists, at least in part, because of gaps in the literature, including a lack of empirical data about the outcomes for children who do and do not receive such treatment. However, we suggest in this paper that there is also merit in examining the parental decision-making process itself, and provide empirical data about the reasoning of one set of parents who ultimately chose part of this treatment for their child. Using the interview data, we illuminate some important points regarding how these parents characterise benefits and harms and their responsibilities as surrogate decision-makers. This analysis could inform decision-making about future requests for growth attenuation and might also have wider relevance to healthcare decision-making for children with profound cognitive impairment. AB - Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. RN - 0 (Hormones) ES - 1473-4257 IL - 0306-6800 DI - medethics-2013-101913 DO - https://dx.doi.org/10.1136/medethics-2013-101913 PT - Journal Article ID - 25858291 [pubmed] ID - medethics-2013-101913 [pii] ID - 10.1136/medethics-2013-101913 [doi] PP - ppublish PH - 2013/11/04 [received] PH - 2015/03/20 [accepted] LG - English EP - 20150409 DP - 2015 Sep DC - 20150825 EZ - 2015/04/11 06:00 DA - 2016/05/10 06:00 DT - 2015/04/11 06:00 YR - 2015 ED - 20160509 RD - 20150825 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25858291 <57. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26360918 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eden KB AU - Scariati P AU - Klein K AU - Watson L AU - Remiker M AU - Hribar M AU - Forro V AU - Michaels L AU - Nelson HD FA - Eden, Karen B FA - Scariati, Paula FA - Klein, Krystal FA - Watson, Lindsey FA - Remiker, Mark FA - Hribar, Michelle FA - Forro, Vanessa FA - Michaels, LeAnn FA - Nelson, Heidi D IN - Eden, Karen B. 1 Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University , Portland, Oregon. IN - Scariati, Paula. 2 Marin General Hospital , Greenbrae, California. IN - Klein, Krystal. 1 Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University , Portland, Oregon. IN - Watson, Lindsey. 1 Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University , Portland, Oregon. IN - Remiker, Mark. 3 Oregon Rural Practice-Based Research Network, Oregon Health and Science University , Portland, Oregon. IN - Hribar, Michelle. 1 Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University , Portland, Oregon. IN - Forro, Vanessa. 3 Oregon Rural Practice-Based Research Network, Oregon Health and Science University , Portland, Oregon. IN - Michaels, LeAnn. 3 Oregon Rural Practice-Based Research Network, Oregon Health and Science University , Portland, Oregon. IN - Nelson, Heidi D. 1 Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University , Portland, Oregon. IN - Nelson, Heidi D. 4 Providence Cancer Center , Providence Health and Services, Portland, Oregon. TI - Mammography Decision Aid Reduces Decisional Conflict for Women in Their Forties Considering Screening. SO - Journal of Women's Health. 24(12):1013-20, 2015 Dec AS - J Womens Health (Larchmt). 24(12):1013-20, 2015 Dec NJ - Journal of women's health (2002) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101159262, 9208978 IO - J Womens Health (Larchmt) PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683542 SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Conflict (Psychology) MH - Decision Making MH - *Decision Support Techniques MH - *Early Detection of Cancer MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Intention MH - *Mammography MH - Middle Aged MH - *Patient Participation AB - BACKGROUND: Clinical guidelines recommend a personalized approach to mammography screening for women in their forties; however, methods to do so are lacking. An evidence-based mammography screening decision aid was developed as an electronic mobile application and evaluated in a before-after study. AB - METHODS: The decision aid (Mammopad) included modules on breast cancer, mammography, risk assessment, and priority setting about screening. Women aged 40-49 years who were patients of rural primary care clinics, had no major risk factors for breast cancer, and no mammography during the previous year were invited to use the decision aid. Twenty women participated in pretesting of the decision aid and 75 additional women completed the before-after study. The primary outcome was decisional conflict measured before and after using Mammopad. Secondary outcomes included decision self-efficacy and intention to begin or continue mammography screening. Differences comparing measures before versus after use were determined using Wilcoxon signed rank tests. AB - RESULTS: After using Mammopad, women reported reduced decisional conflict based on mean Decisional Conflict Scale scores overall (46.33 versus 8.33; Z=-7.225; p<0.001) and on all subscales (p<0.001). Women also reported increased mean Decision Self-Efficacy Scale scores (79.67 versus 95.73; Z=6.816, p<0.001). Although 19% of women changed their screening intentions, this was not statistically significant. AB - CONCLUSIONS: Women reported less conflict about their decisions for mammography screening, and felt more confident to make decisions after using Mammopad. This approach may help guide women through the decision making process to determine personalized screening choices that are appropriate for them. ES - 1931-843X IL - 1540-9996 DO - https://dx.doi.org/10.1089/jwh.2015.5256 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 26360918 [pubmed] ID - 10.1089/jwh.2015.5256 [doi] ID - PMC4683542 [pmc] PP - ppublish GI - No: T15 LM007088 Organization: (LM) *NLM NIH HHS* Country: United States No: T15LM007088 Organization: (LM) *NLM NIH HHS* Country: United States No: UL1TR000128 Organization: (TR) *NCATS NIH HHS* Country: United States LG - English EP - 20150911 DP - 2015 Dec DC - 20151215 EZ - 2015/09/12 06:00 DA - 2016/05/07 06:00 DT - 2015/09/12 06:00 YR - 2015 ED - 20160506 RD - 20161201 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26360918 <58. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26601873 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schmitt WP AU - Eichhorn MG AU - Ford RD FA - Schmitt, William P FA - Eichhorn, Mitchell G FA - Ford, Ronald D IN - Schmitt, William P. Division of Plastic and Reconstructive Surgery, Grand Rapids Medical Education Partners/Michigan State University, 221 Michigan St. NE, Suite 200-A, Grand Rapids, MI 49503, USA. Electronic address: William.schmitt@grmep.com. IN - Eichhorn, Mitchell G. Division of Plastic and Reconstructive Surgery, Grand Rapids Medical Education Partners/Michigan State University, 221 Michigan St. NE, Suite 200-A, Grand Rapids, MI 49503, USA. IN - Ford, Ronald D. Division of Plastic and Reconstructive Surgery, Grand Rapids Medical Education Partners/Michigan State University, 221 Michigan St. NE, Suite 200-A, Grand Rapids, MI 49503, USA. TI - Potential costs of breast augmentation mammaplasty. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 69(1):55-60, 2016 Jan AS - J Plast Reconstr Aesthet Surg. 69(1):55-60, 2016 Jan NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - *Breast Implants/ec [Economics] MH - Costs and Cost Analysis MH - Female MH - Follow-Up Studies MH - *Health Expenditures/td [Trends] MH - Humans MH - *Mammaplasty/ec [Economics] MH - Mammaplasty/mt [Methods] MH - Middle Aged MH - Retrospective Studies MH - United States KW - Analysis; Augmentation; Breast; Costs; Lifetime AB - BACKGROUND: Augmentation mammaplasty is one of the most common surgical procedures performed by plastic surgeons. The aim of this study was to estimate the cost of the initial procedure and its subsequent complications, as well as project the cost of Food and Drug Administration (FDA)-recommended surveillance imaging. AB - METHODS: The potential costs to the individual patient and society were calculated. Local plastic surgeons provided billing data for the initial primary silicone augmentation and reoperative procedures. Complication rates used for the cost analysis were obtained from the Allergen Core study on silicone implants. Imaging surveillance costs were considered in the estimations. AB - RESULTS: The average baseline initial cost of silicone augmentation mammaplasty was calculated at $6335. The average total cost of primary breast augmentation over the first decade for an individual patient, including complications requiring reoperation and other ancillary costs, was calculated at $8226. Each decade thereafter cost an additional $1891. Costs may exceed $15,000 over an averaged lifetime, and the recommended implant surveillance could cost an additional $33,750. AB - DISCUSSION: The potential cost of a breast augmentation, which includes the costs of complications and imaging, is significantly higher than the initial cost of the procedure. AB - LEVEL OF EVIDENCE: Level III, economic and decision analysis study. AB - Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(15)00445-3 DO - https://dx.doi.org/10.1016/j.bjps.2015.09.012 PT - Journal Article ID - 26601873 [pubmed] ID - S1748-6815(15)00445-3 [pii] ID - 10.1016/j.bjps.2015.09.012 [doi] PP - ppublish PH - 2015/05/19 [received] PH - 2015/09/21 [accepted] LG - English EP - 20151023 DP - 2016 Jan DC - 20160106 EZ - 2015/11/26 06:00 DA - 2016/05/06 06:00 DT - 2015/11/26 06:00 YR - 2016 ED - 20160505 RD - 20160106 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26601873 <59. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26554555 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Scariati P AU - Nelson L AU - Watson L AU - Bedrick S AU - Eden KB FA - Scariati, Paula FA - Nelson, Lisa FA - Watson, Lindsey FA - Bedrick, Stephen FA - Eden, Karen B IN - Scariati, Paula. Marin General Hospital, Greenbrae, CA, USA. scariati@vcom.vt.edu. IN - Nelson, Lisa. ConvergeHEALTH by Deloitte, Newton, MA, USA. lisapnelson@gmail.com. IN - Watson, Lindsey. Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. watsolin@ohsu.edu. IN - Bedrick, Stephen. Center for Spoken Language and Understanding, Oregon Health & Science University, Portland, OR, USA. bedricks@ohsu.edu. IN - Eden, Karen B. Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. edenk@ohsu.edu. IN - Eden, Karen B. Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, OR, USA. edenk@ohsu.edu. TI - Impact of a decision aid on reducing uncertainty: pilot study of women in their 40s and screening mammography. SO - BMC Medical Informatics & Decision Making. 15:89, 2015 Nov 10 AS - BMC Med Inf Decis Mak. 15:89, 2015 Nov 10 NJ - BMC medical informatics and decision making PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088682 IO - BMC Med Inform Decis Mak PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4640415 SB - Index Medicus CP - England MH - Adult MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mammography MH - Middle Aged MH - *Patient Preference MH - Pilot Projects MH - *Uncertainty AB - BACKGROUND: In 2009 the United States Preventive Services Task Force updated its breast cancer screening guidelines to recommend that average-risk women obtain a screening mammogram every two years starting at age 50 instead of annually starting at age 40. Inconsistencies in data regarding the benefit versus risk of routine screening for women less than 50-years-of-age led to a second recommendation - that women in their forties engage in a shared decision making process with their provider to make an individualized choice about screening mammography that was right for them. In response, a web-based interactive mammography screening decision aid was developed and evaluated. AB - METHODS: The decision aid was developed using an agile, iterative process. It was further honed based on feedback from clinical and technical subject matter experts. A convenience sample of 51 age- and risk-appropriate women was recruited to pilot the aid. Pre-post decisional conflict and screening choice was assessed. AB - RESULTS: Women reported a significant reduction in overall decisional conflict after using the decision aid (Z=-5.3, p<0.001). These participants also reported statistically significant reductions in each of the decisional conflict subscales: feeling uncertain (Z=-4.7, p<0.001), feeling uninformed (Z=-5.2, p<0.001), feeling unclear about values (Z=-5.0, p<0.001), and feeling unsupported (Z=-4.0, p<0.001). However, a woman's intention to obtain a screening mammogram in the next 1-2 years was not significantly changed (Wilcoxon signed-rank Z=-1.508, p=0.132). AB - CONCLUSION: This mammography screening decision aid brings value to patient care not by impacting what a woman chooses but by lending clarity to why or how she chooses it. ES - 1472-6947 IL - 1472-6947 DI - 10.1186/s12911-015-0210-2 DO - https://dx.doi.org/10.1186/s12911-015-0210-2 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 26554555 [pubmed] ID - 10.1186/s12911-015-0210-2 [doi] ID - 10.1186/s12911-015-0210-2 [pii] ID - PMC4640415 [pmc] PP - epublish PH - 2015/01/22 [received] PH - 2015/10/14 [accepted] GI - No: T15 LM007088 Organization: (LM) *NLM NIH HHS* Country: United States No: 5T15 LM007088 Organization: (LM) *NLM NIH HHS* Country: United States LG - English EP - 20151110 DP - 2015 Nov 10 DC - 20151111 EZ - 2015/11/12 06:00 DA - 2016/05/06 06:00 DT - 2015/11/12 06:00 YR - 2015 ED - 20160505 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26554555 <60. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26238338 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Manca DP AU - Campbell-Scherer D AU - Aubrey-Bassler K AU - Kandola K AU - Aguilar C AU - Baxter J AU - Meaney C AU - Salvalaggio G AU - Carroll JC AU - Faria V AU - Nykiforuk C AU - Grunfeld E AU - original BETTER Trial Investigators and Clinical Working Group FA - Manca, Donna Patricia FA - Campbell-Scherer, Denise FA - Aubrey-Bassler, Kris FA - Kandola, Kami FA - Aguilar, Carolina FA - Baxter, Julia FA - Meaney, Christopher FA - Salvalaggio, Ginetta FA - Carroll, June C FA - Faria, Vee FA - Nykiforuk, Candace FA - Grunfeld, Eva FA - original BETTER Trial Investigators and Clinical Working Group IN - Manca, Donna Patricia. Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada. dpmanca@ualberta.ca. IN - Manca, Donna Patricia. Covenant Health, Grey Nuns Community Hospital, 1100 Youville Drive Northwest, Edmonton, Alberta, T6L 5X8, Canada. dpmanca@ualberta.ca. IN - Campbell-Scherer, Denise. Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada. dlcampbe@ualberta.ca. IN - Campbell-Scherer, Denise. Covenant Health, Grey Nuns Community Hospital, 1100 Youville Drive Northwest, Edmonton, Alberta, T6L 5X8, Canada. dlcampbe@ualberta.ca. IN - Aubrey-Bassler, Kris. Discipline of Family Medicine, Memorial University of Newfoundland, 300 Prince Phillip Drive, St. John's, Newfoundland, A1B 3V6, Canada. kaubrey@mun.ca. IN - Kandola, Kami. Department of Health and Social Services, Government of Northwest Territories, P.O. Box 1320, Yellowknife, Northwest Territories, X1A 2L9, Canada. kami_kandola@gov.nt.ca. IN - Aguilar, Carolina. Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada. carolina.aguilar@ualberta.ca. IN - Baxter, Julia. Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. better.project@utoronto.ca. IN - Meaney, Christopher. Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. christopher.meaney@utoronto.ca. IN - Salvalaggio, Ginetta. Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada. ginetta@ualberta.ca. IN - Carroll, June C. Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. jcarroll@mtsinai.on.ca. IN - Faria, Vee. Department of Health and Social Services, Government of Northwest Territories, P.O. Box 1320, Yellowknife, Northwest Territories, X1A 2L9, Canada. vfaria@auroracollege.nt.ca. IN - Nykiforuk, Candace. School of Public Health, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada. candace.nykiforuk@ualberta.ca. IN - Grunfeld, Eva. Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. eva.grunfeld@utoronto.ca. IN - Grunfeld, Eva. Ontario Institute for Cancer Research, 661 University Avenue, Suite 510, Toronto, Ontario, M5G 0A3, Canada. eva.grunfeld@utoronto.ca. TI - Developing clinical decision tools to implement chronic disease prevention and screening in primary care: the BETTER 2 program (building on existing tools to improve chronic disease prevention and screening in primary care). SO - Implementation Science. 10:107, 2015 Aug 04 AS - Implement Sci. 10:107, 2015 Aug 04 NJ - Implementation science : IS PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101258411 IO - Implement Sci PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4523915 SB - Index Medicus CP - England MH - *Chronic Disease/pc [Prevention & Control] MH - *Decision Support Techniques MH - Humans MH - Mass Screening/mt [Methods] MH - Mass Screening/st [Standards] MH - Practice Guidelines as Topic MH - *Preventive Medicine/mt [Methods] MH - Preventive Medicine/st [Standards] MH - *Primary Health Care/mt [Methods] MH - Primary Health Care/st [Standards] MH - *Quality Improvement AB - BACKGROUND: The Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice (BETTER) trial demonstrated the effectiveness of an approach to chronic disease prevention and screening (CDPS) through a new skilled role of a 'prevention practitioner'(PP). The PP has appointments with patients 40-65 years of age that focus on primary prevention activities and screening of cancer (breast, colorectal, cervical), diabetes and cardiovascular disease and associated lifestyle factors. There are numerous and occasionally conflicting evidence-based guidelines for CDPS, and the majority of these guidelines are focused on specific diseases or conditions; however, primary care providers often attend to patients with multiple conditions. To ensure that high-level evidence guidelines were used, existing clinical practice guidelines and tools were reviewed and integrated into blended BETTER tool kits. Building on the results of the BETTER trial, the BETTER tools were updated for implementation of the BETTER 2 program into participating urban, rural and remote communities across Canada. AB - METHODS: A clinical working group consisting of PPs, clinicians and researchers with support from the Centre for Effective Practice reviewed the literature to update, revise and adapt the integrated evidence algorithms and tool kits used in the BETTER trial. These resources are nuanced, based on individual patient risk, values and preferences and are designed to facilitate decision-making between providers across the target diseases and lifestyle factors included in the BETTER 2 program. Using the updated BETTER 2 toolkit, clinicians 1) determine which CDPS actions patients are eligible to receive and 2) develop individualized 'prevention prescriptions' with patients through shared decision-making and motivational interviewing. AB - RESULTS: The tools identify the patients' risks and eligible primary CDPS activities: the patient survey captures the patient's health history; the prevention visit form and integrated CDPS care map identify eligible CDPS activities and facilitate decisions when certain conditions are met; and the 'bubble diagram' and 'prevention prescription' promote shared decision-making. AB - CONCLUSION: The integrated clinical decision-making tools of BETTER 2 provide resources for clinicians and policymakers that address patients' complex care needs beyond single disease approaches and can be adapted to facilitate CDPS in the urban, rural and remote clinical setting. AB - TRIAL REGISTRATION: The registration number of the original RCT BETTER trial was ISRCTN07170460 . ES - 1748-5908 IL - 1748-5908 DI - 10.1186/s13012-015-0299-9 DO - https://dx.doi.org/10.1186/s13012-015-0299-9 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26238338 [pubmed] ID - 10.1186/s13012-015-0299-9 [doi] ID - 10.1186/s13012-015-0299-9 [pii] ID - PMC4523915 [pmc] PP - epublish PH - 2015/03/01 [received] PH - 2015/07/27 [accepted] LG - English EP - 20150804 DP - 2015 Aug 04 DC - 20150804 EZ - 2015/08/05 06:00 DA - 2016/04/19 06:00 DT - 2015/08/05 06:00 YR - 2015 ED - 20160418 RD - 20150806 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26238338 <61. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26033878 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Juraskova I AU - Butow P AU - Fisher A AU - Bonner C AU - Anderson C AU - Bu S AU - Scarlet J AU - Stockler MR AU - Wetzig N AU - Ung O AU - Campbell I FA - Juraskova, Ilona FA - Butow, Phyllis FA - Fisher, Alana FA - Bonner, Carissa FA - Anderson, Caroline FA - Bu, Stella FA - Scarlet, Jenni FA - Stockler, Martin R FA - Wetzig, Neil FA - Ung, Owen FA - Campbell, Ian IN - Juraskova, Ilona. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia ilona.juraskova@sydney.edu.au. IN - Butow, Phyllis. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia. IN - Fisher, Alana. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia. IN - Bonner, Carissa. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia. IN - Anderson, Caroline. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia. IN - Bu, Stella. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia. IN - Scarlet, Jenni. Breast Cancer Centre, Waikato Hospital, Hamilton, New Zealand. IN - Stockler, Martin R. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia. IN - Wetzig, Neil. Princess Alexandra Hospital, Brisbane, QLD, Australia. IN - Ung, Owen. Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia. IN - Campbell, Ian. Breast Cancer Centre, Waikato Hospital, Hamilton, New Zealand. TI - Development and piloting of a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 breast cancer trial. SO - Clinical Trials. 12(4):409-17, 2015 Aug AS - Clin. trials. 12(4):409-17, 2015 Aug NJ - Clinical trials (London, England) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101197451 IO - Clin Trials SB - Index Medicus CP - England MH - Adult MH - *Breast Neoplasms/su [Surgery] MH - *Clinical Trials as Topic MH - *Decision Support Techniques MH - Female MH - Humans MH - Interviews as Topic MH - Middle Aged MH - *Patient Participation/px [Psychology] MH - Pilot Projects MH - *Sentinel Lymph Node Biopsy MH - Surveys and Questionnaires KW - Decision aid (DA); Sentinel Node Biopsy versus Axillary Clearance 2; axillary clearance; breast cancer; clinical trial participation; informed consent; sentinel node biopsy AB - BACKGROUND/AIMS: This study aimed to (1) develop a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 (SNAC-2) breast cancer surgical trial and (2) obtain evidence on its acceptability, feasibility, and potential efficacy in routine trial clinical practice via a two-stage pilot. AB - METHODS: The decision aid was developed according to International Patient Decision Aid Standards. Study 1: an initial pilot involved 25 members of the consumer advocacy group, Breast Cancer Network Australia. Study 2: the main pilot involved 20 women eligible to participate in the SNAC-2 trial in New Zealand. In both pilots, a questionnaire assessed: information and involvement preferences, decisional conflict, SNAC-2 trial-related understanding and attitudes, psychological distress, and general decision aid feedback. A follow-up telephone interview elicited more detailed feedback on the decision aid design and content. AB - RESULTS: In both pilots, participants indicated good subjective and objective understanding of SNAC-2 trial and reported low decisional conflict and anxiety. The decision aid was found helpful when deciding about trial participation and provided additional, useful information to the standard trial information sheet. AB - CONCLUSION: The development and two-stage piloting process for this decision aid resulted in a resource that women found very acceptable and helpful in assisting decision-making about SNAC-2 trial participation. The process and findings provide a guide for developing other trial decision aids. AB - Copyright © The Author(s) 2015. ES - 1740-7753 IL - 1740-7745 DI - 1740774515586404 DO - https://dx.doi.org/10.1177/1740774515586404 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26033878 [pubmed] ID - 1740774515586404 [pii] ID - 10.1177/1740774515586404 [doi] PP - ppublish LG - English EP - 20150601 DP - 2015 Aug DC - 20150716 EZ - 2015/06/03 06:00 DA - 2016/04/14 06:00 DT - 2015/06/03 06:00 YR - 2015 ED - 20160413 RD - 20150716 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26033878 <62. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27066455 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Bellavance EC AU - Kesmodel SB FA - Bellavance, Emily Catherine FA - Kesmodel, Susan Beth IN - Bellavance, Emily Catherine. Department of General and Oncologic Surgery, University of Maryland , Baltimore, MD , USA. IN - Kesmodel, Susan Beth. Department of General and Oncologic Surgery, University of Maryland , Baltimore, MD , USA. TI - Decision-Making in the Surgical Treatment of Breast Cancer: Factors Influencing Women's Choices for Mastectomy and Breast Conserving Surgery. [Review] SO - Frontiers in Oncology. 6:74, 2016 AS - Front. oncol.. 6:74, 2016 NJ - Frontiers in oncology PI - Journal available in: Electronic-eCollection PI - Citation processed from: Print JC - 101568867 IO - Front Oncol PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4810034 CP - Switzerland KW - breast cancer; breast conserving surgery; contralateral prophylactic mastectomy; mastectomy; shared decision-making AB - One of the most difficult decisions a woman can be faced with when choosing breast cancer treatment is whether or not to undergo breast conserving surgery or mastectomy. The factors that influence these treatment decisions are complex and involve issues regarding access to health care, concerns for cancer recurrence, and the impact of surgery on body image and sexuality. Understanding these factors will help practitioners to improve patient education and to better guide patients through this decision-making process. Although significant scientific and societal advances have been made in improving women's choices for the breast cancer treatment, there are still deficits in the decision-making processes surrounding the surgical treatment of breast cancer. Further research is needed to define optimal patient education and shared decision-making practices in this area. IL - 2234-943X DO - https://dx.doi.org/10.3389/fonc.2016.00074 PT - Journal Article PT - Review ID - 27066455 [pubmed] ID - 10.3389/fonc.2016.00074 [doi] ID - PMC4810034 [pmc] PP - epublish PH - 2016/01/11 [received] PH - 2016/03/14 [accepted] LG - English EP - 20160329 DP - 2016 DC - 20160412 EZ - 2016/04/12 06:00 DA - 2016/04/12 06:01 DT - 2016/04/12 06:00 YR - 2016 ED - 20160412 RD - 20160413 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27066455 <63. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26165568 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Maher JL AU - Mahabir RC AU - Roehl KR FA - Maher, Janae L FA - Mahabir, Raman C FA - Roehl, Kendall R IN - Maher, Janae L. From the Division of Plastic Surgery, Scott & White Memorial Hospital; and Division of Plastic Surgery, Texas A&M Health Science Center, Temple, TX. TI - Addressing the Potential Need for Coronary Artery Bypass Grafting After Free Tissue Transfer for Breast Reconstruction: An Algorithmic Approach. [Review] SO - Annals of Plastic Surgery. 75(2):140-3, 2015 Aug AS - Ann Plast Surg. 75(2):140-3, 2015 Aug NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - *Algorithms MH - *Coronary Artery Bypass MH - *Decision Support Techniques MH - Female MH - Free Tissue Flaps/bs [Blood Supply] MH - *Free Tissue Flaps/tr [Transplantation] MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Mammary Arteries/tr [Transplantation] MH - Middle Aged MH - Risk Assessment AB - The number one cause of death in American women is heart disease. Studies have clearly shown the superiority of internal mammary artery (IMA) grafts for coronary revascularization over other conduits or intracoronary techniques. Our goal was to design an algorithm for recipient vessel selection in patients undergoing free tissue transfer breast reconstruction.A review of the literature was performed to identify potential evidence to contribute to a best-practice guideline. The lack of high-level evidence led us to create a guideline based on a workgroup consensus, expert opinion, cadaveric studies, and case reports.As we operate on older patient populations, the need for IMA use for coronary artery bypass grafting (CABG) after autologous breast reconstruction may arise more frequently. We discuss the current literature regarding recipient vessel choices and level of recipient vessel harvest in free flap breast reconstruction to help continually evolve the practices of our specialty to the potential future needs of our patients. We also present a best-practice decision algorithm for vessel selection and harvest, as well as a sample case of CABG using the left IMA 35 days after previous autologous breast reconstruction using the left IMA.As the number of patients we operate on who may later require their IMA for CABG increases, so too must our understanding of the implications of our selection of recipient vessels for free autologous breast reconstruction. ES - 1536-3708 IL - 0148-7043 DI - 00000637-201508000-00006 DO - https://dx.doi.org/10.1097/SAP.0000000000000070 PT - Case Reports PT - Journal Article PT - Review ID - 26165568 [pubmed] ID - 10.1097/SAP.0000000000000070 [doi] ID - 00000637-201508000-00006 [pii] PP - ppublish LG - English DP - 2015 Aug DC - 20150713 EZ - 2015/07/14 06:00 DA - 2016/04/09 06:00 DT - 2015/07/15 06:00 YR - 2015 ED - 20160408 RD - 20150713 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26165568 <64. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23294338 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Volz S AU - Moore DH AU - Belkora JK FA - Volz, Shelley FA - Moore, Dan H FA - Belkora, Jeffrey K IN - Volz, Shelley. Institute for Health Policy Studies, University of California, San Francisco, NC, USA. TI - Do patients use decision and communication aids as prompted when meeting with breast cancer specialists?. SO - Health Expectations. 18(3):379-91, 2015 Jun AS - Health Expect. 18(3):379-91, 2015 Jun NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Communication MH - *Decision Support Techniques MH - Female MH - Humans MH - Medical Oncology MH - Middle Aged MH - *Physician-Patient Relations KW - breast cancer; communication aids; decision aids; prompting AB - BACKGROUND: Our breast cancer clinic promotes patient use of decision and communication aids (DAs/CAs) through two mechanisms: coaching and prompting. From January through September 2010, we provided services to 462 of 1106 new visitors (42%). Of those 462 visitors, 267 (58%) received coaching. For the remainder (195 or 42%), the best we could do was prompt them to self-administer the DA and CAs. AB - OBJECTIVE: We wanted to learn whether patients prompted to use DAs/CAs did so. AB - METHODS: We surveyed prompted patients after their visits. We asked how much of each DA they reviewed, whether they listed questions, made notes and audio-recorded their consultations. We tallied frequencies and explored associations using logistic regression. AB - RESULTS: Of the 195 prompted patients, 82 responded to surveys (42%). Nearly all (66/73 or 90%) reported reviewing some or all of the booklets and 52/73 (71%) reported viewing some or all of the DVDs. While 63/78 (81%) responded that they wrote a question list, only 14/61 (23%) said they showed it to their doctor. Two-thirds (51/77 or 66%) said someone took notes, but only 16/79 (20%) reported making audio recordings. AB - DISCUSSION: More patients reported following prompts to use DAs than CAs. Few reported showing question lists to physicians or recording their visits. Our exploratory analyses surfaced associations between using CAs and race/ethnicity or education that merit further investigation. AB - CONCLUSION: Prompting patients assures better use of decision than communication aids. Clinicians may need to take a more active role to ensure patients receive adequate notes and recordings. AB - Copyright © 2013 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/hex.12042 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 23294338 [pubmed] ID - 10.1111/hex.12042 [doi] ID - PMC5060785 [pmc] PP - ppublish PH - 2012/12/10 [accepted] LG - English EP - 20130107 DP - 2015 Jun DC - 20150430 EZ - 2013/01/09 06:00 DA - 2016/04/09 06:00 DT - 2013/01/09 06:00 YR - 2015 ED - 20160408 RD - 20161208 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23294338 <65. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26613337 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gillies K AU - Cotton SC AU - Brehaut JC AU - Politi MC AU - Skea Z FA - Gillies, Katie FA - Cotton, Seonaidh C FA - Brehaut, Jamie C FA - Politi, Mary C FA - Skea, Zoe IN - Gillies, Katie. Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building, Foresterhill, Aberdeen, UK, AB25 2ZB. TI - Decision aids for people considering taking part in clinical trials. [Review] SO - Cochrane Database of Systematic Reviews. (11):CD009736, 2015 Nov 27 AS - Cochrane Database Syst Rev. (11):CD009736, 2015 Nov 27 NJ - The Cochrane database of systematic reviews PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 100909747 IO - Cochrane Database Syst Rev SB - Index Medicus CP - England MH - *Clinical Trials as Topic MH - *Decision Making MH - *Decision Support Techniques MH - Humans MH - *Informed Consent MH - *Patient Participation MH - Randomized Controlled Trials as Topic AB - BACKGROUND: Several interventions have been developed to promote informed consent for participants in clinical trials. However, many of these interventions focus on the content and structure of information (e.g. enhanced information or changes to the presentation format) rather than the process of decision making. Patient decision aids support a decision making process about medical options. Decision aids support the decision process by providing information about available options and their associated outcomes, alongside information that enables patients to consider what value they place on particular outcomes, and provide structured guidance on steps of decision making. They have been shown to be effective for treatment and screening decisions but evidence on their effectiveness in the context of informed consent for clinical trials has not been synthesised. AB - OBJECTIVES: To assess the effectiveness of decision aids for clinical trial informed consent compared to no intervention, standard information (i.e. usual practice) or an alternative intervention on the decision making process. AB - SEARCH METHODS: We searched the following databases and to March 2015: Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; MEDLINE (OvidSP) (from 1950); EMBASE (OvidSP) (from 1980); PsycINFO (OvidSP) (from 1806); ASSIA (ProQuest) (from 1987); WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/); ClinicalTrials.gov; ISRCTN Register (http://www.controlled-trials.com/isrctn/). We also searched reference lists of included studies and relevant reviews. We contacted study authors and other experts. There were no language restrictions. AB - SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials comparing decision aids in the informed consent process for clinical trials alone, or in conjunction with standard information (such as written or verbal) or alongside alternative interventions (e.g. paper-based versus web-based decision aids). Included trials involved potential trial participants, or their guardians, being asked to consider participating in a real or hypothetical clinical trial. AB - DATA COLLECTION AND ANALYSIS: At least two authors independently assessed studies for inclusion, extracted reported data and assessed risk of bias. Findings were pooled where appropriate. We used GRADE to assess the quality of the evidence for each outcome. AB - MAIN RESULTS: We identified one study (290 randomised participants) that investigated the effectiveness of decision aids compared to standard information in the informed consent process for clinical trials. This study reported two separate decision aid randomised controlled trials (RCTs). The decision aid trials were nested within two different parent trials focusing on breast cancer in postmenopausal women. One trial focused on informed consent for treatment in women who had previously had surgery for ductal carcinoma in situ (DCIS), the other on informed consent for prevention in women at high risk for breast cancer. Two different decision aids were used in these RCTs, and were compared with standard information.The pooled findings highlight the uncertainty surrounding most reported outcomes, including knowledge, decisional conflict, anxiety, trial participation and attrition. There was very low quality evidence that decision aids lower levels of decisional regret to a small degree (MD -5.53, 95% CI -10.29 to -0.76). No data were identified on several prespecified primary outcomes, including accurate risk perception, values-based decision, or whether potential participants recognised that a decision needed to be made, were able to identify features of options that matter most to individuals, or were involved in the decision. AB - AUTHORS' CONCLUSIONS: There was insufficient evidence to determine whether decision aids to support the informed consent process for clinical trials are more effective than standard information. Additional well designed, adequately powered clinical trials in more diverse clinical and social populations are needed to strengthen the results of this review. More generally, future research on which outcomes are most relevant for assessment in this context would be helpful. ES - 1469-493X IL - 1361-6137 DO - https://dx.doi.org/10.1002/14651858.CD009736.pub2 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 26613337 [pubmed] ID - 10.1002/14651858.CD009736.pub2 [doi] PP - epublish GI - Organization: *Chief Scientist Office* Country: United Kingdom Organization: *Medical Research Council* Country: United Kingdom LG - English EP - 20151127 DP - 2015 Nov 27 DC - 20151201 EZ - 2015/11/28 06:00 DA - 2016/03/31 06:00 DT - 2015/11/28 06:00 YR - 2015 ED - 20160330 RD - 20160602 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26613337 <66. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26198675 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Reder M AU - Kolip P FA - Reder, Maren FA - Kolip, Petra IN - Reder, Maren. Bielefeld University, School of Public Health, Department of Prevention and Health Promotion, Universitatsstrase 25, Bielefeld, 33615, Germany. maren.reder@uni-bielefeld.de. IN - Kolip, Petra. Bielefeld University, School of Public Health, Department of Prevention and Health Promotion, Universitatsstrase 25, Bielefeld, 33615, Germany. petra.kolip@uni-bielefeld.de. TI - Does a decision aid improve informed choice in mammography screening? Study protocol for a randomized controlled trial. SO - BMC Women's Health. 15:53, 2015 Jul 22 AS - BMC Womens Health. 15:53, 2015 Jul 22 NJ - BMC women's health PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088690 IO - BMC Womens Health PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4510898 SB - Index Medicus CP - England MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - *Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - Clinical Protocols MH - Decision Support Techniques MH - *Early Detection of Cancer/px [Psychology] MH - Female MH - Germany MH - Humans MH - *Mammography/px [Psychology] MH - Middle Aged MH - *Patient Acceptance of Health Care/px [Psychology] MH - *Patient Participation MH - *Randomized Controlled Trials as Topic/px [Psychology] MH - Research Design AB - BACKGROUND: When invited for the first time at age 50, most women in Germany have to decide whether they wish to participate in the German mammography screening programme. For ethical reasons, screening decisions should be informed choices, but this is rarely the case with mammography screening. Decision aids are interventions with the potential to support informed choice by improving the following factors: knowledge, clarity of personal attitude, and implementation of an intention. Currently, no systematically evaluated decision aid exists for the German mammography screening programme. Therefore, the objective of this randomized controlled trial is to assess the effectiveness of a decision aid for first-time mammography screening programme invitees. AB - METHODS/DESIGN: We have developed a decision aid for women invited to the mammography screening programme for the first time based on the criteria of the International Patient Decision Aids Standards Collaboration. The effectiveness of the decision aid will be evaluated in a randomized controlled trial with a 3-month follow-up. We will invite 7400 women aged 50 years from the district of Westfalen-Lippe, Germany, to participate. This sample will be drawn from registration office data. The primary outcome will be informed choice. The secondary outcomes will be the components of informed choice (knowledge, attitude, decision/implementation). Decisional conflict, decision regret, eHealth literacy, health behaviours, perceived behavioural control, subjective norms, invitation status, and demographic variables will be assessed. Data will be collected online at baseline, post-intervention, and at the 3-month follow-up. Participants will be randomized to receive either the decision aid or usual care (invitation and standard leaflet of the mammography screening programme). AB - DISCUSSION: This paper describes the evaluation of a decision aid for the German mammography screening programme in a randomized controlled trial. If the decision aid proves to be an effective tool to enhance the rate of informed choice, it will be made accessible to the public and the use of this decision aid for first-time invitees will be recommended. The long-term effect could be an improvement in informed choices in women invited to the mammography screening programme. AB - TRIAL REGISTRATION: German Clinical Trials Register DRKS00005176. ES - 1472-6874 IL - 1472-6874 DI - 10.1186/s12905-015-0210-5 DO - https://dx.doi.org/10.1186/s12905-015-0210-5 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26198675 [pubmed] ID - 10.1186/s12905-015-0210-5 [doi] ID - 10.1186/s12905-015-0210-5 [pii] ID - PMC4510898 [pmc] PP - epublish PH - 2014/08/04 [received] PH - 2015/07/01 [accepted] SI - DRKS SA - DRKS/DRKS00005176 LG - English EP - 20150722 DP - 2015 Jul 22 DC - 20150722 EZ - 2015/07/23 06:00 DA - 2016/03/22 06:00 DT - 2015/07/23 06:00 YR - 2015 ED - 20160321 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26198675 <67. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26062750 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lester-Coll NH AU - Lee JM AU - Gogineni K AU - Hwang WT AU - Schwartz JS AU - Prosnitz RG FA - Lester-Coll, Nataniel H FA - Lee, Janie M FA - Gogineni, Keerthi FA - Hwang, Wei-Ting FA - Schwartz, J Sanford FA - Prosnitz, Robert G IN - Lester-Coll, Nataniel H. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, 06510, USA, nataniel.lester-coll@yale.edu. TI - Benefits and risks of contralateral prophylactic mastectomy in women undergoing treatment for sporadic unilateral breast cancer: a decision analysis. SO - Breast Cancer Research & Treatment. 152(1):217-26, 2015 Jul AS - Breast Cancer Res Treat. 152(1):217-26, 2015 Jul NJ - Breast cancer research and treatment PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. SB - Index Medicus CP - Netherlands MH - British Columbia/ep [Epidemiology] MH - Clinical Decision-Making MH - Decision Support Techniques MH - Female MH - Humans MH - Incidence MH - Life Expectancy MH - Markov Chains MH - Mastectomy/mt [Methods] MH - *Mastectomy MH - Neoplasm Metastasis MH - Prognosis MH - Quality-Adjusted Life Years MH - *Risk Assessment MH - Sensitivity and Specificity MH - Unilateral Breast Neoplasms/ep [Epidemiology] MH - *Unilateral Breast Neoplasms/pc [Prevention & Control] MH - *Unilateral Breast Neoplasms/su [Surgery] AB - The rate of contralateral prophylactic mastectomy (CPM) is rising rapidly, despite limited evidence about the procedure's relative benefits and harms. The objective of this study is to examine the impact of CPM on life expectancy (LE) and quality-adjusted life expectancy (QALE) in women with sporadic unilateral breast cancer. A Markov model was developed to compare 18 hypothetical cohorts of 45-year-old women with newly diagnosed unilateral, sporadic breast cancer treated with or without CPM. The probability of developing distant metastases by American Joint Committee on Cancer stage and molecular subtype was derived from British Columbia Cancer Agency data. Additional model parameters were identified from the medical literature. Sensitivity analyses were performed to examine the impact of plausible variations in key model parameters on results. CPM improved LE in all cohorts (range 0.06-0.54 years). Stage had more effect on LE than subtype (stage I mean, 0.44 years, stage III mean, 0.11 years). However, after adjusting for quality-of-life, No CPM was favored in all cohorts. Univariate sensitivity analysis demonstrated that the most influential model parameter was the post-CPM health state utility. The preferred strategy shifted from No CPM to CPM when the post-CPM utility exceeded 0.83 (base case value 0.81). PSA indicated that LE gains and QALE decreases were stable in all cohorts. The primary determinant of survival after unilateral breast cancer is stage at diagnosis. Our results suggest that routine CPM would not improve quality-adjusted survival for the majority of women with unilateral sporadic breast cancer. ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-015-3462-8 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 26062750 [pubmed] ID - 10.1007/s10549-015-3462-8 [doi] PP - ppublish PH - 2015/05/21 [received] PH - 2015/06/05 [accepted] GI - No: K07CA128816 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20150611 DP - 2015 Jul DC - 20150616 EZ - 2015/06/12 06:00 DA - 2016/03/05 06:00 DT - 2015/06/13 06:00 YR - 2015 ED - 20160304 RD - 20150616 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26062750 <68. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25987488 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rezai M AU - Kellersmann S AU - Knispel S AU - Lax H AU - Kimmig R AU - Kern P FA - Rezai, M FA - Kellersmann, S FA - Knispel, S FA - Lax, H FA - Kimmig, R FA - Kern, P IN - Rezai, M. Breast Center Dusseldorf Luisenkrankenhaus, Director: Dr.Mahdi Rezai, Hans-Gunther-Sohl-Str.6-10, 40235 Dusseldorf, Germany. IN - Kellersmann, S. Breast Center Dusseldorf Luisenkrankenhaus, Director: Dr.Mahdi Rezai, Hans-Gunther-Sohl-Str.6-10, 40235 Dusseldorf, Germany; University Hospital of Essen, Department of Gynecology and Obstetrics, West German Cancer Center, Hufelandstr.55, D-45147 Essen, Germany. IN - Knispel, S. Breast Center Dusseldorf Luisenkrankenhaus, Director: Dr.Mahdi Rezai, Hans-Gunther-Sohl-Str.6-10, 40235 Dusseldorf, Germany; University Hospital of Essen, Department of Gynecology and Obstetrics, West German Cancer Center, Hufelandstr.55, D-45147 Essen, Germany. IN - Lax, H. Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), Zweigertstr. 37, D-45130 Essen, Germany. IN - Kimmig, R. University Hospital of Essen, Department of Gynecology and Obstetrics, West German Cancer Center, Hufelandstr.55, D-45147 Essen, Germany. IN - Kern, P. Breast Center Dusseldorf Luisenkrankenhaus, Director: Dr.Mahdi Rezai, Hans-Gunther-Sohl-Str.6-10, 40235 Dusseldorf, Germany; University Hospital of Essen, Department of Gynecology and Obstetrics, West German Cancer Center, Hufelandstr.55, D-45147 Essen, Germany. TI - Translating the concept of intrinsic subtypes into an oncoplastic cohort of more than 1000 patients - predictors of recurrence and survival. SO - Breast. 24(4):384-90, 2015 Aug AS - BREAST. 24(4):384-90, 2015 Aug NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - Axilla MH - Breast Neoplasms/ch [Chemistry] MH - *Breast Neoplasms/cl [Classification] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Cohort Studies MH - Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Humans MH - *Lymph Node Excision/mo [Mortality] MH - Lymph Nodes/pa [Pathology] MH - *Lymph Nodes/su [Surgery] MH - *Mammaplasty/mo [Mortality] MH - Middle Aged MH - *Neoplasm Recurrence, Local/ep [Epidemiology] MH - Receptor, ErbB-2 MH - Registries MH - Surveys and Questionnaires KW - Breast cancer; Intrinsic subtype; Margins; Recurrence; Survival AB - INTRODUCTION: A paradigm shift in breast cancer was introduced by Sorlie's concept of intrinsic subtypes [1]. We validated this concept - which was originally based on 84 individuals - in a large cohort study of 1035 patients with oncoplastic surgery and analyzed if early and late recurrences are linked to a specific intrinsic tumor subtype or resection margins. AB - MATERIALS AND METHODS: 1035 patients with oncoplastic surgery (2004-2009) were analyzed with regard to treatment characteristics and patterns of early (<5 years) and late recurrence (>5 years) and survival related to the intrinsic subtypes. Data was retrieved from patient's charts, customized patients questionnaires and cancer registries. AB - RESULTS: 944 patients with primary, unilateral breast cancer, median age 58 years, were eligible for analysis. At a median FU of 5.2 years, LRR was 4.0%, 5-year-OS 94.5% and DFS 90.9%. Intrinsic subtypes, but not T-size, nodal-status, resections margins nor histopathology, governed local control and survival. There was no signal for prevelance of unclear margins in any of intrinsic subgroups and no preference of any oncoplastic technique attributed to them. TNBC and Her2 non-luminal breast cancer had highest recurrence and lowest survival rates. Although sentinel involvement (SLN+) was prevailing in the Luminal-B-Her 2 negative subtype at 34.3%, this did not translate into a higher axillary dissection rate. AB - CONCLUSION: This study confirmed the intrinsic subtype concept on a large clinical basis and describes the patterns of early and late recurrence in oncoplastic surgery, concluding that bigger risk may not be overcome by bigger surgery. AB - Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved. RN - EC 2-7-10-1 (ERBB2 protein, human) RN - EC 2-7-10-1 (Receptor, ErbB-2) ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(15)00056-9 DO - https://dx.doi.org/10.1016/j.breast.2015.02.030 PT - Journal Article ID - 25987488 [pubmed] ID - S0960-9776(15)00056-9 [pii] ID - 10.1016/j.breast.2015.02.030 [doi] PP - ppublish PH - 2014/06/30 [received] PH - 2015/02/01 [revised] PH - 2015/02/22 [accepted] LG - English EP - 20150516 DP - 2015 Aug DC - 20150613 EZ - 2015/05/20 06:00 DA - 2016/03/05 06:00 DT - 2015/05/20 06:00 YR - 2015 ED - 20160304 RD - 20150613 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25987488 <69. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26941952 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Speck RM AU - Neuman MD AU - Resnick KS AU - Mellers BA AU - Fleisher LA FA - Speck, Rebecca M FA - Neuman, Mark D FA - Resnick, Kimberly S FA - Mellers, Barbara A FA - Fleisher, Lee A IN - Speck, Rebecca M. Department of Anesthesiology and Critical Care, Center for Pharmacoepidemiology Research and Training, University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104 USA ; Evidera, 1417 4th Ave., Suite 510, Seattle, WA 98101 USA. IN - Neuman, Mark D. Department of Anesthesiology and Critical Care, Leonard Davis Institute, University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104 USA. IN - Resnick, Kimberly S. Department of Psychiatry, University of Pennsylvania, 3535 Market St, Philadelphia, PA 19104 USA. IN - Mellers, Barbara A. Department of Psychology, Department of Marketing, University of Pennsylvania, 3720 Walnut St, Philadelphia, PA 19104 USA. IN - Fleisher, Lee A. Department of Anesthesiology and Critical Care, Center for Pharmacoepidemiology Research and Training, Leonard Davis Institute, University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104 USA. TI - Anticipated regret in shared decision-making: a randomized experimental study. SO - Perioperative Medicine. 5:5, 2016 AS - Perioper Med (Lond). 5:5, 2016 NJ - Perioperative medicine (London, England) PI - Journal available in: Electronic-eCollection PI - Citation processed from: Print JC - 101609072 IO - Perioper Med (Lond) PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776353 CP - England KW - Anticipated regret; Breast cancer; Decision-making; Surgery AB - BACKGROUND: Explicit consideration of anticipated regret is not part of the standard shared decision-making protocols. This pilot study aimed to compare decisions about a hypothetical surgery for breast cancer and examined whether regret is a consideration in treatment decisions. AB - METHODS: In this randomized experimental study, 184 healthy female volunteers were randomized to receive a standard decision aid (control) or one with information on post-surgical regret (experimental). The main outcome measures were the proportion of subjects choosing lumpectomy vs. mastectomy and the proportion reporting that regret played a role in the decision made. We hypothesized that a greater proportion of the experimental group (regret-incorporated decision aid) would make a surgical treatment preference that favored the less regret-inducing option and that they would be more likely to consider regret in their decision-making process as compared to the control group. AB - RESULTS: A significantly greater proportion of the experimental group subjects reported regret played a role in their decision-making process compared to the control counterparts (78 vs. 65 %; p=0.039). Recipients of the regret-incorporated experimental decision aid had a threefold increased odds of choosing the less regret-inducing surgery (OR=2.97; 95 % CI=1.25, 7.09; p value=0.014). AB - CONCLUSIONS: In this hypothetical context, the incorporation of regret in a decision aid for preference-sensitive surgery impacted decision-making. This finding suggests that keying in on anticipated regret may be an important element of shared decision-making strategies. Our results make a strong argument for applying this design and pursuing further research in a surgical patient population. AB - TRIAL REGISTRATION: Clinicaltrials.gov, NCT02563808. IL - 2047-0525 DI - 31 DO - https://dx.doi.org/10.1186/s13741-016-0031-6 PT - Journal Article ID - 26941952 [pubmed] ID - 10.1186/s13741-016-0031-6 [doi] ID - 31 [pii] ID - PMC4776353 [pmc] PP - epublish PH - 2015/09/30 [received] PH - 2016/02/17 [accepted] SI - ClinicalTrials.gov SA - ClinicalTrials.gov/NCT02563808 SL - https://clinicaltrials.gov/search/term=NCT02563808 LG - English EP - 20160302 DP - 2016 DC - 20160304 EZ - 2016/03/05 06:00 DA - 2016/03/05 06:01 DT - 2016/03/05 06:00 YR - 2016 ED - 20160304 RD - 20170221 UP - 20170222 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26941952 <70. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26417898 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bruce JG AU - Tucholka JL AU - Steffens NM AU - Neuman HB FA - Bruce, Jordan G FA - Tucholka, Jennifer L FA - Steffens, Nicole M FA - Neuman, Heather B IN - Bruce, Jordan G. School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin. IN - Tucholka, Jennifer L. Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Wisconsin Surgical Outcomes Research Program, Madison, Wisconsin. IN - Steffens, Nicole M. Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Wisconsin Surgical Outcomes Research Program, Madison, Wisconsin. IN - Neuman, Heather B. School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin. IN - Neuman, Heather B. Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Wisconsin Surgical Outcomes Research Program, Madison, Wisconsin. IN - Neuman, Heather B. Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin. TI - Quality of online information to support patient decision-making in breast cancer surgery. SO - Journal of Surgical Oncology. 112(6):575-80, 2015 Nov AS - J Surg Oncol. 112(6):575-80, 2015 Nov NJ - Journal of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - k79, 0222643 IO - J Surg Oncol PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675620 OI - Source: NLM. NIHMS742391 SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - *Health Services Needs and Demand MH - Humans MH - *Information Dissemination/mt [Methods] MH - *Internet/st [Standards] MH - Mastectomy MH - *Medical Informatics/mt [Methods] MH - *Medical Informatics/st [Standards] MH - Patient Education as Topic MH - Quality Control KW - breast cancer; decision-making; information; internet AB - BACKGROUND: Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. AB - METHODS: Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." AB - RESULTS: 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." AB - CONCLUSION: Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. AB - Copyright © 2015 Wiley Periodicals, Inc. ES - 1096-9098 IL - 0022-4790 DO - https://dx.doi.org/10.1002/jso.24046 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 26417898 [pubmed] ID - 10.1002/jso.24046 [doi] ID - PMC4675620 [pmc] ID - NIHMS742391 [mid] PP - ppublish PH - 2015/06/30 [received] PH - 2015/09/03 [accepted] GI - No: K12 HD055894 Organization: (HD) *NICHD NIH HHS* Country: United States No: L30 CA179525 Organization: (CA) *NCI NIH HHS* Country: United States No: UL1 TR000427 Organization: (TR) *NCATS NIH HHS* Country: United States LG - English EP - 20150929 DP - 2015 Nov DC - 20151027 EZ - 2015/09/30 06:00 DA - 2016/02/18 06:00 DT - 2015/09/30 06:00 YR - 2015 ED - 20160216 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26417898 <71. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25900451 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chen Q FA - Chen, Qiqing IN - Chen, Qiqing. Plastic Surgery Department, Nanfang Hospital, Southern Medical University, No. 1838, Northern Guangzhou Avenue, Guangzhou, 510515, China, ch7q@smu.edu.cn. TI - Comment on Chinese Women's Preferences and Concerns Regarding Incision Location for Breast Augmentation Surgery: A Survey of 216 Patients. CM - Comment in: Aesthetic Plast Surg. 2016 Feb;40(1):184-5; PMID: 26715574 CM - Comment on: Aesthetic Plast Surg. 2015 Apr;39(2):214-26; PMID: 25701388 SO - Aesthetic Plastic Surgery. 39(3):452-3, 2015 Jun AS - Aesthetic Plast Surg. 39(3):452-3, 2015 Jun NJ - Aesthetic plastic surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 2wn, 7701756 IO - Aesthetic Plast Surg SB - Index Medicus CP - United States MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] AB - UNLABELLED: The recent article by Sun et al. regarding a preoperative instrument to aid patients' decision-making on different incision sites in breast augmentation was reviewed. Some key indicators are missing in the instrument. AB - LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . ES - 1432-5241 IL - 0364-216X DO - https://dx.doi.org/10.1007/s00266-015-0488-6 PT - Comment PT - Letter ID - 25900451 [pubmed] ID - 10.1007/s00266-015-0488-6 [doi] PP - ppublish PH - 2015/02/26 [received] PH - 2015/04/08 [accepted] LG - English EP - 20150422 DP - 2015 Jun DC - 20150518 EZ - 2015/04/23 06:00 DA - 2016/02/06 06:00 DT - 2015/04/23 06:00 YR - 2015 ED - 20160205 RD - 20160610 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25900451 <72. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25701388 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sun J AU - Liu C AU - Mu D AU - Wang K AU - Zhu S AU - He Y AU - Luan J FA - Sun, Jingjing FA - Liu, Chunjun FA - Mu, Dali FA - Wang, Keming FA - Zhu, Sainan FA - He, Yi FA - Luan, Jie IN - Sun, Jingjing. Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, 100144, China. TI - Chinese women's preferences and concerns regarding incision location for breast augmentation surgery: a survey of 216 patients. CM - Comment in: Aesthetic Plast Surg. 2015 Jun;39(3):452-3; PMID: 25900451 CM - Comment in: Aesthetic Plast Surg. 2016 Feb;40(1):184-5; PMID: 26715574 SO - Aesthetic Plastic Surgery. 39(2):214-26, 2015 Apr AS - Aesthetic Plast Surg. 39(2):214-26, 2015 Apr NJ - Aesthetic plastic surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 2wn, 7701756 IO - Aesthetic Plast Surg SB - Index Medicus CP - United States MH - Adult MH - Attitude to Health MH - China MH - Cicatrix/pc [Prevention & Control] MH - Female MH - Humans MH - Logistic Models MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - Patient Education as Topic MH - Patient Satisfaction MH - Young Adult AB - BACKGROUND: The axillary approach is the dominant incision used in China for breast augmentation. Systematic preoperative education regarding incision locations for breast augmentation is scarce in China. In this study, we surveyed Chinese patients to ascertain their preferences and concerns for incision location based on a comprehensive understanding of different incisions. AB - METHODS: We used a literature review, patient interviews, and expert panels to develop the preoperative education material and questionnaire regarding different incision locations. The respondents were requested to choose one incision location before and after they received the preoperative education. Their initial choices and final decisions as well as the reasons for these choices were recorded and analyzed. Multinomial logistic regression was preformed to analyze the affecting factors on the incision choice. AB - RESULTS: A total of 216 Chinese women participated in the study between 2012.5 and 2014.1. Initially, 176 (81.48%) women chose axillary incision, 27 (12.50%) chose periareolar incision, and 13 (6.02%) chose inframammary fold (IMF) incision. After they received preoperative education on incisions, the axillary and periareolar approaches decreased to 117 (54.17%) and 13 (6.02%), respectively, while IMF increased to 86 (39.81%). The easily hidden scar (43.98%), lower capsular contracture rate (23.15%), and lower possibility of injury to the breast parenchyma (17.13%) ranked as the top 3 reasons for the incision choice. Patients with a preoperative cup size of AA were 12.316 times more likely to choose the axillary approach relative to the IMF approach compared with those with a B cup (P = 0.044; 95% confidence interval [CI] 1.069-141.923). For each one-unit increase in BMI, the odds that a patient would choose the axillary versus the periareolar approach decreased by 32.4% (P = 0.049; 95% CI 0.457-0.999). AB - CONCLUSIONS: The systematic and objective preoperative education material and questionnaire regarding different incision locations helped the Chinese patients make truly informed decisions and express their personal requirements. The axillary approach was the first option for more than half of Chinese women mainly because an easily hidden scar was considered the primary concern during the decision-making process. The patients with a low BMI and a small preoperative breast cup size were more likely to choose an axillary incision. However, a considerable number of Chinese women would choose the IMF incision and value its superiority in terms of a lower capsular contracture rate, less tissue trauma, and lower possibility of injury to the breast parenchyma. AB - LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. ES - 1432-5241 IL - 0364-216X DO - https://dx.doi.org/10.1007/s00266-015-0457-0 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 25701388 [pubmed] ID - 10.1007/s00266-015-0457-0 [doi] PP - ppublish PH - 2014/10/25 [received] PH - 2015/01/29 [accepted] LG - English EP - 20150221 DP - 2015 Apr DC - 20150311 EZ - 2015/02/22 06:00 DA - 2016/02/05 06:00 DT - 2015/02/24 06:00 YR - 2015 ED - 20160204 RD - 20160610 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25701388 <73. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26504001 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Janssen S AU - Rades D FA - Janssen, Stefan FA - Rades, Dirk IN - Janssen, Stefan. Private Practice of Radiation Oncology, Hannover, Germany Department of Radiation Oncology, University of Lubeck, Lubeck, Germany s.janssen@strahlentherapie.de. IN - Rades, Dirk. Department of Radiation Oncology, University of Lubeck, Lubeck, Germany. TI - Primary Breast Cancer with Synchronous Metastatic Disease - Indications for Local Radiotherapy to the Breast and Chest Wall. [Review] SO - Anticancer Research. 35(11):5807-12, 2015 Nov AS - Anticancer Res. 35(11):5807-12, 2015 Nov NJ - Anticancer research PI - Journal available in: Print PI - Citation processed from: Internet JC - 59l, 8102988 IO - Anticancer Res. SB - Index Medicus CP - Greece MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Female MH - Humans MH - *Neoplasms, Multiple Primary/rt [Radiotherapy] MH - Neoplasms, Multiple Primary/sc [Secondary] MH - Prognosis MH - Thoracic Wall/pa [Pathology] MH - *Thoracic Wall/re [Radiation Effects] KW - Local radiotherapy; metastatic breast cancer; review AB - AIM: To review literature on local therapy in patients with primary metastatic breast cancer with focus on local radiotherapy (RT). AB - PATIENTS AND METHODS: A Medline search using the key words "metastatic breast cancer", "primary resection/radiotherapy", "local therapy", "local radiotherapy" was carried out. All original studies in the English language were included in the present review. AB - RESULTS: A total of 27 original studies including more than 33,000 patients with metastatic breast cancer were identified, including two large database analyses (n=25,757). All studies were retrospective in nature. Most studies showed a survival benefit with the addition of local therapy in a metastatic situation. The majority of studies focused on the role of surgery. Fourteen studies (52%) mentioned radiotherapy (RT) in 0.3% to 100% of patients. Six of these studies analyzed the effect of RT separately and five found an additional benefit of RT. Two studies showed best outcomes when RT and surgery were combined. AB - CONCLUSION: Most retrospective studies showed a survival benefit for local therapy in patients with breast cancer with distant metastases. The role of RT remains unclear. Some reports showed improved outcome with the combination of surgery and RT. This approach should be considered in patients with good survival prognosis in whom local control is important. There are several prognostic factors to aid decision-making. Results of prospective randomized studies are pending. AB - Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved. ES - 1791-7530 IL - 0250-7005 DI - 35/11/5807 PT - Journal Article PT - Review ID - 26504001 [pubmed] ID - 35/11/5807 [pii] PP - ppublish LG - English DP - 2015 Nov DC - 20151027 EZ - 2015/10/28 06:00 DA - 2016/02/03 06:00 DT - 2015/10/28 06:00 YR - 2015 ED - 20160202 RD - 20151027 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26504001 <74. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25887713 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Klafke N AU - Mahler C AU - von Hagens C AU - Rochon J AU - Schneeweiss A AU - Muller A AU - Salize HJ AU - Joos S FA - Klafke, Nadja FA - Mahler, Cornelia FA - von Hagens, Cornelia FA - Rochon, Justine FA - Schneeweiss, Andreas FA - Muller, Andreas FA - Salize, Hans-Joachim FA - Joos, Stefanie IN - Klafke, Nadja. Department of General Practice and Health Services Research, University Hospital Heidelberg, Vosstr. 2, D-69115, Heidelberg, Germany. nadja.klafke@med.uni-heidelberg.de. IN - Mahler, Cornelia. Department of General Practice and Health Services Research, University Hospital Heidelberg, Vosstr. 2, D-69115, Heidelberg, Germany. cornelia.mahler@med.uni-heidelberg.de. IN - von Hagens, Cornelia. Department of Gynaecological Endocrinology and Reproductive Medicine, University Women's Hospital Heidelberg, Im Neuenheimer Feld 440, D-69120, Heidelberg, Germany. cornelia.von.hagens@med.uni-heidelberg.de. IN - Rochon, Justine. Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, D-69120, Heidelberg, Germany. rochon@imbi.uni-heidelberg.de. IN - Schneeweiss, Andreas. National Center for Tumor Diseases, University Hospital, Im Neuenheimer Feld 460, D-69120, Heidelberg, Germany. andreas.schneeweiss@med.uni-heidelberg.de. IN - Muller, Andreas. Community Hospital Karlsruhe, Moltkestrase 90, D-76133, Karlsruhe, Germany. andreas.mueller.fk@klinikum-karlsruhe.de. IN - Salize, Hans-Joachim. Central Institute of Mental Health, Mental Health Services Research Group, Medical Faculty Mannheim/Heidelberg University, Mannheim, D-68159, Germany. hans-joachim.salize@zi-mannheim.de. IN - Joos, Stefanie. Department of General Practice and Health Services Research, University Hospital Heidelberg, Vosstr. 2, D-69115, Heidelberg, Germany. stefanie.joos@uni-tuebingen.de. IN - Joos, Stefanie. Institute of General Practice, University Hospital Tuebingen, Oesterbergstr. 9, D-72074, Tuebingen, Germany. stefanie.joos@uni-tuebingen.de. TI - A complex nursing intervention of complementary and alternative medicine (CAM) to increase quality of life in patients with breast and gynecologic cancer undergoing chemotherapy: study protocol for a partially randomized patient preference trial. SO - Trials [Electronic Resource]. 16:51, 2015 Feb 15 AS - Trials. 16:51, 2015 Feb 15 NJ - Trials PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101263253 IO - Trials PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337273 SB - Index Medicus CP - England MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Complementary Therapies/nu [Nursing] MH - Data Interpretation, Statistical MH - Female MH - Genital Neoplasms, Female/px [Psychology] MH - *Genital Neoplasms, Female/th [Therapy] MH - Humans MH - Outcome Assessment (Health Care) MH - Quality Assurance, Health Care MH - *Quality of Life MH - Sample Size MH - Social Support AB - BACKGROUND: Health-related quality of life (HRQoL) is most adversely affected in cancer patients between diagnosis and the end of chemotherapy. The aim of the Complementary Nursing in Gynecologic Oncology (CONGO) study is to assess the effectiveness of a complex nursing care intervention of CAM to increase HRQoL in cancer patients undergoing chemotherapy. AB - METHODS/DESIGN: CONGO is a prospective partially randomized patient preference (PRPP) trial including adult women diagnosed with breast and gynecologic cancer starting a new chemotherapy regimen. Patients without strong preferences for CAM will be randomized to usual nursing care or complex nursing care; those patients with strong preferences will be allowed their choice. The intervention consists of three interacting and intertwined elements: CAM nursing intervention packet, counseling on CAM using a resource-oriented approach and evidence-based informational material on CAM. Primary outcome data on participants' HRQoL will be collected from baseline until the end of treatment and long-term follow-up using the EORTC-QLQ-C30. Secondary outcomes include nausea, fatigue, pain, anxiety/depression, social support, self-efficacy, patient competence, spiritual wellbeing, and satisfaction with care. Accompanying research on economic outcomes as well as a mixed-methods process evaluation will be conducted. A total of 590 patients (236 patients in the randomized part of the study and 354 patients in the observational part of the study) will be recruited in the two outpatient clinics. The first analysis step will be the intention-to-treat (ITT) analysis of the randomized part of the trial. A linear mixed model will be used to compare the continuous primary endpoint between the intervention and control arm of the randomized group. The observational part of the trial will be analyzed descriptively. External validity will be assessed by comparing randomized with nonrandomized patients. AB - DISCUSSION: Cancer patients are increasingly using CAM as supportive cancer care, however, a patient-centered model of care that includes CAM for the patient during chemotherapy still needs to be evaluated. This protocol has been designed to test if the effects of the intervention go beyond potential benefits in quality-of-life outcomes. AB - TRIAL REGISTRATION: German Clinical Trials Register (DRKS), DRKS00006056 (15 April 2014). ES - 1745-6215 IL - 1745-6215 DI - 10.1186/s13063-014-0538-4 DO - https://dx.doi.org/10.1186/s13063-014-0538-4 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 25887713 [pubmed] ID - 10.1186/s13063-014-0538-4 [doi] ID - 10.1186/s13063-014-0538-4 [pii] ID - PMC4337273 [pmc] PP - epublish PH - 2014/06/14 [received] PH - 2014/12/19 [accepted] SI - DRKS SA - DRKS/DRKS00006056 LG - English EP - 20150215 DP - 2015 Feb 15 DC - 20150418 EZ - 2015/04/19 06:00 DA - 2016/01/28 06:00 DT - 2015/04/19 06:00 YR - 2015 ED - 20160127 RD - 20150420 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25887713 <75. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25935195 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jueckstock J AU - Kasch F AU - Jaeger B AU - Schramm A AU - Janni W AU - Scholz C FA - Jueckstock, J FA - Kasch, F FA - Jaeger, B FA - Schramm, A FA - Janni, W FA - Scholz, C IN - Jueckstock, J. Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Munich, Campus Innenstadt, Maistr. 11, 80337, Munich, Germany. julia.jueckstock@med.uni-muenchen.de. IN - Kasch, F. Department of Cardiology, Klinikum Hamburg-Harburg, Hamburg, Germany. IN - Jaeger, B. Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany. IN - Schramm, A. Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany. IN - Janni, W. Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany. IN - Scholz, C. Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany. TI - Adjuvant therapeutic decisions in elderly breast cancer patients: the role of chemotherapy in a retrospective analysis. SO - Archives of Gynecology & Obstetrics. 292(5):1101-7, 2015 Nov AS - Arch Gynecol Obstet. 292(5):1101-7, 2015 Nov NJ - Archives of gynecology and obstetrics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 6ys, 8710213 IO - Arch. Gynecol. Obstet. SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/th [Therapy] MH - *Chemotherapy, Adjuvant/mt [Methods] MH - Combined Modality Therapy MH - Female MH - Humans MH - Lymph Nodes/pa [Pathology] MH - *Mastectomy MH - Neoplasm Staging MH - *Radiotherapy, Adjuvant/mt [Methods] MH - Retrospective Studies MH - Survival Rate MH - Treatment Outcome KW - Breast cancer; Elderly patients; Neoplasm metastasis; Neoplasm recurrence; Survival AB - PURPOSE: Decisions on the type of adjuvant treatment in older breast cancer patients are challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty on the basis of studies usually excluding patients over 69 years. To aid this decision, we analyzed a database of 6000 unselected patients and of those evaluated elderly primary breast cancer patients with hormone receptor-negative tumors from 1963 until 2003 in respect of survival data depending on adjuvant treatment. AB - METHODS: A total of 131 elderly (i.e., >65 years) patients were observed retrospectively for a median of 72 months. Patients received breast-conserving therapy or mastectomy and adjuvant radiotherapy, chemotherapy, and endocrine therapy. Data were collected from a hospital-intern database. AB - RESULTS: Median age at diagnosis was 72 years. Mostly, tumors were small (81 % T1, 17 % T2) but of unfavorable grading (40 % G2, 35 % G3). Lymph nodes were positive in 42 %. Mastectomy was performed in 65 %. While 42 % of patients received radiotherapy, only 10 % were treated with chemotherapy. Patients with G2 and G3 tumors (p = 0.027), younger women (p = 0.012), and patients with positive lymph node status (p < 0.0001) more likely received chemotherapy. Recurrence-free survival was longer in patients without chemotherapy (37 vs. 29 months, p = 0.234). Overall survival was non-significantly shorter in patients who received chemotherapy (59 vs. 81 months, p = 0.131). AB - CONCLUSIONS: In this analysis, adjuvant chemotherapy was not associated with improved survival, presumably caused by an a priori poor prognosis of these patients. For an aging society more data are urgently needed to help selecting and personalizing adjuvant treatment within subgroups of breast cancer in older women. ES - 1432-0711 IL - 0932-0067 DI - 10.1007/s00404-015-3728-8 DO - https://dx.doi.org/10.1007/s00404-015-3728-8 PT - Journal Article ID - 25935195 [pubmed] ID - 10.1007/s00404-015-3728-8 [doi] ID - 10.1007/s00404-015-3728-8 [pii] PP - ppublish PH - 2014/11/27 [received] PH - 2015/04/20 [accepted] LG - English EP - 20150503 DP - 2015 Nov DC - 20150930 EZ - 2015/05/04 06:00 DA - 2016/01/26 06:00 DT - 2015/05/04 06:00 YR - 2015 ED - 20160125 RD - 20150930 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25935195 <76. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26374088 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Abe SE AU - Hill JS AU - Han Y AU - Walsh K AU - Symanowski JT AU - Hadzikadic-Gusic L AU - Flippo-Morton T AU - Sarantou T AU - Forster M AU - White RL Jr FA - Abe, Shoko E FA - Hill, Joshua S FA - Han, Yimei FA - Walsh, Kendall FA - Symanowski, James T FA - Hadzikadic-Gusic, Lejla FA - Flippo-Morton, Teresa FA - Sarantou, Terry FA - Forster, Meghan FA - White, Richard L Jr IN - Abe, Shoko E. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Hill, Joshua S. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Han, Yimei. Department of Cancer Biostatistics, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Walsh, Kendall. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Symanowski, James T. Department of Cancer Biostatistics, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Hadzikadic-Gusic, Lejla. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Flippo-Morton, Teresa. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Sarantou, Terry. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - Forster, Meghan. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. IN - White, Richard L Jr. Division of Surgical Oncology, Department of Surgery, Levine Cancer Institute, Carolinas Medical Center, Carolinas Healthcare System, Charlotte, North Carolina. TI - Margin re-excision and local recurrence in invasive breast cancer: A cost analysis using a decision tree model. SO - Journal of Surgical Oncology. 112(4):443-8, 2015 Sep AS - J Surg Oncol. 112(4):443-8, 2015 Sep NJ - Journal of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - k79, 0222643 IO - J Surg Oncol SB - Index Medicus CP - United States MH - *Breast Neoplasms/ec [Economics] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Carcinoma, Ductal, Breast/ec [Economics] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - *Cost-Benefit Analysis MH - *Decision Trees MH - Female MH - Follow-Up Studies MH - Humans MH - *Mastectomy, Segmental/ec [Economics] MH - Neoplasm Invasiveness MH - *Neoplasm Recurrence, Local/ec [Economics] MH - Neoplasm Recurrence, Local/pa [Pathology] MH - Neoplasm Recurrence, Local/su [Surgery] MH - Neoplasm Staging MH - Neoplasm, Residual/ec [Economics] MH - Neoplasm, Residual/pa [Pathology] MH - Neoplasm, Residual/su [Surgery] MH - Prognosis MH - *Reoperation/ec [Economics] KW - breast cancer; breast conservation surgery; cost analysis; decision tree AB - BACKGROUND: SSO-ASTRO recently published guidelines defining adequate margins in breast conservation therapy (BCT) as no tumor on ink based on studies demonstrating little difference in local recurrence (LR) with wider margins. We hypothesize that not routinely re-excising close margins results in decreased costs without compromising care. AB - METHODS: A decision tree model was developed for the management of margins after BCT for invasive cancer. Patients were compared among three margin status groups: positive, close (<=2mm) and negative (>2mm). Ten publications provided re-excision rates (RER) and LR rates. The model assumed 140,000 BCT/year. Sensitivity analyses determined the most cost-effective strategy. Surgical costs were estimated using 2013 Medicare reimbursement rates. AB - RESULTS: Re-excising close margins was significantly more costly than the alternative, $233.1 million versus $214.3 million, per year in the United States. Total surgical cost was most sensitive to re-excision of close margins-increasing the RER from 0% to 100% resulted in an $18.8 million cost difference. AB - CONCLUSIONS: The strategy of re-excising close margins resulted in a predicted cost of $18.8 million per year. This does not include hospital costs, the cost of surgical complications after re-excision, and underestimates the potential savings by using Medicare reimbursement rates. AB - Copyright © 2015 Wiley Periodicals, Inc. ES - 1096-9098 IL - 0022-4790 DO - https://dx.doi.org/10.1002/jso.23990 PT - Journal Article ID - 26374088 [pubmed] ID - 10.1002/jso.23990 [doi] PP - ppublish PH - 2015/01/28 [received] PH - 2015/07/13 [accepted] LG - English EP - 20150916 DP - 2015 Sep DC - 20150925 EZ - 2015/09/17 06:00 DA - 2016/01/06 06:00 DT - 2015/09/17 06:00 YR - 2015 ED - 20160105 RD - 20150925 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26374088 <77. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24401804 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Natoli NB AU - Wu LC FA - Natoli, Noel Blythe FA - Wu, Liza C IN - Natoli, Noel Blythe. From the Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA. TI - Vascular variations of the transverse upper gracilis flap in consideration for breast reconstruction. SO - Annals of Plastic Surgery. 74(5):528-31, 2015 May AS - Ann Plast Surg. 74(5):528-31, 2015 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Adult MH - Algorithms MH - Decision Support Techniques MH - Female MH - *Femoral Artery/ab [Abnormalities] MH - Femoral Artery/su [Surgery] MH - Humans MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - *Myocutaneous Flap/bs [Blood Supply] MH - Retrospective Studies MH - *Thigh/bs [Blood Supply] AB - PURPOSE: The transverse upper gracilis (TUG) myocutaneous flap has served as an alternative to abdominally based autologous breast reconstruction since its introduction by Yousif et al in 1992. The reliability of the overlying skin paddle of the gracilis myocutaneous flap depends on the perforator anatomy as well as the vascular pedicle. Although much attention recently has been given to variations in the septocutaneous as well as myocutaneous perforators, we believe that relevant variations in pedicle anatomy have been underappreciated. We would like to report our experience with pedicle variability. AB - METHODS: A retrospective review of records was performed on patients undergoing a TUG flap for autologous breast reconstruction from July 2006 and November 2011 by a single surgeon (L.C.W.). AB - RESULTS: A total of 36 TUG flaps were performed on 24 patients. Twelve patients underwent bilateral simultaneous TUG reconstruction, and 12 patients underwent unilateral TUG reconstruction. Pedicle variability was found in 6 (17%) of 36 dissections. In 5.5% of dissections, there was a split pedicle and 11% were found to have a double main pedicle. There was 1 partial flap loss that resulted in a failed breast reconstruction. Four limbs had some degree of resultant lymphedema as a consequence of flap harvest. AB - CONCLUSIONS: Although still a viable alternative to abdominally based autologous reconstruction, we find that the variability of the main pedicle has been quite underestimated in earlier reports. We also present a logical algorithm for flap dissection when the microsurgeon encounters such aberrancies. ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/01.sap.0000435501.19566.75 PT - Case Reports PT - Journal Article ID - 24401804 [pubmed] ID - 10.1097/01.sap.0000435501.19566.75 [doi] PP - ppublish LG - English DP - 2015 May DC - 20150416 EZ - 2014/01/10 06:00 DA - 2016/01/05 06:00 DT - 2014/01/10 06:00 YR - 2015 ED - 20160104 RD - 20150416 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24401804 <78. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25829374 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Savelberg W AU - Moser A AU - Smidt M AU - Boersma L AU - Haekens C AU - van der Weijden T FA - Savelberg, Wilma FA - Moser, Albine FA - Smidt, Marjolein FA - Boersma, Liesbeth FA - Haekens, Christel FA - van der Weijden, Trudy IN - Savelberg, Wilma. Oncology Center, Maastricht University Medical Center, Maastricht, The Netherlands. IN - Moser, Albine. Zuyd University of Applied Sciences, Heerlen, The Netherlands. IN - Smidt, Marjolein. Oncology Center, Maastricht University Medical Center, Maastricht, The Netherlands. IN - Boersma, Liesbeth. Department of Radiotherapy, Maastricht University Medical Center, Maastricht, The Netherlands. IN - Haekens, Christel. Oncology Center, Maastricht University Medical Center, Maastricht, The Netherlands. IN - van der Weijden, Trudy. Department of Family Medicine, Maastricht University, Maastricht, The Netherlands School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands. TI - Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer. SO - BMJ Open. 5(3):e007698, 2015 Mar 31 AS - BMJ Open. 5(3):e007698, 2015 Mar 31 NJ - BMJ open PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101552874 IO - BMJ Open PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386223 SB - Index Medicus CP - England MH - Attitude of Health Personnel MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Clinical Protocols MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Mastectomy, Segmental MH - Neoplasm Staging MH - Outcome Assessment (Health Care) MH - *Patient Participation MH - Patient Preference MH - Qualitative Research MH - Research Design KW - Decision support Techniques; Patient participation; Patient preferences; Quality improvement; Shared decision making AB - BACKGROUND: The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients' informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to beta test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. AB - METHODS/DESIGN: This paper concerns a pre-implementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid. AB - ETHICS AND DISSEMINATION: This protocol was approved by the Maastricht University Medical Centre (MUMC) ethics committee. The findings will be disseminated through peer-reviewed journal articles and presentations at national conferences. Findings will be used to finalise a multi-faceted implementation strategy to test the implementation of SDM and a patient decision aid in terms of cost-effectiveness, in a multicentre cluster randomised controlled trial (RCT). AB - STUDY REGISTRATION NUMBER: NTR4879. AB - Copyright Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. ES - 2044-6055 IL - 2044-6055 DI - bmjopen-2015-007698 DO - https://dx.doi.org/10.1136/bmjopen-2015-007698 PT - Journal Article PT - Multicenter Study ID - 25829374 [pubmed] ID - bmjopen-2015-007698 [pii] ID - 10.1136/bmjopen-2015-007698 [doi] ID - PMC4386223 [pmc] PP - epublish SI - NTR SA - NTR/NTR4879 LG - English EP - 20150331 DP - 2015 Mar 31 DC - 20150401 EZ - 2015/04/02 06:00 DA - 2015/12/22 06:00 DT - 2015/04/02 06:00 YR - 2015 ED - 20151221 RD - 20160603 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25829374 <79. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25805427 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Michishita S AU - Kim SJ AU - Shimazu K AU - Sota Y AU - Naoi Y AU - Maruyama N AU - Kagara N AU - Shimoda M AU - Shimomura A AU - Noguchi S FA - Michishita, Shintaro FA - Kim, Seung Jin FA - Shimazu, Kenzo FA - Sota, Yoshiaki FA - Naoi, Yasuto FA - Maruyama, Naomi FA - Kagara, Naofumi FA - Shimoda, Masafumi FA - Shimomura, Atsushi FA - Noguchi, Shinzaburo IN - Michishita, Shintaro. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Kim, Seung Jin. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. Electronic address: kimsj@onsurg.med.osaka-u.ac.jp. IN - Shimazu, Kenzo. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Sota, Yoshiaki. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Naoi, Yasuto. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Maruyama, Naomi. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Kagara, Naofumi. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Shimoda, Masafumi. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Shimomura, Atsushi. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. IN - Noguchi, Shinzaburo. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. TI - Prediction of pathological complete response to neoadjuvant chemotherapy by magnetic resonance imaging in breast cancer patients. SO - Breast. 24(2):159-65, 2015 Apr AS - BREAST. 24(2):159-65, 2015 Apr NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - *Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/pa [Pathology] MH - *Carcinoma, Ductal, Breast/dt [Drug Therapy] MH - Carcinoma, Ductal, Breast/me [Metabolism] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Lobular/dt [Drug Therapy] MH - Carcinoma, Lobular/me [Metabolism] MH - Carcinoma, Lobular/pa [Pathology] MH - Cohort Studies MH - Cyclophosphamide/ad [Administration & Dosage] MH - Decision Support Techniques MH - Epirubicin/ad [Administration & Dosage] MH - Estrogen Receptor alpha/me [Metabolism] MH - Female MH - Fluorouracil/ad [Administration & Dosage] MH - Humans MH - Magnetic Resonance Imaging MH - *Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Neoadjuvant Therapy MH - Neoplasm Grading MH - Neoplasm Staging MH - Paclitaxel/ad [Administration & Dosage] MH - Prognosis MH - Receptor, ErbB-2/me [Metabolism] MH - Receptors, Progesterone/me [Metabolism] MH - Retrospective Studies MH - Treatment Outcome MH - Tumor Burden MH - Young Adult KW - Intrinsic subtype; MRI morphology; Neoadjuvant chemotherapy; Predictor; pCR AB - The purpose of this study was to evaluate whether the baseline breast MRI findings would be useful for the prediction for pathological complete response (pCR) by breast cancer patients to neoadjuvant chemotherapy. Primary breast cancer patients (stage II-III) preoperatively treated with sequential paclitaxel (12 cycles) and fluorouracil, epirubicin, and cyclophosphamide (4 cycles), followed by surgery were retrospectively enrolled, and 229 patients were eligible. Before chemotherapy, breast MRI studies were performed. Breast tumors were dichotomized into round + oval and irregular types based on MRI morphology. The round + oval tumors showed a significantly higher pCR rate than the irregular tumors (42.0% vs 17.3%; P < 0.001). In addition, PAM50 analysis revealed that basal and HER2-enriched tumors were significantly more prevalent among round + oval than irregular type tumors (P = 0.015). Baseline MRI morphology appears to be a significant predictor for pCR. The higher rate of the basal and HER2-enriched tumors among the round + oval tumors may explain their better chemo-sensitivity. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. RN - 0 (Estrogen Receptor alpha) RN - 0 (Receptors, Progesterone) RN - 0 (estrogen receptor alpha, human) RN - 3Z8479ZZ5X (Epirubicin) RN - 8N3DW7272P (Cyclophosphamide) RN - EC 2-7-10-1 (ERBB2 protein, human) RN - EC 2-7-10-1 (Receptor, ErbB-2) RN - P88XT4IS4D (Paclitaxel) RN - U3P01618RT (Fluorouracil) ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(15)00002-8 DO - https://dx.doi.org/10.1016/j.breast.2015.01.001 PT - Clinical Study PT - Journal Article ID - 25805427 [pubmed] ID - S0960-9776(15)00002-8 [pii] ID - 10.1016/j.breast.2015.01.001 [doi] PP - ppublish PH - 2014/09/06 [received] PH - 2014/12/14 [revised] PH - 2015/01/01 [accepted] LG - English DP - 2015 Apr DC - 20150325 EZ - 2015/03/26 06:00 DA - 2015/12/17 06:00 DT - 2015/03/26 06:00 YR - 2015 ED - 20151215 RD - 20150325 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25805427 <80. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25603922 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Somogyi RB AU - Webb A AU - Baghdikian N AU - Stephenson J AU - Edward KL AU - Morrison W FA - Somogyi, Ron Barry FA - Webb, Angela FA - Baghdikian, Nairy FA - Stephenson, John FA - Edward, Karen-Leigh FA - Morrison, Wayne IN - Somogyi, Ron Barry. Division of Plastic & Reconstructive Surgery, Peter MacCallum Cancer Centre, 7 St Andrews Place, East Melbourne, VIC 3002, Australia; Department of Plastic & Reconstructive Surgery, St. Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC 3065, Australia. Electronic address: ron.somogyi@gmail.com. IN - Webb, Angela. Division of Plastic & Reconstructive Surgery, Peter MacCallum Cancer Centre, 7 St Andrews Place, East Melbourne, VIC 3002, Australia; Department of Plastic & Reconstructive Surgery, St. Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC 3065, Australia. IN - Baghdikian, Nairy. Cogentum Inc., Level 9, 45 William St, P.O. Box 50, Darling South, VIC 3145, Australia. IN - Stephenson, John. Department of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, United Kingdom. IN - Edward, Karen-Leigh. Australian Catholic University and St Vincent's Private Hospital, Melbourne Nursing Research Unit, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, MDC, Fitzroy, VIC 3065, Australia. IN - Morrison, Wayne. The O'Brien Institute of Microsurgery, 42 Fitzroy St, Fitzroy, VIC 3065, Australia; Department of Plastic & Reconstructive Surgery, St. Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC 3065, Australia. TI - Understanding the factors that influence breast reconstruction decision making in Australian women. SO - Breast. 24(2):124-30, 2015 Apr AS - BREAST. 24(2):124-30, 2015 Apr NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Age Factors MH - Attitude to Health MH - Australia MH - Body Image MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Employment MH - Female MH - Health Care Costs MH - Health Services Accessibility MH - Hospitals, Private MH - Humans MH - Likelihood Functions MH - Logistic Models MH - *Mammaplasty MH - *Mastectomy MH - Middle Aged MH - Qualitative Research KW - Barriers; Breast reconstruction; Decision making; Mastectomy AB - BACKGROUND: Breast reconstruction is safe and improves quality of life. Despite this, many women do not undergo breast reconstruction and the reasons for this are poorly understood. This study aims to identify the factors that influence a woman's decision whether or not to have breast reconstruction and to better understand their attitudes toward reconstruction. AB - METHODOLOGY: An online survey was distributed to breast cancer patients from Breast Cancer Network Australia. Results were tabulated, described qualitatively and analyzed for significance using a multiple logistic regression model. AB - RESULTS: 501 mastectomy patients completed surveys, of which 62% had undergone breast reconstruction. Factors that positively influenced likelihood of reconstruction included lower age, bilateral mastectomy, access to private hospitals, decreased home/work responsibilities, increased level of home support and early discussion of reconstructive options. Most common reasons for avoiding reconstruction included "I don't feel the need" and "I don't want more surgery". The most commonly sited sources of reconstruction information came from the breast surgeon followed by the plastic surgeon then the breast cancer nurse and the most influential of these was the plastic surgeon. AB - CONCLUSIONS: A model using factors easily obtained on clinical history can be used to understand likelihood of reconstruction. This knowledge may help identify barriers to reconstruction, ultimately improving the clinicians' ability to appropriately educate mastectomy patients and ensure effective decision making around breast reconstruction. AB - Copyright © 2014 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(14)00218-5 DO - https://dx.doi.org/10.1016/j.breast.2014.11.013 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 25603922 [pubmed] ID - S0960-9776(14)00218-5 [pii] ID - 10.1016/j.breast.2014.11.013 [doi] PP - ppublish PH - 2014/05/31 [received] PH - 2014/09/11 [revised] PH - 2014/11/22 [accepted] LG - English EP - 20150117 DP - 2015 Apr DC - 20150325 EZ - 2015/01/22 06:00 DA - 2015/12/17 06:00 DT - 2015/01/22 06:00 YR - 2015 ED - 20151215 RD - 20150325 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25603922 <81. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25600630 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Silverstein MJ AU - Lagios MD FA - Silverstein, Melvin J FA - Lagios, Michael D IN - Silverstein, Melvin J. Breast Service, Hoag Memorial Hospital Presbyterian, Newport Beach, California; Keck School of Medicine, University of Southern California, Los Angeles, California. TI - Treatment selection for patients with ductal carcinoma in situ (DCIS) of the breast using the University of Southern California/Van Nuys (USC/VNPI) prognostic index. SO - Breast Journal. 21(2):127-32, 2015 Mar-Apr AS - Breast J. 21(2):127-32, 2015 Mar-Apr NJ - The breast journal PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - d1h, 9505539 IO - Breast J SB - Index Medicus CP - United States MH - Adult MH - Algorithms MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Carcinoma, Intraductal, Noninfiltrating/di [Diagnosis] MH - Carcinoma, Intraductal, Noninfiltrating/rt [Radiotherapy] MH - *Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Female MH - Humans MH - *Mastectomy MH - Middle Aged MH - Prognosis MH - Prospective Studies KW - DCIS; ductal carcinoma in situ; noninvasive breast cancer AB - The University of Southern California/Van Nuys Prognostic Index (USC/VNPI) is an algorithm that quantifies five measurable prognostic factors known to be important in predicting local recurrence in conservatively treated patients with ductal carcinoma in situ (DCIS) (tumor size, margin width, nuclear grade, age, and comedonecrosis). With five times as many patients since originally developed, sufficient numbers now exist for analysis by individual scores rather than groups of scores. To achieve a local recurrence rate of less than 20% at 12 years, these data support excision alone for all patients scoring 4, 5, or 6 and patients who score 7 but have margin widths >=3 mm. Excision plus RT achieves the less than 20% local recurrence threshold at 12 years for patients who score 7 and have margins <3 mm, patients who score 8 and have margins >=3 mm, and for patients who score 9 and have margins >=5 mm. Mastectomy is required for patients who score 8 and have margins <3 mm, who score 9 and have margins <5 mm and for all patients who score 10, 11, or 12 to keep the local recurrence rate less than 20% at 12 years. DCIS is a highly favorable disease. There is no difference in mortality rate regardless of which treatment is chosen. The USC/VNPI is a numeric tool that can be used to aid the treatment decision-making process. AB - Copyright © 2015 Wiley Periodicals, Inc. ES - 1524-4741 IL - 1075-122X DO - https://dx.doi.org/10.1111/tbj.12368 PT - Journal Article ID - 25600630 [pubmed] ID - 10.1111/tbj.12368 [doi] PP - ppublish LG - English EP - 20150120 DP - 2015 Mar-Apr DC - 20150304 EZ - 2015/01/21 06:00 DA - 2015/12/15 06:00 DT - 2015/01/21 06:00 YR - 2015 ED - 20151214 RD - 20150304 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25600630 <82. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25433370 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - O'Brien MA AU - Charles C AU - Lovrics P AU - Wright FC AU - Whelan T AU - Simunovic M AU - Kennedy E AU - Grunfeld E FA - O'Brien, Mary Ann FA - Charles, Cathy FA - Lovrics, Peter FA - Wright, Frances C FA - Whelan, Tim FA - Simunovic, Marko FA - Kennedy, Erin FA - Grunfeld, Eva IN - O'Brien, Mary Ann. Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Fifth Floor, Toronto, ON, M5G 1 V7, Canada. maryann.obrien@utoronto.ca. IN - O'Brien, Mary Ann. Knowledge Translation Research Network, Health Services Research Program, Ontario Institute for Cancer Research, Toronto, ON, Canada. maryann.obrien@utoronto.ca. IN - Charles, Cathy. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. charlesc@mcmaster.ca. IN - Lovrics, Peter. St. Joseph's Healthcare, Hamilton, ON, Canada. lovricsp@mcmaster.ca. IN - Wright, Frances C. Odette Cancer Centre, Toronto, ON, Canada. Frances.Wright@sunnybrook.ca. IN - Whelan, Tim. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Tim.Whelan@jcc.hhsc.ca. IN - Whelan, Tim. Juravinski Cancer Centre, Hamilton, ON, Canada. Tim.Whelan@jcc.hhsc.ca. IN - Simunovic, Marko. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. Marko.Simunovic@jcc.hhsc.ca. IN - Simunovic, Marko. Juravinski Cancer Centre, Hamilton, ON, Canada. Marko.Simunovic@jcc.hhsc.ca. IN - Kennedy, Erin. Mount Sinai Hospital, University Health Network, Toronto, ON, Canada. EKennedy@mtsinai.on.ca. IN - Grunfeld, Eva. Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Fifth Floor, Toronto, ON, M5G 1 V7, Canada. eva.grunfeld@utoronto.ca. IN - Grunfeld, Eva. Knowledge Translation Research Network, Health Services Research Program, Ontario Institute for Cancer Research, Toronto, ON, Canada. eva.grunfeld@utoronto.ca. TI - Enablers and barriers to using patient decision aids in early stage breast cancer consultations: a qualitative study of surgeons' views. SO - Implementation Science. 9:174, 2014 Nov 29 AS - Implement Sci. 9:174, 2014 Nov 29 NJ - Implementation science : IS PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101258411 IO - Implement Sci PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258030 SB - Index Medicus CP - England MH - *Attitude of Health Personnel MH - Awareness MH - *Breast Neoplasms/su [Surgery] MH - Clinical Competence/st [Standards] MH - Communication MH - *Decision Support Systems, Clinical/ut [Utilization] MH - Diffusion of Innovation MH - Female MH - *General Surgery MH - Humans MH - Male MH - Middle Aged MH - Ontario MH - Referral and Consultation/st [Standards] AB - BACKGROUND: For early stage breast cancer, randomized controlled trials (RCTs) have shown that patient decision aids (PtDAs), when used by surgeons, result in increased patient knowledge about options and different patient treatment choices as compared to standard care. Yet, recent data suggests that PtDAs are used by less than 25% of Canadian cancer physicians. We conducted a study to explore breast cancer surgeons' views on enablers and barriers to the use of PtDAs in their practice. AB - METHODS: Purposeful sampling was used to select breast cancer surgeons in three Ontario health regions to participate in semi-structured interviews. Inductive coding and the constant comparative method were used to identify the main themes. AB - RESULTS: Twenty-two surgeons (79%) agreed to participate (median age, 50 years; 9 (40%) female). Surgeons practiced in academic (n=7, 32%) or community (n=15, 68%) hospitals. Fourteen surgeons were aware of PtDAs, nine had used a PtDA with patients as part of an RCT, and six had developed their own informal PtDA for use in their practice. Enablers of informal PtDA use included surgeon exposure during training and surgeon perceived need for a systematic approach when communicating risks and benefits of surgical treatments with patients. Barriers to formal PtDA use included high surgeon confidence in their verbal communication skills, surgeon belief that patients understood conveyed information, and difficulties embedding such tools in practice routines. AB - CONCLUSIONS: Surgeons in this study valued systematic communication with patients. Several surgeons changed their practice to include formal or informal PtDAs provided they perceived there was a clear benefit to themselves or to patients. However, high surgeon confidence in their personal communications skills coupled with beliefs that patients understand conveyed information may be key barriers to PtDA uptake once surgeons have established communication routines. ES - 1748-5908 IL - 1748-5908 DI - s13012-014-0174-0 DO - https://dx.doi.org/10.1186/s13012-014-0174-0 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 25433370 [pubmed] ID - 10.1186/s13012-014-0174-0 [doi] ID - s13012-014-0174-0 [pii] ID - PMC4258030 [pmc] PP - epublish PH - 2014/03/28 [received] PH - 2014/11/08 [accepted] GI - Organization: *Canadian Institutes of Health Research* Country: Canada LG - English EP - 20141129 DP - 2014 Nov 29 DC - 20150428 EZ - 2014/12/01 06:00 DA - 2015/11/17 06:00 DT - 2014/12/01 06:00 YR - 2014 ED - 20151116 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25433370 <83. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26180920 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Yeo B AU - Zabaglo L AU - Hills M AU - Dodson A AU - Smith I AU - Dowsett M FA - Yeo, B FA - Zabaglo, L FA - Hills, M FA - Dodson, A FA - Smith, I FA - Dowsett, M IN - Yeo, B. 1] Department of Medicine, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK [2] Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK [3] Institute of Cancer Research, Fulham Road, London SW3 6JB, UK. IN - Zabaglo, L. 1] Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK [2] Institute of Cancer Research, Fulham Road, London SW3 6JB, UK. IN - Hills, M. Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. IN - Dodson, A. Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. IN - Smith, I. Department of Medicine, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. IN - Dowsett, M. 1] Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK [2] Institute of Cancer Research, Fulham Road, London SW3 6JB, UK. TI - Clinical utility of the IHC4+C score in oestrogen receptor-positive early breast cancer: a prospective decision impact study. SO - British Journal of Cancer. 113(3):390-5, 2015 Jul 28 AS - Br J Cancer. 113(3):390-5, 2015 Jul 28 NJ - British journal of cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522631 SB - Index Medicus CP - England MH - Aged MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/pa [Pathology] MH - *Decision Making/ph [Physiology] MH - Decision Support Techniques MH - Female MH - Humans MH - *Immunohistochemistry/mt [Methods] MH - Middle Aged MH - Predictive Value of Tests MH - Prognosis MH - Receptors, Estrogen/me [Metabolism] MH - Research Design MH - Retrospective Studies AB - BACKGROUND: Most oestrogen receptor (ER)-positive early breast cancer diagnosed today is highly curable with multimodality treatment. Systemic adjuvant treatments including endocrine therapy and chemotherapy have made a significant contribution to the increasing cure rates over the past three decades. However not all women will require chemotherapy. The IHC4+C score is a prognostic tool that integrates four immunohistochemical measures with clinicopathological features to estimate the residual risk of distant recurrence at 10 years in post-menopausal women with ER-positive breast cancer who have received 5 years of endocrine therapy. Retrospective studies indicate that the test can identify a set of women that are at such low risk of recurrence that chemotherapy can be of little benefit. AB - METHODS: In this study, 124 patients were prospectively selected from the multidisciplinary team meeting between January 2013 and April 2014 for IHC4+C testing. Adjuvant systemic treatment recommendations by clinicians were recorded without and with the availability of the score in addition to the patient's decision. AB - RESULTS: There was concordance in the MDT's recommendation without and with the availability of the score in 73% of cases. Clinicians recommended chemotherapy or at least its discussion to 74 (59%) patients, which fell to 32 (34%) patients after the IHC4+C score was made available, sparing one in four tested patients a chemotherapy recommendation, along with its toxicity and expense. AB - CONCLUSION: This decision impact study shows that when used by clinicians in the multidisciplinary team meeting for adjuvant decision-making, a significant proportion of patients are spared chemotherapy recommendations. RN - 0 (Receptors, Estrogen) ES - 1532-1827 IL - 0007-0920 DI - bjc2015222 DO - https://dx.doi.org/10.1038/bjc.2015.222 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26180920 [pubmed] ID - bjc2015222 [pii] ID - 10.1038/bjc.2015.222 [doi] ID - PMC4522631 [pmc] PP - ppublish PH - 2015/02/03 [received] PH - 2015/05/13 [revised] PH - 2015/05/25 [accepted] LG - English EP - 20150716 DP - 2015 Jul 28 DC - 20150729 EZ - 2015/07/17 06:00 DA - 2015/10/16 06:00 DT - 2015/07/17 06:00 YR - 2015 ED - 20151014 RD - 20160728 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26180920 <84. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25810128 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rutter CE AU - Lester-Coll NH AU - Mancini BR AU - Corso CD AU - Park HS AU - Yeboa DN AU - Gross CP AU - Evans SB FA - Rutter, Charles E FA - Lester-Coll, Nataniel H FA - Mancini, Brandon R FA - Corso, Christopher D FA - Park, Henry S FA - Yeboa, Debra N FA - Gross, Cary P FA - Evans, Suzanne B IN - Rutter, Charles E. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Lester-Coll, Nataniel H. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Mancini, Brandon R. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Corso, Christopher D. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Park, Henry S. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Yeboa, Debra N. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Gross, Cary P. Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Gross, Cary P. Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Evans, Suzanne B. Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut. IN - Evans, Suzanne B. Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale School of Medicine, Yale University, New Haven, Connecticut. TI - The evolving role of adjuvant radiotherapy for elderly women with early-stage breast cancer. SO - Cancer. 121(14):2331-40, 2015 Jul 15 AS - Cancer. 121(14):2331-40, 2015 Jul 15 NJ - Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/ch [Chemistry] MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Decision Making MH - Dose Fractionation MH - Female MH - Humans MH - Kaplan-Meier Estimate MH - Logistic Models MH - *Mastectomy, Segmental MH - Neoplasm Grading MH - Neoplasm Staging MH - Radiotherapy, Adjuvant MH - Receptors, Estrogen/an [Analysis] MH - Treatment Outcome KW - Cancer and Leukemia Group B (CALGB) 9343; boost; elderly; radiation AB - BACKGROUND: Elderly patients with early-stage breast cancer (ESBC) derive a local control benefit from radiotherapy (RT) after lumpectomy, without any apparent effect on overall survival. Therefore, the use of RT is controversial. In the current study, the authors characterized updated trends in RT for elderly patients with estrogen receptor (ER)-positive ESBC. AB - METHODS: Patients aged >=70 years with ER-positive ESBC measuring <=2 cm after lumpectomy with negative resection margins and known RT details were identified in the National Cancer Data Base. Patients were classified by year of diagnosis and segregated into 3 groups relative to the initial publication and updated presentation of the Cancer and Leukemia Group B (CALGB) 9343 trial. RT use overall, prescription of hypofractionated RT, and use of boost RT were compared between groups using logistic regression analysis, and the influence of clinicopathologic covariates was determined with multivariable logistic regression analysis. AB - RESULTS: A total of 122,796 elderly patients with ER-positive ESBC who were diagnosed between 1998 and 2011 were identified. Overall, 84,649 patients (68.9%) received adjuvant RT, with a decline observed between successive cohorts (71.3% in the pre-initial publication cohort, 69.5% in the pre-update cohort, and 64.7% in the post-update cohort; P <.001). Hypofractionated RT use increased among treated patients over time (P<.001). Boost RT was used in 67.5% of patients, with a decline noted between the pre-update and post-update cohorts (68.7% vs 57.7%; P<.001). Overall RT use as well as use of boost RT were found to be lower among older patients and those with lower-grade or smaller tumors (P<.001), whereas hypofractionated RT was used more commonly in these groups (P<.001). AB - CONCLUSIONS: RT use appears to have declined in elderly patients with ER-positive ESBC, a finding that is reflective of evidence-based practice integrating mature trial data. Further research is needed to develop tools to aid in the decision-making process regarding the delivery or avoidance of RT in this setting. AB - Copyright © 2015 American Cancer Society. RN - 0 (Receptors, Estrogen) ES - 1097-0142 IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.29377 PT - Journal Article ID - 25810128 [pubmed] ID - 10.1002/cncr.29377 [doi] PP - ppublish PH - 2015/01/17 [received] PH - 2015/02/23 [revised] PH - 2015/03/04 [accepted] LG - English EP - 20150324 DP - 2015 Jul 15 DC - 20150703 EZ - 2015/03/27 06:00 DA - 2015/10/03 06:00 DT - 2015/03/27 06:00 YR - 2015 ED - 20151002 RD - 20150703 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25810128 <85. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25647821 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lam WW AU - Fielding R AU - Butow P AU - Cowling BJ AU - Chan M AU - Or A AU - Kwong A AU - Suen D FA - Lam, W W T FA - Fielding, R FA - Butow, P FA - Cowling, B J FA - Chan, M FA - Or, A FA - Kwong, A FA - Suen, D IN - Lam, W W T. Department of Community Medicine, School of Public Health, The University of Hong Kong. IN - Fielding, R. Department of Community Medicine, School of Public Health, The University of Hong Kong. IN - Butow, P. School of Psychology, University of Sydney. IN - Cowling, B J. Department of Community Medicine, School of Public Health, The University of Hong Kong. IN - Chan, M. The Breast Centre, Department of Surgery, Kwong Wah Hospital. IN - Or, A. The Breast Centre, Department of Surgery, Kwong Wah Hospital. IN - Kwong, A. Breast Surgery Division, Department of Surgery, The University of Hong Kong. IN - Suen, D. Breast Surgery Division, Department of Surgery, The University of Hong Kong. TI - Decision aids for breast cancer surgery: a randomised controlled trial. SO - Hong Kong Medical Journal. 20 Suppl 7:24-7, 2014 Dec AS - HONG KONG MED. J.. 20 Suppl 7:24-7, 2014 Dec NJ - Hong Kong medical journal = Xianggang yi xue za zhi PI - Journal available in: Print PI - Citation processed from: Internet JC - dnz, 9512509 IO - Hong Kong Med J SB - Index Medicus CP - China MH - Adult MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - China MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - *Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Pamphlets IS - 1024-2708 IL - 1024-2708 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 25647821 [pubmed] PP - ppublish LG - English DP - 2014 Dec DC - 20150204 EZ - 2015/02/04 06:00 DA - 2015/09/29 06:00 DT - 2015/02/04 06:00 YR - 2014 ED - 20150928 RD - 20161020 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25647821 <86. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26176340 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Waaijer L AU - Willems SM AU - Verkooijen HM AU - Buck DB AU - van der Pol CC AU - van Diest PJ AU - Witkamp AJ FA - Waaijer, L FA - Willems, S M FA - Verkooijen, H M FA - Buck, D B FA - van der Pol, C C FA - van Diest, P J FA - Witkamp, A J IN - Waaijer, L. Departments of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands. IN - Willems, S M. Departments of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands. IN - Verkooijen, H M. Departments of Imaging Division, University Medical Centre Utrecht, Utrecht, The Netherlands. IN - Buck, D B. Departments of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands. IN - van der Pol, C C. Departments of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands. IN - van Diest, P J. Departments of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands. IN - Witkamp, A J. Departments of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands. TI - Impact of preoperative evaluation of tumour grade by core needle biopsy on clinical risk assessment and patient selection for adjuvant systemic treatment in breast cancer. SO - British Journal of Surgery. 102(9):1048-55, 2015 Aug AS - Br J Surg. 102(9):1048-55, 2015 Aug NJ - The British journal of surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b34, 0372553 IO - Br J Surg SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - Adult MH - Aged MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Biopsy, Large-Core Needle MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/dt [Drug Therapy] MH - *Carcinoma, Ductal, Breast/pa [Pathology] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Chemotherapy, Adjuvant MH - Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - Middle Aged MH - Neoplasm Grading MH - *Patient Selection MH - *Preoperative Care MH - Retrospective Studies MH - Risk Assessment AB - BACKGROUND: Histological characteristics are important when making a decision on adjuvant systemic treatment in breast cancer. Preoperative assessments of core needle biopsy (CNB) specimens are becoming increasingly relevant as novel minimally invasive ablative techniques are introduced, because a surgical specimen is no longer obtained with these methods. The clinical impact of potential underestimation of tumour grade on preoperative CNB on clinical decision-making was evaluated. AB - METHODS: Histological tumour grade was reassessed on CNB and resection specimens from consecutive invasive ductal carcinomas diagnosed between 2010 and 2013. For each patient, the indication for systemic therapy was assessed, based on either CNB or surgical excision, in combination with clinical characteristics and imaging findings. The clinical impact of discordance between tumour grade on CNB versus the resection specimen was assessed. AB - RESULTS: The analysis included 213 invasive ductal carcinomas in 199 patients. Discordance in tumour grade between CNB and the resection specimen was observed in 64 (30.0 per cent) of 213 tumours (kappa=0.53, 95 per cent c.i. 0.43 to 0.63). A decision on adjuvant treatment based on CNB would have resulted in overtreatment in seven (3.5 per cent) and undertreatment in three (1.5 per cent) of 199 patients. In the undertreated patients, incorrect omission of adjuvant systemic treatment would have increased the predicted 10-year mortality rate by 2.6-5.2 per cent and 10-year recurrence rate by 8.2-15.3 per cent based on the online risk assessment tool Adjuvant! AB - CONCLUSION: The substantial discordance in tumour grading between CNB and resection specimens from breast cancer affects the indication for adjuvant therapy in only a small minority of patients with invasive ductal carcinoma. Assessment of tumour grade by CNB is feasible and accurate for the planning of postoperative treatment. AB - Copyright © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd. RN - 0 (Antineoplastic Agents) ES - 1365-2168 IL - 0007-1323 DO - https://dx.doi.org/10.1002/bjs.9858 PT - Evaluation Studies PT - Journal Article ID - 26176340 [pubmed] ID - 10.1002/bjs.9858 [doi] PP - ppublish PH - 2014/11/17 [received] PH - 2015/02/05 [revised] PH - 2015/04/16 [accepted] LG - English EP - 20150616 DP - 2015 Aug DC - 20150716 EZ - 2015/07/16 06:00 DA - 2015/09/26 06:00 DT - 2015/07/16 06:00 YR - 2015 ED - 20150925 RD - 20150716 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26176340 <87. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25479685 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Willis BH AU - Hyde CJ FA - Willis, Brian H FA - Hyde, Christopher J IN - Willis, Brian H. School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: b.h.willis@bham.ac.uk. IN - Hyde, Christopher J. Institute of Health Research, University of Exeter Medical School, The Veysey Building, Salmon Pool lane, Exeter, EX2 4SG, UK. TI - What is the test's accuracy in my practice population? Tailored meta-analysis provides a plausible estimate. SO - Journal of Clinical Epidemiology. 68(8):847-54, 2015 Aug AS - J Clin Epidemiol. 68(8):847-54, 2015 Aug NJ - Journal of clinical epidemiology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jce, 8801383 IO - J Clin Epidemiol SB - Index Medicus CP - United States MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/ep [Epidemiology] MH - Data Interpretation, Statistical MH - Decision Making MH - *Depression/di [Diagnosis] MH - Depression/ep [Epidemiology] MH - *Diagnostic Tests, Routine MH - Evidence-Based Practice MH - Female MH - Humans MH - Male MH - *Mass Screening MH - Research Design MH - State Medicine MH - *Streptococcal Infections/di [Diagnosis] MH - Streptococcal Infections/ep [Epidemiology] MH - Surveys and Questionnaires MH - United Kingdom/ep [Epidemiology] KW - Data interpretation, statistical; Decision making; Diagnosis tests, routine; Mass screening; Meta-analysis; Models, statistical AB - OBJECTIVES: Diagnostic test accuracy studies and meta-analyses may, in some cases, provide estimates that are highly improbable in practice; tailored meta-analysis provides a potential solution. To investigate the utility of tailored meta-analysis in synthesizing estimates of a test's accuracy compared with conventional meta-analysis for three case examples. AB - STUDY DESIGN AND SETTING: MEDLINE, Embase, and CINAHL were searched for relevant studies, and routine data were collected on the test positive rate and disease prevalence from the case settings to define an applicable region for each setting. Three cases were evaluated: mammography in the NHS Breast Screening Programme, Patient Health Questionnaire-9 to screen for depression in general practice, and Centor's criteria used to diagnose group A beta-hemolytic streptococcus in general practice. For conventional meta-analysis, studies were selected using standard systematic review methods; for tailored meta-analysis, this selection was refined to those with results compatible with the applicable region for the setting. AB - RESULTS: In each example, studies were excluded as a result of incorporating an applicable region for the setting. Comparing tailored with conventional meta-analysis, the positive likelihood ratios (with 95% confidence intervals in brackets) were 36.5 (23.0, 57.9) and 19.8 (12.8, 30.9), respectively, for mammography and 4.89 (2.02, 11.8) and 2.35 (1.51, 3.67), respectively, for Centor's criteria. This had the effect of increasing the positive predictive value from 17% to 27% for mammography and 23% to 38% for Centor's criteria. AB - CONCLUSION: Tailored meta-analysis has the potential to provide a plausible estimate for a test's accuracy, which is specific to the practice setting. When compared with conventional meta-analysis, the difference may, in some cases, be sufficient to lead to different decisions on patient management. AB - Copyright © 2015 Elsevier Inc. All rights reserved. ES - 1878-5921 IL - 0895-4356 DI - S0895-4356(14)00407-7 DO - https://dx.doi.org/10.1016/j.jclinepi.2014.10.002 PT - Journal Article PT - Meta-Analysis ID - 25479685 [pubmed] ID - S0895-4356(14)00407-7 [pii] ID - 10.1016/j.jclinepi.2014.10.002 [doi] PP - ppublish PH - 2014/06/04 [received] PH - 2014/10/09 [revised] PH - 2014/10/15 [accepted] GI - No: G0701649 Organization: *Medical Research Council* Country: United Kingdom LG - English EP - 20141203 DP - 2015 Aug DC - 20150626 EZ - 2014/12/07 06:00 DA - 2015/09/24 06:00 DT - 2014/12/07 06:00 YR - 2015 ED - 20150922 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25479685 <88. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26047763 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Grimmer L AU - Liederbach E AU - Velasco J AU - Pesce C AU - Wang CH AU - Yao K FA - Grimmer, Laura FA - Liederbach, Erik FA - Velasco, Jose FA - Pesce, Catherine FA - Wang, Chi-Hsiung FA - Yao, Katharine IN - Grimmer, Laura. Department of Surgery, Rush University Medical College, Chicago, IL. IN - Liederbach, Erik. Department of Surgery, NorthShore University Health System, Evanston, IL. IN - Velasco, Jose. Department of Surgery, NorthShore University Health System, Evanston, IL. IN - Pesce, Catherine. Department of Surgery, NorthShore University Health System, Evanston, IL. IN - Wang, Chi-Hsiung. Center for Biomedical Research Informatics, NorthShore University Health System, Evanston, IL. IN - Yao, Katharine. Department of Surgery, NorthShore University Health System, Evanston, IL. Electronic address: kyao@northshore.org. TI - Variation in Contralateral Prophylactic Mastectomy Rates According to Racial Groups in Young Women with Breast Cancer, 1998 to 2011: A Report from the National Cancer Data Base. CM - Comment in: J Am Coll Surg. 2015 Jul;221(1):196; PMID: 26095571 SO - Journal of the American College of Surgeons. 221(1):187-96, 2015 Jul AS - J Am Coll Surg. 221(1):187-96, 2015 Jul NJ - Journal of the American College of Surgeons PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - bzb, 9431305 IO - J. Am. Coll. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/eh [Ethnology] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/eh [Ethnology] MH - *Carcinoma, Ductal, Breast/pc [Prevention & Control] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Carcinoma, Lobular/eh [Ethnology] MH - *Carcinoma, Lobular/pc [Prevention & Control] MH - Carcinoma, Lobular/su [Surgery] MH - *Continental Population Groups MH - Databases, Factual MH - Female MH - *Healthcare Disparities/eh [Ethnology] MH - Healthcare Disparities/sn [Statistics & Numerical Data] MH - Humans MH - Logistic Models MH - Mastectomy/sn [Statistics & Numerical Data] MH - *Mastectomy/ut [Utilization] MH - Middle Aged MH - Multivariate Analysis MH - Prophylactic Surgical Procedures/sn [Statistics & Numerical Data] MH - *Prophylactic Surgical Procedures/ut [Utilization] MH - Retrospective Studies MH - Socioeconomic Factors MH - United States AB - BACKGROUND: The rate of contralateral prophylactic mastectomy (CPM) for unilateral breast cancer has increased over the past decade, particularly for young women. This study investigates the impact of race and socioeconomic status (SES) on use of CPM. AB - STUDY DESIGN: Using the National Cancer Data Base (NCDB), we selected 1,781,409 stage 0 to II unilateral breast cancer patients between 1998 and 2011. Trends in use of CPM by race and SES were analyzed using chi-square tests and logistic regression models. AB - RESULTS: For women of all ages, rates of CPM increased, from 1.9% in 1998 to 10.2% in 2011 (p < 0.001), with higher rates in women <=45 years old, rising from 3.7% in 1998 to 26.2% in 2011 (p < 0.001). Among young women, white women had the greatest increase in CPM from 4.3% in 1998 to 30.2% in 2011 (p < 0.001). In 2011, CPM rates were 30.2% for white, 18.5% for Hispanic, 16.5% for black, and 15.2% for Asian patients (p < 0.001). The gap in CPM use between white and minority patients persisted in every SES classification, geographic region, and facility type. On multivariate analysis, minority women were 50% less likely to undergo CPM than white women were. AB - CONCLUSIONS: Young, white, breast cancer patients are twice as likely to undergo CPM compared with women in other racial groups, even after accounting for pathologic, patient, and facility factors. Variations in shared decision-making processes between women of different backgrounds may contribute to these trends, supporting the need for future studies investigating decision-making processes and decisional aids. AB - Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved. ES - 1879-1190 IL - 1072-7515 DI - S1072-7515(15)00238-0 DO - https://dx.doi.org/10.1016/j.jamcollsurg.2015.03.033 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26047763 [pubmed] ID - S1072-7515(15)00238-0 [pii] ID - 10.1016/j.jamcollsurg.2015.03.033 [doi] PP - ppublish PH - 2015/01/02 [received] PH - 2015/03/11 [accepted] LG - English EP - 20150423 DP - 2015 Jul DC - 20150622 EZ - 2015/06/07 06:00 DA - 2015/09/01 06:00 DT - 2015/06/07 06:00 YR - 2015 ED - 20150831 RD - 20150622 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=26047763 <89. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25701273 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hersch J AU - Barratt A AU - Jansen J AU - Irwig L AU - McGeechan K AU - Jacklyn G AU - Thornton H AU - Dhillon H AU - Houssami N AU - McCaffery K FA - Hersch, Jolyn FA - Barratt, Alexandra FA - Jansen, Jesse FA - Irwig, Les FA - McGeechan, Kevin FA - Jacklyn, Gemma FA - Thornton, Hazel FA - Dhillon, Haryana FA - Houssami, Nehmat FA - McCaffery, Kirsten IN - Hersch, Jolyn. Screening & Test Evaluation Program (STEP), The University of Sydney, Sydney, NSW 2006, Australia; Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW 2006, Australia. IN - Barratt, Alexandra. Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW 2006, Australia. IN - Jansen, Jesse. Screening & Test Evaluation Program (STEP), The University of Sydney, Sydney, NSW 2006, Australia; Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW 2006, Australia. IN - Irwig, Les. Screening & Test Evaluation Program (STEP), The University of Sydney, Sydney, NSW 2006, Australia. IN - McGeechan, Kevin. Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW 2006, Australia. IN - Jacklyn, Gemma. School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia. IN - Thornton, Hazel. Department of Health Sciences, University of Leicester; Leicester, UK. IN - Dhillon, Haryana. Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW 2006, Australia; Central Clinical School, The University of Sydney, Sydney, NSW 2006, Australia. IN - Houssami, Nehmat. Screening & Test Evaluation Program (STEP), The University of Sydney, Sydney, NSW 2006, Australia. IN - McCaffery, Kirsten. Screening & Test Evaluation Program (STEP), The University of Sydney, Sydney, NSW 2006, Australia; Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW 2006, Australia. Electronic address: kirsten.mccaffery@sydney.edu.au. TI - Use of a decision aid including information on overdetection to support informed choice about breast cancer screening: a randomised controlled trial.[Erratum appears in Lancet. 2015 Apr 25;385(9978):1622; PMID: 25943820] CM - Comment in: Lancet. 2015 Apr 25;385(9978):1597-9; PMID: 25701272 SO - Lancet. 385(9978):1642-52, 2015 Apr 25 AS - Lancet. 385(9978):1642-52, 2015 Apr 25 NJ - Lancet (London, England) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 2985213r, l0s, 0053266 IO - Lancet SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/pc [Prevention & Control] MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - *Mammography/ut [Utilization] MH - Middle Aged MH - Patient Education as Topic MH - Patient Participation AB - BACKGROUND: Mammography screening can reduce breast cancer mortality. However, most women are unaware that inconsequential disease can also be detected by screening, leading to overdiagnosis and overtreatment. We aimed to investigate whether including information about overdetection of breast cancer in a decision aid would help women aged around 50 years to make an informed choice about breast screening. AB - METHODS: We did a community-based, parallel-group, randomised controlled trial in New South Wales, Australia, using a random cohort of women aged 48-50 years. Recruitment to the study was done by telephone; women were eligible if they had not had mammography in the past 2 years and did not have a personal or strong family history of breast cancer. With a computer program, we randomly assigned 879 participants to either the intervention decision aid (comprising evidence-based explanatory and quantitative information on overdetection, breast cancer mortality reduction, and false positives) or a control decision aid (including information on breast cancer mortality reduction and false positives). Participants and interviewers were masked to group assignment. The primary outcome was informed choice (defined as adequate knowledge and consistency between attitudes and screening intentions), which we assessed by telephone interview about 3 weeks after random allocation. The primary outcome was analysed in all women who completed the relevant follow-up interview questions fully. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12613001035718. AB - FINDINGS: Between January, 2014, and July, 2014, 440 women were allocated to the intervention group and 439 were assigned to the control group. 21 women in the intervention group and 20 controls were lost to follow-up; a further ten women assigned to the intervention and 11 controls did not answer all questions on attitudes. Therefore, 409 women in the intervention group and 408 controls were analysed for the primary outcome. 99 (24%) of 409 women in the intervention group made an informed choice compared with 63 (15%) of 408 in the control group (difference 9%, 95% CI 3-14; p=0.0017). Compared with controls, more women in the intervention group met the threshold for adequate overall knowledge (122/419 [29%] vs 71/419 [17%]; difference 12%, 95% CI 6-18; p<0.0001), fewer women expressed positive attitudes towards screening (282/409 [69%] vs 340/408 [83%]; 14%, 9-20; p<0.0001), and fewer women intended to be screened (308/419 [74%] vs 363/419 [87%]; 13%, 8-19; p<0.0001). When conceptual knowledge alone was considered, 203 (50%) of 409 women in the intervention group made an informed choice compared with 79 (19%) of 408 in the control group (p<0.0001). AB - INTERPRETATION: Information on overdetection of breast cancer provided within a decision aid increased the number of women making an informed choice about breast screening. Becoming better informed might mean women are less likely to choose screening. AB - FUNDING: Australian National Health and Medical Research Council. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. ES - 1474-547X IL - 0140-6736 DI - S0140-6736(15)60123-4 DO - https://dx.doi.org/10.1016/S0140-6736(15)60123-4 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 25701273 [pubmed] ID - S0140-6736(15)60123-4 [pii] ID - 10.1016/S0140-6736(15)60123-4 [doi] PP - ppublish SI - ANZCTR SA - ANZCTR/ACTRN12613001035718 LG - English EP - 20150218 DP - 2015 Apr 25 DC - 20150506 EZ - 2015/02/22 06:00 DA - 2015/07/21 06:00 DT - 2015/02/24 06:00 YR - 2015 ED - 20150720 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25701273 <90. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26171096 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Hui KJ AU - Liu XX AU - Luan A AU - Lee GK FA - Hui, Kenneth J FA - Liu, Xiang X FA - Luan, Anna FA - Lee, Gordon K IN - Hui, Kenneth J. Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif. IN - Liu, Xiang X. Division of Plastic and Reconstructive Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. IN - Luan, Anna. Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif. IN - Lee, Gordon K. Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, Stanford, Calif. TI - Design and Focus Test of a Preconsultation Decision Aid for Breast Cancer Reconstruction Patients: A Quality Improvement Initiative. SO - Eplasty [Electronic Resource]. 15:e24, 2015 AS - Eplasty. 15:e24, 2015 NJ - Eplasty PI - Journal available in: Electronic-eCollection PI - Citation processed from: Print JC - 101316107 IO - Eplasty PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485615 CP - United States KW - breast reconstruction; clinical outcomes; decision aid; patient satisfaction; regret AB - OBJECTIVE: To design, develop, and evaluate via focus group a preconsultation decision aid to improve patient satisfaction for breast reconstruction. AB - METHODS: The design of the decision aid was based on perceived patient needs, literature, existing decision aids, and current standard of breast cancer reconstruction treatment and consultation at Stanford. Our decision aid was designed to (1) reducing fear of the unknown in patients via providing a knowledge base that they can rely on, (2) helping patients identify their key breast reconstruction concerns, (3) addressing common patient concerns, (4) providing a framework to help patients identify the treatment option that may be right for them, and (5) promoting shared decision making. Physicians were consulted on the decision aid, following which a focus group was conducted for patient feedback. AB - RESULTS: Interviewed patients (n = 12) were supportive of the decision aid initiative. Participants were especially pleased with the side-by-side comparison of surgical options and the parsimonious way information was represented. All patients before undergoing reconstruction (n = 3) requested the decision guide to reference at home. All interviewed patients believed information level was "about right." AB - CONCLUSIONS: Decision aid was well received by patients in the focus group. As the initiative is for quality improvement, we saw no need to further delay the distribution of the decision aid. A pilot study will be conducted to evaluate whether our decision aid has an effect on patients' decision regret, stress, and anxiety. IL - 1937-5719 PT - Journal Article ID - 26171096 [pubmed] ID - PMC4485615 [pmc] PP - epublish LG - English EP - 20150622 DP - 2015 DC - 20150714 EZ - 2015/07/15 06:00 DA - 2015/07/15 06:01 DT - 2015/07/15 06:00 YR - 2015 ED - 20150714 RD - 20150719 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26171096 <91. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25752562 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Moran MS FA - Moran, Meena S IN - Moran, Meena S. Yale University School of Medicine, Department of Therapeutic Radiology, New Haven, CT, USA. Electronic address: Meena.Moran@yale.edu. TI - Radiation therapy in the locoregional treatment of triple-negative breast cancer. [Review] SO - Lancet Oncology. 16(3):e113-22, 2015 Mar AS - Lancet Oncol. 16(3):e113-22, 2015 Mar NJ - The Lancet. Oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - 100957246 IO - Lancet Oncol. SB - Index Medicus CP - England MH - Biomarkers, Tumor/an [Analysis] MH - Biomarkers, Tumor/ge [Genetics] MH - Decision Support Techniques MH - Dose Fractionation MH - Female MH - Genetic Predisposition to Disease MH - Humans MH - *Mastectomy MH - Neoplasm Recurrence, Local MH - Patient Selection MH - Phenotype MH - Predictive Value of Tests MH - Radiation Tolerance MH - Radiotherapy, Adjuvant MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome MH - Triple Negative Breast Neoplasms/ch [Chemistry] MH - Triple Negative Breast Neoplasms/ge [Genetics] MH - Triple Negative Breast Neoplasms/pa [Pathology] MH - *Triple Negative Breast Neoplasms/rt [Radiotherapy] MH - *Triple Negative Breast Neoplasms/su [Surgery] AB - This Review assesses the relevant data and controversies regarding the use of radiotherapy for, and locoregional management of, women with triple-negative breast cancer (TNBC). In view of the strong association between BRCA1 and TNBC, knowledge of baseline mutation status can be useful to guide locoregional treatment decisions. TNBC is not a contraindication for breast conservation therapy because data suggest increased locoregional recurrence risks (relative to luminal subtypes) with breast conservation therapy or mastectomy. Although a boost to the tumour bed should routinely be considered after whole breast radiation therapy, TNBC should not be the sole indication for post-mastectomy radiation, and accelerated delivery methods for TNBC should be offered on clinical trials. Preliminary data implying a relative radioresistance for TNBC do not imply radiation omission because radiation provides an absolute locoregional risk reduction. At present, the integration of subtypes in locoregional management decisions is still in its infancy. Until level 1 data supporting treatment decisions based on subtypes are available, standard locoregional management principles should be adhered to. AB - Copyright © 2015 Elsevier Ltd. All rights reserved. RN - 0 (Biomarkers, Tumor) ES - 1474-5488 IL - 1470-2045 DI - S1470-2045(14)71104-0 DO - https://dx.doi.org/10.1016/S1470-2045(14)71104-0 PT - Journal Article PT - Review ID - 25752562 [pubmed] ID - S1470-2045(14)71104-0 [pii] ID - 10.1016/S1470-2045(14)71104-0 [doi] PP - ppublish LG - English DP - 2015 Mar DC - 20150310 EZ - 2015/03/11 06:00 DA - 2015/07/15 06:00 DT - 2015/03/11 06:00 YR - 2015 ED - 20150709 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25752562 <92. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24611803 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bjerrome Ahlin H AU - Kolby L AU - Elander A AU - Selvaggi G FA - Bjerrome Ahlin, Henrik FA - Kolby, Lars FA - Elander, Anna FA - Selvaggi, Gennaro IN - Bjerrome Ahlin, Henrik. Department of Plastic Surgery, Sahlgrenska University Hospital , Gothenburg , Sweden. TI - Improved results after implementation of the Ghent algorithm for subcutaneous mastectomy in female-to-male transsexuals. SO - Journal of Plastic Surgery and Hand Surgery. 48(6):362-7, 2014 Dec AS - J Plast Surg Hand Surg. 48(6):362-7, 2014 Dec NJ - Journal of plastic surgery and hand surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101534130 IO - J Plast Surg Hand Surg SB - Index Medicus CP - Sweden MH - Adult MH - Body Mass Index MH - Cicatrix/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Male MH - *Mastectomy, Subcutaneous MH - *Sex Reassignment Surgery/mt [Methods] MH - *Transsexualism/su [Surgery] MH - Treatment Outcome KW - Transsexualism; female-to-male; gender dysphoria; gender reassignment surgery; mastectomy AB - The subcutaneous mastectomy is an important step in the treatment of female-to-male transsexual patients. At the Sahlgrenska University Hospital, a two-step procedure was used for mastectomies through 2002-2011. With this procedure, all patients were operated on with a concentric circular incision in the first session of surgery, followed by a second session 7-12 months later. From July 2011, a new approach was adopted, which consists of treating patients according to the algorithm and methods described by Monstrey et al. The aim of this study is to evaluate these two different approaches and determine if similar results, possibly with fewer surgeries and overall lower complication rate, can be achieved by using multiple techniques and a decision-making algorithm as compared to the two-step approach where only a concentric circular technique was used. All female-to-male transsexuals who had mastectomy at Sahlgrenska between 2002-2012 were included in the study. These were divided in two groups: those who were treated according to the single-step, algorithm based, approach (16 patients, 32 mastectomies), and those who were treated with the two-step, concentric circular approach (14 patients, 28 mastectomies). Within the single-step, algorithm based, group the following techniques were used: 6% transareolar technique, 6% semicircular, 13% free nipple graft, 31% extended concentric circular, and 44% concentric circular. Data including type of surgical technique used, complications, and number of surgeries were collected and compared. Complications (e.g., haematoma, nipple necrosis, seroma, wound dehiscence, and infection) occurred in 50% of the patients following the first surgery in the two-step, concentric-circular approach group, for a total of 71.43% of patients with complications following either the first- or the second-step surgery; complications occurred only in 25% of the patients in the one-step, algorithm-based group. The mean number of surgeries per breast was 2.5 for the two-step concentric circular approach, and 1.25 for the single step, algorithm-based approach; particularly, when the concentric circular technique was chosen for the single step, algorithm-based approach, only two of the patients required revision surgery to improve the cosmetic outcome. This study shows that the number of complications and the total number of surgeries performed to satisfy patients were lower after Monstrey's algorithm for mastectomies was implemented as routine practice at the Sahlgrenska University Hospital. ES - 2000-6764 IL - 2000-6764 DO - https://dx.doi.org/10.3109/2000656X.2014.893887 PT - Journal Article ID - 24611803 [pubmed] ID - 10.3109/2000656X.2014.893887 [doi] PP - ppublish LG - English EP - 20140311 DP - 2014 Dec DC - 20141117 EZ - 2014/03/12 06:00 DA - 2015/07/15 06:00 DT - 2014/03/13 06:00 YR - 2014 ED - 20150708 RD - 20141117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24611803 <93. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26140844 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Kaufman EM AU - Peshkin BN AU - Lawrence WF AU - Shelby R AU - Isaacs C AU - Brown K AU - Rispoli J AU - O'Neill S AU - Hurley K AU - DeMarco T AU - Brogan B AU - Grumet S AU - Jandorf L AU - McKenna K AU - Valdimarsdottir H AU - Schwartz MD FA - Kaufman, Elizabeth M FA - Peshkin, Beth N FA - Lawrence, William F FA - Shelby, Rebecca FA - Isaacs, Claudine FA - Brown, Karen FA - Rispoli, Jessica FA - O'Neill, Suzanne FA - Hurley, Karen FA - DeMarco, Tiffani FA - Brogan, Barbara FA - Grumet, Sherry FA - Jandorf, Lina FA - McKenna, Kristine FA - Valdimarsdottir, Heiddis FA - Schwartz, Marc D IN - Kaufman, Elizabeth M. Division of Cancer Control, Department of Oncology, Georgetown University - Lombardi Cancer Center, Washington, District of Columbia, emk6@georgetown.edu. TI - Development of an Interactive Decision Aid for Female BRCA1/BRCA2 Carriers. SO - Journal of Genetic Counseling. 12(2):109-29, 2003 Apr AS - J Genet Couns. 12(2):109-29, 2003 Apr NJ - Journal of genetic counseling PI - Journal available in: Print PI - Citation processed from: Print JC - 9206865 IO - J Genet Couns CP - United States AB - Shared decision making between patients and providers is becoming increasingly common, particularly when there is no clear preferred course of action. As a result, decision aids are being adopted with growing frequency and have been applied to many medical decision-making issues. One such issue where there is uncertainty is breast cancer risk management among BRCA1/BRCA2 carriers. We present the development of a CD-ROM decision aid to facilitate risk management decision making in this population. Our decision aid was developed with the intention of providing it through a randomized clinical trial. The CD-ROM is a multimedia, interactive intervention which provides information about breast cancer, risks associated with BRCA1 and BRCA2 mutations, risk management options for hereditary breast cancer, and a breast cancer risk management decision aid. The goal of this CD-ROM, offered as an adjunctive intervention, is to reduce decisional conflict and psychological distress and improve comprehension of risk information, decisional satisfaction, medical adherence, and quality of life for this population of women at increased risk for breast cancer. IS - 1059-7700 IL - 1059-7700 DO - https://dx.doi.org/10.1023/A:1022698112236 PT - Journal Article ID - 26140844 [pubmed] ID - 10.1023/A:1022698112236 [doi] PP - ppublish LG - English DP - 2003 Apr DC - 20150704 EZ - 2015/07/05 06:00 DA - 2003/04/01 00:01 DT - 2003/04/01 00:00 YR - 2003 ED - 20150708 RD - 20150704 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26140844 <94. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25351455 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Causarano N AU - Platt J AU - Baxter NN AU - Bagher S AU - Jones JM AU - Metcalfe KA AU - Hofer SO AU - O'Neill AC AU - Cheng T AU - Starenkyj E AU - Zhong T FA - Causarano, Natalie FA - Platt, Jennica FA - Baxter, Nancy N FA - Bagher, Shaghayegh FA - Jones, Jennifer M FA - Metcalfe, Kelly A FA - Hofer, Stefan O P FA - O'Neill, Anne C FA - Cheng, Terry FA - Starenkyj, Elizabeth FA - Zhong, Toni IN - Causarano, Natalie. Division of Plastic & Reconstructive Surgery, Breast Reconstruction Program, University Health Network, 8N871, 200 Elizabeth St., Toronto, ON, M5G 2C4, Canada. TI - Pre-consultation educational group intervention to improve shared decision-making for postmastectomy breast reconstruction: a pilot randomized controlled trial. SO - Supportive Care in Cancer. 23(5):1365-75, 2015 May AS - Support Care Cancer. 23(5):1365-75, 2015 May NJ - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9302957, b1l IO - Support Care Cancer SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Informed Consent MH - *Mammaplasty/ed [Education] MH - Mastectomy MH - Middle Aged MH - *Patient Education as Topic MH - Physician-Patient Relations MH - Pilot Projects MH - Referral and Consultation MH - Self Efficacy MH - Surveys and Questionnaires AB - PURPOSE: Breast cancer survivors who make preference-sensitive decisions about postmastectomy breast reconstruction often have large gaps in knowledge and undergo procedures that are misaligned with their treatment goals. We evaluated the feasibility and effect of a pre-consultation educational group intervention on the decision-making process for breast reconstruction. AB - METHODS: We conducted a pilot randomized controlled trial (RCT) where participants were randomly assigned to the intervention with routine education or routine education alone. The outcomes evaluated were decisional conflict, decision self-efficacy, satisfaction with information, perceived involvement in care, and uptake of reconstruction following surgical consultation. Trial feasibility and acceptability were evaluated, and effect sizes were calculated to determine the primary outcome for the full-scale RCT. AB - RESULTS: Of the 41 patients enrolled, recruitment rate was 72 %, treatment fidelity was 98 %, and retention rate was 95 %. The Cohen's d effect size in reduction of decisional conflict was moderate to high for the intervention group compared to routine education (0.69, 95 % CI=0.02-1.42), while the effect sizes of increase in decision self-efficacy (0.05, 95 % CI=-0.60-0.71) and satisfaction with information (0.11, 95 % CI=-0.53-0.76) were small. A higher proportion of patients receiving routine education signed informed consent to undergo breast reconstruction (14/20 or 70 %) compared to the intervention group (8/21 or 38 %) P=0.06. AB - CONCLUSIONS: A pre-consultation educational group intervention improves patients' shared decision-making quality compared to routine preoperative patient education. A full-scale definitive RCT is warranted based on high feasibility outcomes, and the primary outcome for the main trial will be decisional conflict. ES - 1433-7339 IL - 0941-4355 DO - https://dx.doi.org/10.1007/s00520-014-2479-6 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 25351455 [pubmed] ID - 10.1007/s00520-014-2479-6 [doi] PP - ppublish PH - 2013/12/09 [received] PH - 2014/10/06 [accepted] LG - English EP - 20141029 DP - 2015 May DC - 20150330 EZ - 2014/10/30 06:00 DA - 2015/06/18 06:00 DT - 2014/10/30 06:00 YR - 2015 ED - 20150617 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25351455 <95. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24443115 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - van Agt HM AU - Korfage IJ AU - Essink-Bot ML FA - van Agt, Heleen M E FA - Korfage, Ida J FA - Essink-Bot, Marie-Louise IN - van Agt, Heleen M E. 1 Department of Public Health, Erasmus MC University Medical Center Rotterdam, the Netherlands h.vanagt@erasmusmc.nl. IN - Korfage, Ida J. 1 Department of Public Health, Erasmus MC University Medical Center Rotterdam, the Netherlands. IN - Essink-Bot, Marie-Louise. 2 Department of Public Health, Academic Medical Center / University of Amsterdam, the Netherlands. TI - Interventions to enhance informed choices among invitees of screening programmes-a systematic review. [Review] SO - European Journal of Public Health. 24(5):789-801, 2014 Oct AS - Eur J Public Health. 24(5):789-801, 2014 Oct NJ - European journal of public health PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - d0w, 9204966 IO - Eur J Public Health SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Choice Behavior MH - Female MH - Fetal Diseases/di [Diagnosis] MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Infant, Newborn MH - Male MH - *Mass Screening/mt [Methods] MH - Mass Screening/sn [Statistics & Numerical Data] MH - Middle Aged MH - Neonatal Screening/mt [Methods] MH - *Neoplasms/di [Diagnosis] MH - *Patient Participation/mt [Methods] MH - Patient Participation/sn [Statistics & Numerical Data] MH - Pregnancy MH - *Prenatal Diagnosis/mt [Methods] MH - Prenatal Diagnosis/sn [Statistics & Numerical Data] MH - *Program Evaluation/mt [Methods] MH - Program Evaluation/sn [Statistics & Numerical Data] AB - BACKGROUND: Informed decision making about participation has become an explicit purpose in invitations for screening programmes in western countries. An informed choice is commonly defined as based on: (i) adequate levels of knowledge of the screening and (ii) agreement between the invitee's values towards own screening participation and actual (intention to) participation. AB - METHODS: We systematically reviewed published studies that empirically evaluated the effects of interventions aiming at enhancing informed decision making in screening programmes targeted at the general population. We focused on prenatal screening and neonatal screening for diseases of the foetus/new-born and screening for breast cancer, cervical cancer and colorectal cancer. The Medline, EMBASE and Cochrane databases were searched for studies published till April 2012, using the terms 'informed choice', 'decision making' and 'mass screening' separately and in combination and terms referring to the specific screening programmes. AB - RESULTS: Of the 2238 titles identified, 15 studies were included, which evaluated decision aids (DAs), information leaflets, film, video, counselling and a specific screening visit for informed decision making in prenatal screening, breast and colorectal cancer screening. Most of the included studies evaluated DAs and showed improved knowledge and informed decision making. Due to the limited number of studies the results could not be synthesized. AB - CONCLUSION: The empirical evidence regarding interventions to improve informed decision making in screening is limited. It is unknown which strategies to enhance informed decision making are most effective, although DAs are promising. Systematic development of interventions to enhance informed choices in screening deserves priority, especially in disadvantaged groups. AB - Copyright © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. ES - 1464-360X IL - 1101-1262 DI - ckt205 DO - https://dx.doi.org/10.1093/eurpub/ckt205 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 24443115 [pubmed] ID - ckt205 [pii] ID - 10.1093/eurpub/ckt205 [doi] PP - ppublish LG - English EP - 20140116 DP - 2014 Oct DC - 20140920 EZ - 2014/01/21 06:00 DA - 2015/06/13 06:00 DT - 2014/01/21 06:00 YR - 2014 ED - 20150612 RD - 20140920 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24443115 <96. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25719690 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chatterjee A AU - Ramkumar DB AU - Dawli TB AU - Nigriny JF AU - Stotland MA AU - Ridgway EB FA - Chatterjee, Abhishek FA - Ramkumar, Dipak B FA - Dawli, Tamara B FA - Nigriny, John F FA - Stotland, Mitchell A FA - Ridgway, Emily B IN - Chatterjee, Abhishek. Lebanon, N.H. From the Dartmouth-Hitchcock Medical Center. TI - The use of mesh versus primary fascial closure of the abdominal donor site when using a transverse rectus abdominis myocutaneous flap for breast reconstruction: a cost-utility analysis. [Review] SO - Plastic & Reconstructive Surgery. 135(3):682-9, 2015 Mar AS - Plast Reconstr Surg. 135(3):682-9, 2015 Mar NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Cost-Benefit Analysis/mt [Methods] MH - *Fasciotomy MH - Female MH - Humans MH - *Mammaplasty/ec [Economics] MH - Mammaplasty/mt [Methods] MH - *Myocutaneous Flap MH - *Rectus Abdominis/tr [Transplantation] MH - Wound Healing AB - BACKGROUND: During breast reconstruction using the transverse rectus abdominis myocutaneous (TRAM) flap, the use of mesh for abdominal donor-site closure provides for a technology that potentially offers clinical benefit yet incurs an added cost. The authors' goal was to determine whether it is cost effective to use mesh during abdominal donor-site closure when performing a TRAM flap for breast reconstruction. AB - METHODS: A literature review was conducted to identify and collect published hernia and bulge rates at abdominal TRAM flap donor sites closed either primarily or with mesh. A decision tree analysis was performed. Outcome probabilities, costs of complications, and expert utility estimates were populated into the decision tree model to evaluate the cost-utility of using mesh in TRAM abdominal donor-site closure. One-way sensitivity analyses were performed to verify the robustness of the results. AB - RESULTS: The authors' literature review resulted in 10 articles describing 1195 patients who had TRAM abdominal donor-site closure primarily and 696 patients who had donor-site closure performed with mesh. Pooled hernia/bulge complication rates for these two groups were 7.87 percent and 4.45 percent, respectively. The use of mesh was more clinically effective based on total quality-adjusted life-years gained of 30.53 compared with 30.41 when performing primary fascial closure alone. The incremental additional cost incurred by the mesh arm when running the decision tree model was $693.14. This difference in cost, divided by the difference in clinical efficacy (0.12), results in an incremental cost-utility ratio value of $5776.17 per quality-adjusted life-year gained when using mesh, making it cost effective (when using a willingness-to-pay threshold of $50,000). One-way sensitivity analysis revealed the following: (1) using mesh was a cost effective option, provided that the price of mesh was less than or equal to $5970; (2) mesh was cost effective when its use led to a hernia/bulge rate less than or equal to 7.25 percent; and (3) primary facial closure was cost effective when its use led to a hernia/bulge rate less than or equal to 4.75 percent. AB - CONCLUSION: The use of mesh when repairing the abdominal donor site during a pedicled or free TRAM flap breast reconstruction is cost effective compared with primary fascial closure alone. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201503000-00009 DO - https://dx.doi.org/10.1097/PRS.0000000000000957 PT - Journal Article PT - Review ID - 25719690 [pubmed] ID - 10.1097/PRS.0000000000000957 [doi] ID - 00006534-201503000-00009 [pii] PP - ppublish LG - English DP - 2015 Mar DC - 20150227 EZ - 2015/02/27 06:00 DA - 2015/06/13 06:00 DT - 2015/02/27 06:00 YR - 2015 ED - 20150611 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25719690 <97. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25719688 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Agarwal S AU - Kidwell KM AU - Kraft CT AU - Kozlow JH AU - Sabel MS AU - Chung KC AU - Momoh AO FA - Agarwal, Shailesh FA - Kidwell, Kelley M FA - Kraft, Casey T FA - Kozlow, Jeffrey H FA - Sabel, Michael S FA - Chung, Kevin C FA - Momoh, Adeyiza O IN - Agarwal, Shailesh. Ann Arbor, Mich. From the Section of Plastic Surgery, Department of Surgery, the Section of Surgical Oncology, Department of Surgery, University of Michigan Medical School; and the Department of Biostatistics, School of Public Health, University of Michigan. TI - Defining the relationship between patient decisions to undergo breast reconstruction and contralateral prophylactic mastectomy. SO - Plastic & Reconstructive Surgery. 135(3):661-70, 2015 Mar AS - Plast Reconstr Surg. 135(3):661-70, 2015 Mar NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822506 OI - Source: NLM. NIHMS773268 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - Female MH - Follow-Up Studies MH - Humans MH - *Mammaplasty/mt [Methods] MH - Mammaplasty/px [Psychology] MH - *Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Middle Aged MH - *Patient Compliance/px [Psychology] MH - *Patient Education as Topic MH - Prognosis MH - *Registries MH - Retrospective Studies MH - Surveys and Questionnaires MH - United States MH - Young Adult AB - BACKGROUND: Recent studies suggest that the decisions to undergo breast reconstruction and contralateral prophylactic mastectomy are closely related. In this article, the relationship between method of reconstruction and decision to undergo contralateral prophylactic mastectomy is described. Recent trends in contralateral use in the context of literature questioning its oncologic benefit are also evaluated. AB - METHODS: Female patients with unilateral breast cancer were identified and data extracted from the Surveillance, Epidemiology, and End Results database from 2000 through 2010. Logistic regression analyses were performed to study the relationship between having contralateral prophylactic mastectomy and key demographic, oncologic, and reconstructive factors among women with unilateral breast cancer. AB - RESULTS: A total of 157,042 patients with unilateral breast cancer were included. The contralateral prophylactic mastectomy rate increased from 7.7 percent to 28.3 percent during the study period, and the proportion of reconstructed patients who underwent contralateral prophylactic mastectomy increased from 19 percent to 46 percent. Reconstruction was associated with higher odds of contralateral prophylactic mastectomy (OR, 2.79; 95 percent CI, 2.70 to 2.88; p < 0.0001). Among women who had reconstruction, implant-based reconstruction was associated with significantly higher odds of contralateral prophylactic mastectomy than autologous tissue reconstruction (OR, 1.38; p < 0.0001). AB - CONCLUSIONS: This study confirms that reconstruction and the decision to undergo contralateral prophylactic mastectomy are closely related, with implant reconstruction dominating in these patients. Given the close relationship between reconstruction and the choice for contralateral prophylactic mastectomy, plastic surgeons should play an active role in educating patients to avoid decisions made based on inaccurate information. AB - CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201503000-00003 DO - https://dx.doi.org/10.1097/PRS.0000000000001044 PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 25719688 [pubmed] ID - 10.1097/PRS.0000000000001044 [doi] ID - 00006534-201503000-00003 [pii] ID - PMC4822506 [pmc] ID - NIHMS773268 [mid] PP - ppublish GI - No: K24 AR053120 Organization: (AR) *NIAMS NIH HHS* Country: United States LG - English DP - 2015 Mar DC - 20150227 EZ - 2015/02/27 06:00 DA - 2015/06/13 06:00 DT - 2015/02/27 06:00 YR - 2015 ED - 20150611 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25719688 <98. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25811560 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Krishnan NM AU - Purnell C AU - Nahabedian MY AU - Freed GL AU - Nigriny JF AU - Rosen JM AU - Rosson GD FA - Krishnan, Naveen M FA - Purnell, Chad FA - Nahabedian, Maurice Y FA - Freed, Gary L FA - Nigriny, John F FA - Rosen, Joseph M FA - Rosson, Gedge D IN - Krishnan, Naveen M. Hannover and Lebanon, N.H.; Chicago, Ill.; Washington, D.C.; and Baltimore, Md. From the Geisel School of Medicine at Dartmouth; the Division of Plastic Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center; the Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine; the Department of Plastic Surgery, Georgetown Hospital; and the Department of Plastic Surgery, Johns Hopkins University School of Medicine. TI - The cost effectiveness of the DIEP flap relative to the muscle-sparing TRAM flap in postmastectomy breast reconstruction. [Review] SO - Plastic & Reconstructive Surgery. 135(4):948-58, 2015 Apr AS - Plast Reconstr Surg. 135(4):948-58, 2015 Apr NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Cost-Benefit Analysis MH - Female MH - Humans MH - *Mammaplasty/ec [Economics] MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Perforator Flap/ec [Economics] MH - *Surgical Flaps/ec [Economics] AB - BACKGROUND: The deep inferior epigastric perforator (DIEP) flap has gained notoriety because of its proposed benefit in decreasing donor-site morbidity but has been associated with longer operative times, higher perfusion-related complications, and increased cost relative to muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flaps. The authors performed the first cost-utility analysis examining the cost effectiveness of DIEP flaps relative to muscle-sparing free TRAM flaps in women who underwent mastectomy. AB - METHODS: A comprehensive literature review was conducted using the MED- LINE, Embase, and Cochrane library databases to include studies directly comparing DIEP to muscle-sparing free TRAM flaps in matched patient cohorts. Eight studies were included, examining 740 DIEP flaps and 807 muscle-sparing free TRAM flaps. Costs were derived adopting both societal and third-party payer perspectives. Utilities were derived from a previous cost-utility analysis. Probabilities of clinically relevant complications were combined with cost and utility estimates to fit into a decision tree analysis. AB - RESULTS: The overall complication rates were 24.7 percent and 21.8 percent for DIEP and muscle-sparing free TRAM flaps, respectively. The authors' baseline analysis using Medicare reimbursement revealed a cost decrease of $69.42 and a clinical benefit of 0.0035 quality-adjusted life-year when performing DIEP flap surgery relative to muscle-sparing free TRAM flap surgery, yielding an incremental cost-utility ratio of -$19,834.29. When using societal costs, the incremental cost-utility ratio increased to $87,800. AB - CONCLUSION: DIEP flaps are cost effective relative to muscle-sparing free TRAM flaps when patients are carefully selected based on perforator anatomy and surgery is performed by experienced surgeons. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201504000-00003 DO - https://dx.doi.org/10.1097/PRS.0000000000001125 PT - Comparative Study PT - Journal Article PT - Review ID - 25811560 [pubmed] ID - 10.1097/PRS.0000000000001125 [doi] ID - 00006534-201504000-00003 [pii] PP - ppublish LG - English DP - 2015 Apr DC - 20150327 EZ - 2015/03/27 06:00 DA - 2015/06/02 06:00 DT - 2015/03/27 06:00 YR - 2015 ED - 20150601 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25811560 <99. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25517410 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Offodile AC 2nd AU - Chatterjee A AU - Vallejo S AU - Fisher CS AU - Tchou JC AU - Guo L FA - Offodile, Anaeze C 2nd FA - Chatterjee, Abhishek FA - Vallejo, Sergio FA - Fisher, Carla S FA - Tchou, Julia C FA - Guo, Lifei IN - Offodile, Anaeze C 2nd. Burlington, Mass.; and Philadelphia, Pa. From the Department of Plastic Surgery, Lahey Hospital and Medical Center; and the Divisions of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania. TI - A cost-utility analysis of the use of preoperative computed tomographic angiography in abdomen-based perforator flap breast reconstruction. [Review][Erratum appears in Plast Reconstr Surg. 2015 Sep;136(3):626] SO - Plastic & Reconstructive Surgery. 135(4):662e-9e, 2015 Apr AS - Plast Reconstr Surg. 135(4):662e-9e, 2015 Apr NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Abdomen MH - *Angiography/ec [Economics] MH - *Angiography/mt [Methods] MH - *Cost-Benefit Analysis MH - Decision Support Techniques MH - Humans MH - *Mammaplasty/ec [Economics] MH - *Perforator Flap/ec [Economics] MH - *Preoperative Care/ec [Economics] MH - *Tomography, X-Ray Computed/ec [Economics] MH - *Ultrasonography, Doppler/ec [Economics] AB - BACKGROUND: Computed tomographic angiography is a diagnostic tool increasingly used for preoperative vascular mapping in abdomen-based perforator flap breast reconstruction. This study compared the use of computed tomographic angiography and the conventional practice of Doppler ultrasonography only in postmastectomy reconstruction using a cost-utility model. AB - METHODS: Following a comprehensive literature review, a decision analytic model was created using the three most clinically relevant health outcomes in free autologous breast reconstruction with computed tomographic angiography versus Doppler ultrasonography only. Cost and utility estimates for each health outcome were used to derive the quality-adjusted life-years and incremental cost-utility ratio. One-way sensitivity analysis was performed to scrutinize the robustness of the authors' results. AB - RESULTS: Six studies and 782 patients were identified. Cost-utility analysis revealed a baseline cost savings of $3179, a gain in quality-adjusted life-years of 0.25. This yielded an incremental cost-utility ratio of -$12,716, implying a dominant choice favoring preoperative computed tomographic angiography. Sensitivity analysis revealed that computed tomographic angiography was costlier when the operative time difference between the two techniques was less than 21.3 minutes. However, the clinical advantage of computed tomographic angiography over Doppler ultrasonography only showed that computed tomographic angiography would still remain the cost-effective option even if it offered no additional operating time advantage. AB - CONCLUSIONS: The authors' results show that computed tomographic angiography is a cost-effective technology for identifying lower abdominal perforators for autologous breast reconstruction. Although the perfect study would be a randomized controlled trial of the two approaches with true cost accrual, the authors' results represent the best available evidence. ES - 1529-4242 IL - 0032-1052 DO - https://dx.doi.org/10.1097/PRS.0000000000001133 PT - Comparative Study PT - Evaluation Studies PT - Journal Article PT - Review ID - 25517410 [pubmed] ID - 10.1097/PRS.0000000000001133 [doi] PP - ppublish LG - English DP - 2015 Apr DC - 20150327 EZ - 2014/12/18 06:00 DA - 2015/06/02 06:00 DT - 2014/12/18 06:00 YR - 2015 ED - 20150601 RD - 20151103 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25517410 <100. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25590246 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Konneker S AU - Vogt PM AU - Jokuszies A FA - Konneker, Soren FA - Vogt, Peter M FA - Jokuszies, Andreas IN - Konneker, Soren. Department of Plastic Hand and Reconstructive Surgery Hannover Medical School Hannover, Germany. TI - A classification system for fat necrosis in autologous breast reconstruction. CM - Comment on: Ann Plast Surg. 2013 May;70(5):553-6; PMID: 23542852 SO - Annals of Plastic Surgery. 74(2):269, 2015 Feb AS - Ann Plast Surg. 74(2):269, 2015 Feb NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - *Decision Support Techniques MH - *Fat Necrosis/cl [Classification] MH - Female MH - Humans MH - *Mammaplasty MH - *Postoperative Complications/cl [Classification] ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/01.sap.0000460803.22412.44 PT - Comment PT - Letter ID - 25590246 [pubmed] ID - 10.1097/01.sap.0000460803.22412.44 [doi] PP - ppublish LG - English DP - 2015 Feb DC - 20150116 EZ - 2015/01/16 06:00 DA - 2015/05/20 06:00 DT - 2015/01/16 06:00 YR - 2015 ED - 20150519 RD - 20150116 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25590246 <101. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24325874 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Nguyen F AU - Moumjid N AU - Charles C AU - Gafni A AU - Whelan T AU - Carrere MO FA - Nguyen, Florence FA - Moumjid, Nora FA - Charles, Cathy FA - Gafni, Amiram FA - Whelan, Tim FA - Carrere, Marie-Odile IN - Nguyen, Florence. Lyon University, F-69622 Lyon, France; Lyon 1 University, Villeurbanne, France; CNRS, UMR5824, Groupe d'Analyse et de Theorie Economique Lyon Saint-Etienne, France; Centre Leon Berard, F-69008 Lyon, France. IN - Moumjid, Nora. Lyon University, F-69622 Lyon, France; Lyon 1 University, Villeurbanne, France; CNRS, UMR5824, Groupe d'Analyse et de Theorie Economique Lyon Saint-Etienne, France; Centre Leon Berard, F-69008 Lyon, France. Electronic address: nora.moumjid@univ-lyon1.fr. IN - Charles, Cathy. CHEPA (Center for Health Economics and Policy Analysis), Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. IN - Gafni, Amiram. CHEPA (Center for Health Economics and Policy Analysis), Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. IN - Whelan, Tim. Juravinski Cancer Centre, Hamilton, Ontario, Canada. IN - Carrere, Marie-Odile. Lyon University, F-69622 Lyon, France; Lyon 1 University, Villeurbanne, France; CNRS, UMR5824, Groupe d'Analyse et de Theorie Economique Lyon Saint-Etienne, France; Centre Leon Berard, F-69008 Lyon, France. TI - Treatment decision-making in the medical encounter: comparing the attitudes of French surgeons and their patients in breast cancer care. SO - Patient Education & Counseling. 94(2):230-7, 2014 Feb AS - Patient Educ Couns. 94(2):230-7, 2014 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - *Attitude of Health Personnel MH - *Breast Neoplasms/su [Surgery] MH - Cross-Sectional Studies MH - *Decision Making MH - Female MH - Health Care Surveys MH - Humans MH - Middle Aged MH - *Patient Participation MH - Patient Preference MH - *Patient Satisfaction MH - *Physician-Patient Relations MH - *Surgeons/px [Psychology] MH - Surveys and Questionnaires KW - Breast cancer; Medical encounter; Patient participation; Treatment decision-making AB - OBJECTIVES: To explore attitudes of French surgeons and their patients towards treatment decision-making (TDM) in the medical encounter. AB - METHODS: Surgeons involved in early stage breast cancer and their patients treated in a French cancer care network received a cross-sectional survey questionnaire containing examples of four different approaches to TDM: paternalistic, "some sharing", informed TDM and, shared TDM. AB - RESULTS: Surgeons' interaction styles were clearly distributed among paternalistic, shared and mixed. The paternalistic approach seemed to be associated with private rather than public practice and with less professional experience. Patients reported a rather low level of participation in TDM, varying by socio-demographic characteristics. One third of patients were dissatisfied with the way their treatment decision had been made. AB - CONCLUSION: Most surgeons reported adopting the "some sharing" approach. However, one patient out of three reported that they would have liked to participate more in the TDM process. AB - PRACTICE IMPLICATIONS: Surgeons need to ask patients what their preferences for involvement in TDM are and then think about ways to accommodate both their own and patients' preferences regarding the TDM process to be used in each encounter. In addition, decision aids could be offered to surgeons to help them discuss treatment options with their patients. AB - Copyright © 2013 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(13)00287-5 DO - https://dx.doi.org/10.1016/j.pec.2013.07.011 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24325874 [pubmed] ID - S0738-3991(13)00287-5 [pii] ID - 10.1016/j.pec.2013.07.011 [doi] PP - ppublish PH - 2011/11/28 [received] PH - 2013/07/12 [revised] PH - 2013/07/18 [accepted] LG - English EP - 20131208 DP - 2014 Feb DC - 20140127 EZ - 2013/12/12 06:00 DA - 2015/05/16 06:00 DT - 2013/12/12 06:00 YR - 2014 ED - 20150515 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24325874 <102. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24316055 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lam WW AU - Kwok M AU - Chan M AU - Hung WK AU - Ying M AU - Or A AU - Kwong A AU - Suen D AU - Yoon S AU - Fielding R FA - Lam, Wendy W T FA - Kwok, Marie FA - Chan, Miranda FA - Hung, Wai Ka FA - Ying, Marcus FA - Or, Amy FA - Kwong, Ava FA - Suen, Dacita FA - Yoon, Sungwon FA - Fielding, Richard IN - Lam, Wendy W T. School of Public Health, The University of Hong Kong, Hong Kong. Electronic address: wwtlam@hku.hk. IN - Kwok, Marie. School of Public Health, The University of Hong Kong, Hong Kong. IN - Chan, Miranda. The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong. IN - Hung, Wai Ka. The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong. IN - Ying, Marcus. The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong. IN - Or, Amy. The Breast Centre, Department of Surgery, Kwong Wah Hospital, Hong Kong. IN - Kwong, Ava. Breast Surgery Division, Department of Surgery, The University of Hong Kong, Hong Kong. IN - Suen, Dacita. Breast Surgery Division, Department of Surgery, The University of Hong Kong, Hong Kong. IN - Yoon, Sungwon. School of Public Health, The University of Hong Kong, Hong Kong. IN - Fielding, Richard. School of Public Health, The University of Hong Kong, Hong Kong. TI - Does the use of shared decision-making consultation behaviors increase treatment decision-making satisfaction among Chinese women facing decision for breast cancer surgery?. SO - Patient Education & Counseling. 94(2):243-9, 2014 Feb AS - Patient Educ Couns. 94(2):243-9, 2014 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - *Asian Continental Ancestry Group/px [Psychology] MH - Breast Neoplasms/eh [Ethnology] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - China MH - *Decision Making MH - Female MH - Health Care Surveys MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - *Outcome and Process Assessment (Health Care) MH - *Patient Participation MH - *Patient Satisfaction/eh [Ethnology] MH - Personal Satisfaction MH - Physician-Patient Relations MH - Referral and Consultation MH - Surveys and Questionnaires MH - Tape Recording KW - Breast cancer; Breast surgical consultation; Chinese; Shared decision making AB - OBJECTIVE: To assess the extent to which breast surgical consultations used shared decision making (SDM), identify factors associated with use of SDM, and assess if using SDM increases decision-making satisfaction. AB - METHODS: Two hundred and eighty-three video-recorded diagnostic-treatment decision consultations between breast surgeons and women with breast cancer were assessed using the Decision Analysis System for Oncology (DAS-O) coding system designed for assessing SDM behaviors. Women completed a questionnaire at pre-consultation, one-week post-consultation and one-month post-surgery. Patient outcomes included decision conflict, patient satisfaction with medical consultation, and decision regret. AB - RESULTS: Overall, the level of SDM behaviors was low. The extent of SDM behavior within consultation was related to greater consultation duration (p<0.001), more than one treatment being offered (p<0.001), and fewer questions raised by patients/companions (p<0.05). While use of SDM consultation did not influence post-consultation decision conflict, it increased satisfaction with information given and explained, patients' feelings of trust and confidence in their surgeons, and reduced post-surgical decision regret. AB - CONCLUSION: These breast surgical consultations mostly adopted informed treatment decision-making approaches. Using SDM improved patient consultation and decision satisfaction. AB - PRACTICE IMPLICATIONS: The study findings highlight a need to reinforce the importance of SDM in consultations among breast surgeons. AB - Copyright © 2013 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(13)00505-3 DO - https://dx.doi.org/10.1016/j.pec.2013.11.006 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24316055 [pubmed] ID - S0738-3991(13)00505-3 [pii] ID - 10.1016/j.pec.2013.11.006 [doi] PP - ppublish PH - 2013/05/22 [received] PH - 2013/10/24 [revised] PH - 2013/11/19 [accepted] LG - English EP - 20131128 DP - 2014 Feb DC - 20140127 EZ - 2013/12/10 06:00 DA - 2015/05/16 06:00 DT - 2013/12/10 06:00 YR - 2014 ED - 20150515 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24316055 <103. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25870388 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Portschy PR AU - Kuntz KM AU - Tuttle TM FA - Portschy, Pamela R FA - Kuntz, Karen M FA - Tuttle, Todd M IN - Portschy, Pamela R. Department of Surgery, University of Minnesota (PRP, TMT);Department of Health Policy and Management, University of Minnesota (KMK). ports001@umn.edu. IN - Kuntz, Karen M. Department of Surgery, University of Minnesota (PRP, TMT);Department of Health Policy and Management, University of Minnesota (KMK). IN - Tuttle, Todd M. Department of Surgery, University of Minnesota (PRP, TMT);Department of Health Policy and Management, University of Minnesota (KMK). TI - Response. CM - Comment on: J Natl Cancer Inst. 2015 Apr;107(4). pii: djv092. doi: 10.1093/jnci/djv092; PMID: 25870387 CM - Comment on: J Natl Cancer Inst. 2014 Aug;106(8). pii: dju160. doi: 10.1093/jnci/dju160; PMID: 25031308 SO - Journal of the National Cancer Institute. 107(4), 2015 Apr AS - J Natl Cancer Inst. 107(4), 2015 Apr NJ - Journal of the National Cancer Institute PI - Journal available in: Print PI - Citation processed from: Internet JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - *Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - *Secondary Prevention/mt [Methods] ES - 1460-2105 IL - 0027-8874 DI - djv093 DO - https://dx.doi.org/10.1093/jnci/djv093 PT - Comment PT - Letter ID - 25870388 [pubmed] ID - djv093 [pii] ID - 10.1093/jnci/djv093 [doi] PP - ppublish LG - English DP - 2015 Apr DC - 20150414 EZ - 2015/04/15 06:00 DA - 2015/05/15 06:00 DT - 2015/04/15 06:00 YR - 2015 ED - 20150514 RD - 20150414 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25870388 <104. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25870387 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Narod SA FA - Narod, Steven A IN - Narod, Steven A. Familial Breast Cancer Research Unit, Women's College Research Institute steven.narod@wchospital.ca. TI - Re: Survival outcomes after contralateral prophylactic mastectomy: a decision analysis. CM - Comment in: J Natl Cancer Inst. 2015 Apr;107(4). pii: djv093. doi: 10.1093/jnci/djv093; PMID: 25870388 CM - Comment on: J Natl Cancer Inst. 2014 Aug;106(8). pii: dju160. doi: 10.1093/jnci/dju160; PMID: 25031308 SO - Journal of the National Cancer Institute. 107(4), 2015 Apr AS - J Natl Cancer Inst. 107(4), 2015 Apr NJ - Journal of the National Cancer Institute PI - Journal available in: Print PI - Citation processed from: Internet JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - *Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - *Secondary Prevention/mt [Methods] ES - 1460-2105 IL - 0027-8874 DI - djv092 DO - https://dx.doi.org/10.1093/jnci/djv092 PT - Comment PT - Letter ID - 25870387 [pubmed] ID - djv092 [pii] ID - 10.1093/jnci/djv092 [doi] PP - ppublish LG - English DP - 2015 Apr DC - 20150414 EZ - 2015/04/15 06:00 DA - 2015/05/15 06:00 DT - 2015/04/15 06:00 YR - 2015 ED - 20150514 RD - 20150414 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25870387 <105. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24966093 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Parvez E AU - Hodgson N AU - Cornacchi SD AU - Ramsaroop A AU - Gordon M AU - Farrokhyar F AU - Porter G AU - Quan ML AU - Wright F AU - Lovrics PJ FA - Parvez, Elena FA - Hodgson, Nicole FA - Cornacchi, Sylvie D FA - Ramsaroop, Amanda FA - Gordon, Maggie FA - Farrokhyar, Forough FA - Porter, Geoffrey FA - Quan, May Lynn FA - Wright, Francis FA - Lovrics, Peter J IN - Parvez, Elena. Department of Surgery, McMaster University, Hamilton, Ontario, Canada. TI - Survey of American and Canadian general surgeons' perceptions of margin status and practice patterns for breast conserving surgery. SO - Breast Journal. 20(5):481-8, 2014 Sep-Oct AS - Breast J. 20(5):481-8, 2014 Sep-Oct NJ - The breast journal PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - d1h, 9505539 IO - Breast J SB - Index Medicus CP - United States MH - *Attitude of Health Personnel MH - *Breast Neoplasms/su [Surgery] MH - Canada MH - Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Cross-Sectional Studies MH - Data Collection MH - Decision Support Techniques MH - Female MH - Humans MH - Male MH - *Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] MH - United States KW - breast conserving surgery; margin status; mastectomy; re-excision; surgical decision-making; survey AB - Although breast conservation surgery (BCS) is commonly performed, several aspects of the procedure remain controversial. We undertook a cross-sectional survey to compare Canadian (CDN) and American (AM) general surgeons' reported BCS practice patterns to better understand the cross-border differences in early-stage breast cancer surgery care. A modified Dillman Method survey was mailed to 1,447 AM and 1,443 CDN surgeons. Factors evaluated included preoperative assessment, margin definition, surgical techniques, and re-excision practices. The response rate was 26% and 51% for AM and CDN surgeons, respectively. There was variation in use of preoperative core biopsies. American surgeons required wider margins for invasive cancer and ductal carcinoma in situ, and more often recommend re-excision for invasive cancer with 1 and 2 mm margins (p < 0.05). There was also variability in surgical techniques used for intraoperative margin assessment. Wide variation in BCS practice was observed, with some of this variability related to surgeon country. AB - Copyright © 2014 Wiley Periodicals, Inc. ES - 1524-4741 IL - 1075-122X DO - https://dx.doi.org/10.1111/tbj.12299 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24966093 [pubmed] ID - 10.1111/tbj.12299 [doi] PP - ppublish LG - English EP - 20140626 DP - 2014 Sep-Oct DC - 20140904 EZ - 2014/06/27 06:00 DA - 2015/05/15 06:00 DT - 2014/06/27 06:00 YR - 2014 ED - 20150514 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24966093 <106. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25713152 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Portschy PR AU - Kuntz KM AU - Tuttle TM FA - Portschy, Pamela R FA - Kuntz, Karen M FA - Tuttle, Todd M TI - Response. CM - Comment on: J Natl Cancer Inst. 2015 Mar;107(3). doi: 10.1093/jnci/dju507; PMID: 25713151 CM - Comment on: J Natl Cancer Inst. 2014 Aug;106(8). pii: dju160. doi: 10.1093/jnci/dju160; PMID: 25031308 SO - Journal of the National Cancer Institute. 107(3), 2015 Mar AS - J Natl Cancer Inst. 107(3), 2015 Mar NJ - Journal of the National Cancer Institute PI - Journal available in: Print PI - Citation processed from: Internet JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - *Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - *Secondary Prevention/mt [Methods] ES - 1460-2105 IL - 0027-8874 DI - dju508 DO - https://dx.doi.org/10.1093/jnci/dju508 PT - Comment PT - Letter ID - 25713152 [pubmed] ID - dju508 [pii] ID - 10.1093/jnci/dju508 [doi] PP - ppublish LG - English DP - 2015 Mar DC - 20150307 EZ - 2015/02/26 06:00 DA - 2015/04/07 06:00 DT - 2015/02/26 06:00 YR - 2015 ED - 20150406 RD - 20150307 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25713152 <107. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25713151 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Narod SA FA - Narod, Steven A TI - Re: Survival outcomes after contralateral prophylactic mastectomy: a decision analysis. CM - Comment in: J Natl Cancer Inst. 2015 Mar;107(3). doi: 10.1093/jnci/dju508; PMID: 25713152 CM - Comment on: J Natl Cancer Inst. 2014 Aug;106(8). pii: dju160. doi: 10.1093/jnci/dju160; PMID: 25031308 SO - Journal of the National Cancer Institute. 107(3), 2015 Mar AS - J Natl Cancer Inst. 107(3), 2015 Mar NJ - Journal of the National Cancer Institute PI - Journal available in: Print PI - Citation processed from: Internet JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - *Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - *Secondary Prevention/mt [Methods] ES - 1460-2105 IL - 0027-8874 DI - dju507 DO - https://dx.doi.org/10.1093/jnci/dju507 PT - Comment PT - Letter ID - 25713151 [pubmed] ID - dju507 [pii] ID - 10.1093/jnci/dju507 [doi] PP - ppublish LG - English DP - 2015 Mar DC - 20150307 EZ - 2015/02/26 06:00 DA - 2015/04/07 06:00 DT - 2015/02/26 06:00 YR - 2015 ED - 20150406 RD - 20150307 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25713151 <108. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23384155 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Shaffer VA AU - Tomek S AU - Hulsey L FA - Shaffer, Victoria A FA - Tomek, Sara FA - Hulsey, Lukas IN - Shaffer, Victoria A. a Department of Health Sciences and Department of Psychological Sciences , University of Missouri. TI - The effect of narrative information in a publicly available patient decision aid for early-stage breast cancer. SO - Health Communication. 29(1):64-73, 2014 AS - Health Commun. 29(1):64-73, 2014 NJ - Health communication PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dr9, 8908762 IO - Health Commun SB - Index Medicus CP - England MH - Adult MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - Midwestern United States MH - *Narration MH - *Patient Preference MH - Video Recording MH - Young Adult AB - This study was designed to (1) evaluate the effect of narratives used in a popular, publicly available patient decision aid for early-stage breast cancer on hypothetical treatment decisions and attitudes toward the decision aid and (2) explore the moderating effects of participant numeracy, electronic health literacy and decision-making style. Two hundred women were asked to imagine that they had been diagnosed with early-stage breast cancer and viewed one of two versions of a video decision aid for early-stage breast cancer. The narrative version of the aid included stories from breast cancer survivors; the control version had no patient stories. After viewing the video decision aid, participants made a hypothetical treatment choice between lumpectomy with radiation and mastectomy, answered several questions about their decision, and evaluated the quality of the decision aid. Participants received $100 for completing the study. The two conditions differed in their motivations for the treatment decision and perceptions of the aid's trustworthiness and emotionality but showed no differences in preferences for surgical treatments or evaluations of the decision aid's quality. However, the impact of patient narratives was moderated by numeracy and electronic health literacy. Higher levels of numeracy were associated with decreased decisional confidence and lower ratings of trustworthiness for the decision aid in the narrative video condition but not in the control video condition. In contrast, higher levels of electronic health literacy were associated with increased decisional confidence and greater perceptions of trustworthiness and credibility of the decision aid in the narrative video condition but not the control video condition. ES - 1532-7027 IL - 1041-0236 DO - https://dx.doi.org/10.1080/10410236.2012.717341 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 23384155 [pubmed] ID - 10.1080/10410236.2012.717341 [doi] PP - ppublish LG - English EP - 20130205 DP - 2014 DC - 20131122 EZ - 2013/02/07 06:00 DA - 2015/04/04 06:00 DT - 2013/02/07 06:00 YR - 2014 ED - 20150402 RD - 20131122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23384155 <109. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25759620 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Rhiem K AU - Schmutzler R FA - Rhiem, Kerstin FA - Schmutzler, Rita IN - Rhiem, Kerstin. Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Germany. IN - Schmutzler, Rita. Center for Hereditary Breast and Ovarian Cancer, University Hospital Cologne, Germany. TI - Impact of Prophylactic Mastectomy in BRCA1/2 Mutation Carriers. [Review] SO - Breast Care. 9(6):385-9, 2014 Dec AS - Breast Care (Basel). 9(6):385-9, 2014 Dec NJ - Breast care (Basel, Switzerland) PI - Journal available in: Print PI - Citation processed from: Print JC - 101254060 IO - Breast Care (Basel) PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4317675 CP - Switzerland KW - BRCA1; BRCA2; High-risk genes; Prophylactic mastectomy AB - Unlike the general decrease in invasive oncologic care, the trend for prophylactic bilateral mastectomy in healthy women and prophylactic contralateral mastectomy in women with unilateral breast cancer is steadily rising. This is even more surprising when considering that for e.g. prophylactic contralateral mastectomy no clear survival benefit has been demonstrated so far. The decision-making process around risk-reducing surgery may be influenced by several conflicting parameters such as the patient's fears and desire to achieve a survival advantage, the surgeon's financial motivations, or the oncologist's paternalistic approach to the above trend. Physicians should support their patients throughout the decision-making process, guide them through the dense fog of information, and encourage them to reconsider all options and alternatives before embarking on an irreversible surgical intervention. Healthy and diseased women should be comprehensively informed about their absolute individual risks for cancer, the benefits and harms of the surgery, alternative preventive strategies, and last but not least the competing risks of preceding carcinomas and cancer in general. Within the framework of non-directive counseling in the specialized centers of the German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC), decision-making aids are being developed with grants from the Federal Ministry of Health and the German Cancer Aid to support women in making conclusive and satisfactory decisions. IS - 1661-3791 IL - 1661-3791 DI - brc-0009-0385 DO - https://dx.doi.org/10.1159/000369592 PT - Journal Article PT - Review ID - 25759620 [pubmed] ID - 10.1159/000369592 [doi] ID - brc-0009-0385 [pii] ID - PMC4317675 [pmc] PP - ppublish LG - English DP - 2014 Dec DC - 20150311 EZ - 2015/03/12 06:00 DA - 2015/03/12 06:01 DT - 2015/03/12 06:00 YR - 2014 ED - 20150311 RD - 20151201 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=25759620 <110. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24991748 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sherman KA AU - Harcourt DM AU - Lam TC AU - Shaw LK AU - Boyages J FA - Sherman, Kerry A FA - Harcourt, Diana M FA - Lam, Thomas C FA - Shaw, Laura-Kate FA - Boyages, John IN - Sherman, Kerry A. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Sydney, Australia. TI - BRECONDA: development and acceptability of an interactive decisional support tool for women considering breast reconstruction. SO - Psycho-Oncology. 23(7):835-8, 2014 Jul AS - Psychooncology. 23(7):835-8, 2014 Jul NJ - Psycho-oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Adult MH - Australia MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/px [Psychology] MH - Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Choice Behavior MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mammaplasty MH - Middle Aged MH - Patient Acceptance of Health Care MH - Patient Participation KW - breast cancer; cancer; decision aid; oncology; reconstruction; surgery ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.3498 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24991748 [pubmed] ID - 10.1002/pon.3498 [doi] PP - ppublish PH - 2013/08/13 [received] PH - 2014/01/12 [revised] PH - 2014/01/15 [accepted] LG - English EP - 20140206 DP - 2014 Jul DC - 20140704 EZ - 2014/07/04 06:00 DA - 2015/02/27 06:00 DT - 2014/07/06 06:00 YR - 2014 ED - 20150226 RD - 20140704 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24991748 <111. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25678823 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Davies KR AU - Cantor SB AU - Brewster AM FA - Davies, Kalatu R FA - Cantor, Scott B FA - Brewster, Abenaa M IN - Davies, Kalatu R. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Cantor, Scott B. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Brewster, Abenaa M. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. TI - Better contralateral breast cancer risk estimation and alternative options to contralateral prophylactic mastectomy. [Review] SO - International Journal of Women's Health. 7:181-7, 2015 AS - Int J Women Health. 7:181-7, 2015 NJ - International journal of women's health PI - Journal available in: Electronic-eCollection PI - Citation processed from: Print JC - 101531698 IO - Int J Womens Health PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324540 CP - New Zealand KW - contralateral breast cancer; contralateral prophylactic mastectomy; endocrine therapy; risk assessment; sporadic breast cancer AB - The incidence of contralateral prophylactic mastectomy (CPM) has increased among women with breast cancer, despite uncertain survival benefit and a declining incidence of contralateral breast cancer (CBC). Patient-related reasons for undergoing CPM include an overestimation of the risk of CBC, increased cancer worry, and a desire to improve survival. We summarize the existing literature on CBC risk and outcomes and the clinical benefit of CPM among women with unilateral breast cancer who have a low-to-moderate risk of developing a secondary cancer in the contralateral breast. Published studies were retrieved from the MEDLINE database with the keywords "contralateral breast cancer" and "contralateral prophylactic mastectomy". These include observational studies, clinical trials, survival analyses, and decision models examining the risk of CBC, the clinical and psychosocial effects of CPM, and other treatment strategies to reduce CBC risk. Studies that have evaluated CBC risk estimate it to be approximately 0.5% annually on average. Patient-related factors associated with an increased risk of CBC include carriers of BRCA1/2 mutations, young age at breast cancer, and strong family history of breast cancer in the absence of a BRCA1/2 mutation. Although CPM reduces the risk of CBC by approximately 94%, it may not provide a significant gain in overall survival and there is conflicting evidence that it improves disease-free survival among women with breast cancer regardless of estrogen receptor (ER) status. Therefore, alternative strategies such as the use of tamoxifen or aromatase inhibitors, which reduce the risk of CBC by approximately 50%, should be encouraged for eligible women with ER-positive breast cancers. Future research is needed to evaluate the impact of decision and educational tools that can be used for personalized counseling of patients regarding their CBC risk, the uncertain role of CPM, and alternative CBC risk reduction strategies. IL - 1179-1411 DI - ijwh-7-181 DO - https://dx.doi.org/10.2147/IJWH.S52380 PT - Journal Article PT - Review ID - 25678823 [pubmed] ID - 10.2147/IJWH.S52380 [doi] ID - ijwh-7-181 [pii] ID - PMC4324540 [pmc] PP - epublish GI - No: R21 CA149803 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20150204 DP - 2015 DC - 20150214 EZ - 2015/02/14 06:00 DA - 2015/02/14 06:01 DT - 2015/02/14 06:00 YR - 2015 ED - 20150214 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=25678823 <112. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24460266 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Abdullah A AU - Abdullah KL AU - Yip CH AU - Teo SH AU - Taib NA AU - Ng CJ FA - Abdullah, Adina FA - Abdullah, Khatijah Lim FA - Yip, Cheng Har FA - Teo, Soo-Hwang FA - Taib, Nur Aishah FA - Ng, Chirk Jenn IN - Abdullah, Adina. Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail : adina@ummc.edu.my. TI - The decision-making journey of malaysian women with early breast cancer: a qualitative study. SO - Asian Pacific Journal of Cancer Prevention: Apjcp. 14(12):7143-7, 2013 AS - Asian Pac J Cancer Prev. 14(12):7143-7, 2013 NJ - Asian Pacific journal of cancer prevention : APJCP PI - Journal available in: Print PI - Citation processed from: Internet JC - 101130625 IO - Asian Pac. J. Cancer Prev. SB - Index Medicus CP - Thailand MH - Adult MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Complementary Therapies MH - *Decision Making MH - Family MH - Female MH - Follow-Up Studies MH - Humans MH - Malaysia MH - Middle Aged MH - *Patient Participation MH - Prognosis MH - *Qualitative Research MH - Survivors MH - Women's Health AB - BACKGROUND: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. AB - OBJECTIVE: This study aimed to explore the decision making experiences of women with early breast cancer. AB - MATERIALS AND METHODS: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. AB - RESULTS: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. AB - CONCLUSIONS: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding. IS - 1513-7368 IL - 1513-7368 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24460266 [pubmed] PP - ppublish LG - English DP - 2013 DC - 20140127 EZ - 2014/01/28 06:00 DA - 2015/01/07 06:00 DT - 2014/01/28 06:00 YR - 2013 ED - 20150106 RD - 20140127 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24460266 <113. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24460266 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Abdullah A AU - Abdullah KL AU - Yip CH AU - Teo SH AU - Taib NA AU - Ng CJ FA - Abdullah, Adina FA - Abdullah, Khatijah Lim FA - Yip, Cheng Har FA - Teo, Soo-Hwang FA - Taib, Nur Aishah FA - Ng, Chirk Jenn IN - Abdullah, Adina. Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail : adina@ummc.edu.my. TI - The decision-making journey of malaysian women with early breast cancer: a qualitative study. SO - Asian Pacific Journal of Cancer Prevention: Apjcp. 14(12):7143-7, 2013 AS - Asian Pac J Cancer Prev. 14(12):7143-7, 2013 NJ - Asian Pacific journal of cancer prevention : APJCP PI - Journal available in: Print PI - Citation processed from: Internet JC - 101130625 IO - Asian Pac. J. Cancer Prev. SB - Index Medicus CP - Thailand MH - Adult MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Complementary Therapies MH - *Decision Making MH - Family MH - Female MH - Follow-Up Studies MH - Humans MH - Malaysia MH - Middle Aged MH - *Patient Participation MH - Prognosis MH - *Qualitative Research MH - Survivors MH - Women's Health AB - BACKGROUND: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy. AB - OBJECTIVE: This study aimed to explore the decision making experiences of women with early breast cancer. AB - MATERIALS AND METHODS: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach. AB - RESULTS: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves. AB - CONCLUSIONS: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding. ES - 2476-762X IL - 1513-7368 PT - Journal Article PT - Research Support, Non-U.S. Gov't PP - ppublish LG - English DP - 2013 DC - 20140127 EZ - 2014/01/28 06:00 DA - 2015/01/07 06:00 DT - 2014/01/28 06:00 YR - 2013 ED - 20150106 RD - 20170308 UP - 20170310 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=24460266 <114. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24695044 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Janes H AU - Brown MD AU - Huang Y AU - Pepe MS FA - Janes, Holly FA - Brown, Marshall D FA - Huang, Ying FA - Pepe, Margaret S TI - An approach to evaluating and comparing biomarkers for patient treatment selection. SO - The International Journal of Biostatistics. 10(1):99-121, 2014 AS - Int J Biostat. 10(1):99-121, 2014 NJ - The international journal of biostatistics PI - Journal available in: Print PI - Citation processed from: Internet JC - 101313850 IO - Int J Biostat PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341986 OI - Source: NLM. NIHMS663213 SB - Index Medicus CP - Germany MH - *Biomarkers, Tumor/an [Analysis] MH - Breast Neoplasms/dt [Drug Therapy] MH - Chemotherapy, Adjuvant/ae [Adverse Effects] MH - *Data Interpretation, Statistical MH - Female MH - Humans MH - Software AB - Despite the heightened interest in developing biomarkers predicting treatment response that are used to optimize patient treatment decisions, there has been relatively little development of statistical methodology to evaluate these markers. There is currently no unified statistical framework for marker evaluation. This paper proposes a suite of descriptive and inferential methods designed to evaluate individual markers and to compare candidate markers. An R software package has been developed which implements these methods. Their utility is illustrated in the breast cancer treatment context, where candidate markers are evaluated for their ability to identify a subset of women who do not benefit from adjuvant chemotherapy and can therefore avoid its toxicity. RN - 0 (Biomarkers, Tumor) ES - 1557-4679 IL - 1557-4679 DI - /j/ijb.2014.10.issue-1/ijb-2012-0052/ijb-2012-0052.xml DI - /j/ijb.ahead-of-print/ijb-2012-0052/ijb-2012-0052.xml DO - https://dx.doi.org/10.1515/ijb-2012-0052 PT - Journal Article ID - 24695044 [pubmed] ID - 10.1515/ijb-2012-0052 [doi] ID - /j/ijb.ahead-of-print/ijb-2012-0052/ijb-2012-0052.xml [pii] ID - PMC4341986 [pmc] ID - NIHMS663213 [mid] PP - ppublish GI - No: P01 CA053996 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA152089 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 GM054438 Organization: (GM) *NIGMS NIH HHS* Country: United States LG - English DP - 2014 DC - 20140520 EZ - 2014/04/04 06:00 DA - 2015/01/06 06:00 DT - 2014/04/04 06:00 YR - 2014 ED - 20150105 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24695044 <115. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24271037 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Underhill ML AU - Crotser CB FA - Underhill, Meghan L FA - Crotser, Cheryl B IN - Underhill, Meghan L. The Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, 450 Brookline Avenue, L522, Boston, MA, 02115, USA, meghanl_underhill@dfci.harvard.edu. TI - Seeking balance: decision support needs of women without cancer and a deleterious BRCA1 or BRCA2 mutation. SO - Journal of Genetic Counseling. 23(3):350-62, 2014 Jun AS - J Genet Couns. 23(3):350-62, 2014 Jun NJ - Journal of genetic counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9206865 IO - J Genet Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138835 OI - Source: NLM. NIHMS614397 SB - Index Medicus CP - United States MH - *Decision Making MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Humans MH - *Mutation MH - Neoplasms/ge [Genetics] MH - *Neoplasms/px [Psychology] AB - Recommendations for women with a deleterious BRCA1 or BRCA2 gene mutation include complex medical approaches related to cancer risk reduction and detection. Current science has not yet fully elucidated decision support needs that women face when living with medical consequences associated with known hereditary cancer risk. The purpose of this study was to describe health communication and decision support needs in healthy women with BRCA1/2 gene mutations. The original researchers completed an interpretive secondary qualitative data analysis of 23 phenomenological narratives collected between 2008 and 2010. The Ottawa Decision Support and Patient Centered Communication frameworks guided the study design and analysis. Women described a pattern wherein breast and ovarian cancer risk, health related recommendations and decisions, and personal values were prioritized over time based on life contexts. Knowing versus acting on cancer risk was not a static process but an ongoing balancing act of considering current and future personal and medical values, further compounded by the complexity of recommendations. Women shared stories of anticipatory, physical and psychosocial consequences of the decision making experience. The findings have potential to generate future research questions and guide intervention development. Importantly, findings indicate a need for ongoing, long-term, support from genetics professionals and decision support interventions, which challenges the current practice paradigm. ES - 1573-3599 IL - 1059-7700 DO - https://dx.doi.org/10.1007/s10897-013-9667-2 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 24271037 [pubmed] ID - 10.1007/s10897-013-9667-2 [doi] ID - PMC4138835 [pmc] ID - NIHMS614397 [mid] PP - ppublish PH - 2013/02/11 [received] PH - 2013/10/30 [accepted] GI - No: U54 CA156732 Organization: (CA) *NCI NIH HHS* Country: United States No: NCIU54CA156732 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20131122 DP - 2014 Jun DC - 20140519 EZ - 2013/11/26 06:00 DA - 2015/01/03 06:00 DT - 2013/11/26 06:00 YR - 2014 ED - 20150102 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24271037 <116. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24321102 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Yamauchi H AU - Nakagawa C AU - Takei H AU - Chao C AU - Yoshizawa C AU - Yagata H AU - Yoshida A AU - Hayashi N AU - Hell S AU - Nakamura S FA - Yamauchi, Hideko FA - Nakagawa, Chizuko FA - Takei, Hiroyuki FA - Chao, Calvin FA - Yoshizawa, Carl FA - Yagata, Hiroshi FA - Yoshida, Atsushi FA - Hayashi, Naoki FA - Hell, Susanne FA - Nakamura, Seigo IN - Yamauchi, Hideko. St Luke's International Hospital, Department of Breast Surgery, Tokyo, Japan. Electronic address: hideyama@luke.or.jp. IN - Nakagawa, Chizuko. St Luke's International Hospital, Department of Breast Surgery, Tokyo, Japan. IN - Takei, Hiroyuki. Saitama Cancer Center, Division of Breast Surgery, Saitama, Japan. IN - Chao, Calvin. Genomic Health, Inc, Redwood City, CA. IN - Yoshizawa, Carl. Genomic Health, Inc, Redwood City, CA. IN - Yagata, Hiroshi. St Luke's International Hospital, Department of Breast Surgery, Tokyo, Japan. IN - Yoshida, Atsushi. St Luke's International Hospital, Department of Breast Surgery, Tokyo, Japan. IN - Hayashi, Naoki. St Luke's International Hospital, Department of Breast Surgery, Tokyo, Japan. IN - Hell, Susanne. Medical Affairs Consulting, Speyer, Germany. IN - Nakamura, Seigo. St Luke's International Hospital, Department of Breast Surgery, Tokyo, Japan; Department of Breast Surgery, Showa University, Tokyo, Japan. TI - Prospective study of the effect of the 21-gene assay on adjuvant clinical decision-making in Japanese women with estrogen receptor-positive, node-negative, and node-positive breast cancer. SO - Clinical Breast Cancer. 14(3):191-7, 2014 Jun AS - Clin Breast Cancer. 14(3):191-7, 2014 Jun NJ - Clinical breast cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100898731 IO - Clin. Breast Cancer SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Asian Continental Ancestry Group MH - *Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pa [Pathology] MH - Chemotherapy, Adjuvant MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Gene Expression Profiling MH - Humans MH - Lymphatic Metastasis MH - Middle Aged MH - Receptors, Estrogen/ge [Genetics] KW - Adjuvant; Chemotherapy; Early breast cancer; Multi-gene assay; Recurrence Score AB - BACKGROUND: In this study we investigated if the 21-gene assay result affects adjuvant decision-making in Japanese women with ER+ invasive EBC. AB - PATIENTS AND METHODS: A total of 124 consecutive eligible patients with ER+, HER2-negative EBC and 0 to 3 positive lymph nodes were enrolled. Treatment recommendations, physicians' confidence and patients' decisional conflict before and after knowledge of the Recurrence Score results of the 21-gene assay were recorded. AB - RESULTS: One-hundred four patients (84%) had N0 disease, including micrometastases, and 20 (16%) had N+ disease. Overall, recommendations changed in 33% (95% CI, 24%-43%) of N0 and 65% (95% CI, 41%-85%) of N+ patients. In 27 of 48 (56%) of N0 and 13 of 15 (87%) of N+ patients an initial recommendation for chemohormonal therapy was revised to only hormonal therapy after assay results, and in 7 of 56 (13%) of N0 and 0 of 5 N+ patients from only hormonal to combined chemohormonal therapy. Decisions appeared to follow the Recurrence Score results for low and high values. For patients with intermediate Recurrence Score values, overall recommendations for chemohormonal treatment tended to decrease after assay results. Physicians' confidence increased in 106 of 124 (85.5%; 95% CI, 78%-91%) cases. Patients' decisional conflict significantly improved as indicated by changes in the total score and the 5 defined subscores (P = .014 for Informed Subscore; P < .001 for all others). AB - CONCLUSION: Results from this prospective study in a Japanese population confirm an effect of the 21-gene assay results on adjuvant treatment decision-making, consistent with reported experiences from the United States and Europe. AB - Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved. RN - 0 (Receptors, Estrogen) ES - 1938-0666 IL - 1526-8209 DI - S1526-8209(13)00254-1 DO - https://dx.doi.org/10.1016/j.clbc.2013.10.017 PT - Journal Article PT - Multicenter Study ID - 24321102 [pubmed] ID - S1526-8209(13)00254-1 [pii] ID - 10.1016/j.clbc.2013.10.017 [doi] PP - ppublish PH - 2013/06/29 [received] PH - 2013/10/01 [revised] PH - 2013/10/23 [accepted] LG - English EP - 20131026 DP - 2014 Jun DC - 20140509 EZ - 2013/12/11 06:00 DA - 2015/01/01 06:00 DT - 2013/12/11 06:00 YR - 2014 ED - 20141231 RD - 20140509 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24321102 <117. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25357022 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sun CS AU - Cantor SB AU - Reece GP AU - Fingeret MC AU - Crosby MA AU - Markey MK FA - Sun, Clement S FA - Cantor, Scott B FA - Reece, Gregory P FA - Fingeret, Michelle C FA - Crosby, Melissa A FA - Markey, Mia K IN - Sun, Clement S. Austin, Texas From the Department of Biomedical Engineering, The University of Texas at Austin; and the Departments of Plastic Surgery, Behavioral Science, Health Services Research, and Imaging Physics, The University of Texas M. D. Anderson Cancer Center. TI - Helping patients make choices about breast reconstruction: a decision analysis approach. SO - Plastic & Reconstructive Surgery. 134(4):597-608, 2014 Oct AS - Plast Reconstr Surg. 134(4):597-608, 2014 Oct NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217136 OI - Source: NLM. NIHMS600333 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mammaplasty AB - Decision analysis can help breast reconstruction patients and their surgeons to methodically evaluate clinical alternatives and make hard decisions. The purpose of this article is to help plastic surgeons guide patients in making decisions though a case study in breast reconstruction. By making good decisions, patient outcomes may be improved. This article aims to illustrate decision analysis techniques from the patient perspective, with an emphasis on her values and preferences. The authors introduce normative decision-making through a fictional breast reconstruction patient and systematically build the decision basis to help her make a good decision. The authors broadly identify alternatives of breast reconstruction, propose types of outcomes that the patient should consider, discuss sources of probabilistic information and outcome values, and demonstrate how to make a good decision. The concepts presented here may be extended to other shared decision-making problems in plastic and reconstructive surgery. In addition, the authors discuss how sensitivity analysis may test the robustness of the decision and how to evaluate the quality of decisions. The authors also present tools to help implement these concepts in practice. Finally, the authors examine limitations that hamper adoption of patient decision analysis in reconstructive surgery and health care in general. In particular, the authors emphasize the need for routine collection of quality-of-life information, out-of-pocket expense, and recovery time. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201410000-00006 DO - https://dx.doi.org/10.1097/PRS.0000000000000514 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 25357022 [pubmed] ID - 10.1097/PRS.0000000000000514 [doi] ID - 00006534-201410000-00006 [pii] ID - PMC4217136 [pmc] ID - NIHMS600333 [mid] PP - ppublish GI - No: R01 CA143190 Organization: (CA) *NCI NIH HHS* Country: United States No: R01CA143190 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2014 Oct DC - 20141031 EZ - 2014/10/31 06:00 DA - 2014/12/30 06:00 DT - 2014/10/31 06:00 YR - 2014 ED - 20141229 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25357022 <118. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23395006 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Banegas MP AU - McClure JB AU - Barlow WE AU - Ubel PA AU - Smith DM AU - Zikmund-Fisher BJ AU - Greene SM AU - Fagerlin A FA - Banegas, Matthew P FA - McClure, Jennifer B FA - Barlow, William E FA - Ubel, Peter A FA - Smith, Dylan M FA - Zikmund-Fisher, Brian J FA - Greene, Sarah M FA - Fagerlin, Angela IN - Banegas, Matthew P. University of Washington, Department of Health Services, Seattle, WA, USA. banegasmp@mail.nih.gov TI - Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer. SO - Patient Education & Counseling. 91(3):364-71, 2013 Jun AS - Patient Educ Couns. 91(3):364-71, 2013 Jun NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650477 OI - Source: NLM. NIHMS444469 SB - Nursing Journal CP - Ireland MH - Aged MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/px [Psychology] MH - Conflict (Psychology) MH - *Decision Support Techniques MH - Female MH - Humans MH - Internet MH - Michigan MH - Middle Aged MH - *Raloxifene Hydrochloride/tu [Therapeutic Use] MH - Risk Factors MH - *Tamoxifen/tu [Therapeutic Use] MH - Treatment Outcome AB - OBJECTIVE: To assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women's decisions about prophylactic tamoxifen and raloxifene use. AB - METHODS: Postmenopausal women, age 46-74, with BCRAT 5-year risk >= 1.66% and no prior history of breast cancer were randomized to one of three study arms:intervention (n=690), Time 1 control (n=160), or 3-month control (n=162). Intervention participants viewed GtD prior to completing a post-test and 3 month follow-up assessment. Controls did not. We assessed the impact of GtD on women's decisional conflict levels and treatment decision behavior at post-test and at 3 months, respectively. AB - RESULTS: Intervention participants had significantly lower decisional conflict levels at post-test (p<0.001) and significantly higher odds of making a decision about whether or not to take prophylactic tamoxifen or raloxifene at 3-month follow-up (p<0.001) compared to control participants. AB - CONCLUSION: GtD lowered decisional conflict and helped women at high risk of breast cancer decide whether to take prophylactic tamoxifen or raloxifene to reduce their cancer risk. AB - PRACTICE IMPLICATIONS: Web-based, tailored decision aids should be used more routinely to facilitate informed medical decisions, reduce patients' decisional conflict, and empower patients to choose the treatment strategy that best reflects their own values. AB - Copyright Published by Elsevier Ireland Ltd. RN - 094ZI81Y45 (Tamoxifen) RN - 4F86W47BR6 (Raloxifene Hydrochloride) ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(13)00007-4 DO - https://dx.doi.org/10.1016/j.pec.2012.12.014 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural ID - 23395006 [pubmed] ID - S0738-3991(13)00007-4 [pii] ID - 10.1016/j.pec.2012.12.014 [doi] ID - PMC3650477 [pmc] ID - NIHMS444469 [mid] PP - ppublish PH - 2012/02/14 [received] PH - 2012/11/22 [revised] PH - 2012/12/29 [accepted] SI - ClinicalTrials.gov SA - ClinicalTrials.gov/NCT00967824 SA - ClinicalTrials.gov/NCT00967824 SL - https://clinicaltrials.gov/search/term=NCT00967824 SL - https://clinicaltrials.gov/search/term=NCT00967824 GI - No: R25 CA092408 Organization: (CA) *NCI NIH HHS* Country: United States No: P50 CA101451 Organization: (CA) *NCI NIH HHS* Country: United States No: R25CA092408 Organization: (CA) *NCI NIH HHS* Country: United States No: 1U54CA153502-01 Organization: (CA) *NCI NIH HHS* Country: United States No: U54 CA132381 Organization: (CA) *NCI NIH HHS* Country: United States No: U54 CA153502 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20130208 DP - 2013 Jun DC - 20130503 EZ - 2013/02/12 06:00 DA - 2014/12/24 06:00 DT - 2013/02/12 06:00 YR - 2013 ED - 20141223 RD - 20161206 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23395006 <119. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23395006 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Banegas MP AU - McClure JB AU - Barlow WE AU - Ubel PA AU - Smith DM AU - Zikmund-Fisher BJ AU - Greene SM AU - Fagerlin A FA - Banegas, Matthew P FA - McClure, Jennifer B FA - Barlow, William E FA - Ubel, Peter A FA - Smith, Dylan M FA - Zikmund-Fisher, Brian J FA - Greene, Sarah M FA - Fagerlin, Angela IN - Banegas, Matthew P. University of Washington, Department of Health Services, Seattle, WA, USA. banegasmp@mail.nih.gov TI - Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer. SO - Patient Education & Counseling. 91(3):364-71, 2013 Jun AS - Patient Educ Couns. 91(3):364-71, 2013 Jun NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650477 OI - Source: NLM. NIHMS444469 SB - Nursing Journal CP - Ireland MH - Aged MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/px [Psychology] MH - Conflict (Psychology) MH - *Decision Support Techniques MH - Female MH - Humans MH - Internet MH - Michigan MH - Middle Aged MH - *Raloxifene Hydrochloride/tu [Therapeutic Use] MH - Risk Factors MH - *Tamoxifen/tu [Therapeutic Use] MH - Treatment Outcome AB - OBJECTIVE: To assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women's decisions about prophylactic tamoxifen and raloxifene use. AB - METHODS: Postmenopausal women, age 46-74, with BCRAT 5-year risk >= 1.66% and no prior history of breast cancer were randomized to one of three study arms:intervention (n=690), Time 1 control (n=160), or 3-month control (n=162). Intervention participants viewed GtD prior to completing a post-test and 3 month follow-up assessment. Controls did not. We assessed the impact of GtD on women's decisional conflict levels and treatment decision behavior at post-test and at 3 months, respectively. AB - RESULTS: Intervention participants had significantly lower decisional conflict levels at post-test (p<0.001) and significantly higher odds of making a decision about whether or not to take prophylactic tamoxifen or raloxifene at 3-month follow-up (p<0.001) compared to control participants. AB - CONCLUSION: GtD lowered decisional conflict and helped women at high risk of breast cancer decide whether to take prophylactic tamoxifen or raloxifene to reduce their cancer risk. AB - PRACTICE IMPLICATIONS: Web-based, tailored decision aids should be used more routinely to facilitate informed medical decisions, reduce patients' decisional conflict, and empower patients to choose the treatment strategy that best reflects their own values. AB - Copyright Published by Elsevier Ireland Ltd. RN - 094ZI81Y45 (Tamoxifen) RN - 4F86W47BR6 (Raloxifene Hydrochloride) ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(13)00007-4 DO - https://dx.doi.org/10.1016/j.pec.2012.12.014 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural ID - 23395006 [pubmed] ID - S0738-3991(13)00007-4 [pii] ID - 10.1016/j.pec.2012.12.014 [doi] ID - PMC3650477 [pmc] ID - NIHMS444469 [mid] PP - ppublish PH - 2012/02/14 [received] PH - 2012/11/22 [revised] PH - 2012/12/29 [accepted] SI - ClinicalTrials.gov SA - ClinicalTrials.gov/NCT00967824 SL - https://clinicaltrials.gov/search/term=NCT00967824 GI - No: R25 CA092408 Organization: (CA) *NCI NIH HHS* Country: United States No: P50 CA101451 Organization: (CA) *NCI NIH HHS* Country: United States No: R25CA092408 Organization: (CA) *NCI NIH HHS* Country: United States No: 1U54CA153502-01 Organization: (CA) *NCI NIH HHS* Country: United States No: U54 CA132381 Organization: (CA) *NCI NIH HHS* Country: United States No: U54 CA153502 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20130208 DP - 2013 Jun DC - 20130503 EZ - 2013/02/12 06:00 DA - 2014/12/24 06:00 DT - 2013/02/12 06:00 YR - 2013 ED - 20141223 RD - 20161215 UP - 20161222 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=23395006 <120. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24667879 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Nykiel M AU - Sayid Z AU - Wong R AU - Lee GK FA - Nykiel, Matthew FA - Sayid, Zahra FA - Wong, Ryan FA - Lee, Gordon K IN - Nykiel, Matthew. From the Division of Plastic Surgery, Stanford University, Stanford, CA. TI - Management of mastectomy skin flap necrosis in autologous breast reconstruction. SO - Annals of Plastic Surgery. 72 Suppl 1:S31-4, 2014 May AS - Ann Plast Surg. 72 Suppl 1:S31-4, 2014 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Adult MH - Algorithms MH - *Breast/pa [Pathology] MH - Breast/su [Surgery] MH - *Breast Neoplasms/su [Surgery] MH - Debridement MH - Decision Support Techniques MH - Female MH - *Free Tissue Flaps/tr [Transplantation] MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Mastectomy MH - Middle Aged MH - Necrosis/ep [Epidemiology] MH - Necrosis/et [Etiology] MH - Necrosis/su [Surgery] MH - Postoperative Complications/ep [Epidemiology] MH - *Postoperative Complications/su [Surgery] MH - Retrospective Studies MH - Skin Transplantation MH - Transplantation, Autologous MH - Treatment Outcome MH - Wound Closure Techniques AB - INTRODUCTION: Mastectomy skin flap necrosis is a significant problem in the autologous breast reconstruction. The necrosis may create unsightly scarring, produce contour irregularities, and deform the breast mound. This may lead to a poor reconstruction and patient satisfaction. Most importantly, the development and treatment of mastectomy skin flap necrosis can delay further oncologic treatment.We performed a retrospective chart review of all patients undergoing autologous breast reconstruction in the past 5 years to examine our incidence and treatment of mastectomy skin flap necrosis. We then used these data to create a management algorithm for mastectomy skin flap necrosis. The goals of this algorithm were as follows: (1) to not delay further oncologic treatment, (2) to expedite the healing time while minimizing patient risk, and (3) to create an aesthetically pleasing breast reconstruction. AB - MATERIALS AND METHODS: A retrospective chart review from 2008 to 2013 was performed of all autologous breast reconstruction at our institution. We then analyzed our data and patient outcomes and developed a treatment algorithm. AB - RESULTS: We identified 204 patients who underwent autologous free flap breast reconstruction that was performed by the senior author (G.K.L.). Our incidence of mastectomy skin necrosis was 30%. There was no delay in adjuvant oncologic treatment for any of our patients. The development of mastectomy skin necrosis was significant for patients with diabetes (P=0.03), current tobacco use (P=0.04), and body mass index (P=0.01). The time for wound healing was prolonged in patients with a high body mass index (P=0.04). Regression analysis of wound size showed full-thickness wounds greater than 6 cm benefited from operative closure. AB - CONCLUSIONS: Our incidence of mastectomy skin necrosis was 30%. Despite our high incidence mastectomy skin necrosis, we had no delays in adjuvant oncologic treatment. Retrospective data analysis allowed us to then develop a management algorithm for mastectomy skin necrosis. We feel it is advantageous to the patient and the reconstructive outcome to heal the breast wounds in the acute phase (within 3 weeks); and with regression analysis, we found full-thickness wounds greater than 6 cm benefit from operative intervention. Finally, patients requiring adjuvant oncologic treatment should be healed as quickly as possible so they may continue on with their oncologic care. ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/SAP.0000000000000174 PT - Evaluation Studies PT - Journal Article ID - 24667879 [pubmed] ID - 10.1097/SAP.0000000000000174 [doi] PP - ppublish LG - English DP - 2014 May DC - 20140417 EZ - 2014/03/27 06:00 DA - 2014/12/17 06:00 DT - 2014/03/29 06:00 YR - 2014 ED - 20141216 RD - 20140417 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24667879 <121. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24814422 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kim JY AU - Khavanin N AU - Jordan SW AU - ver Halen JP AU - Mlodinow AS AU - Bethke KP AU - Khan SA AU - Hansen NM AU - Losken A AU - Fine NA FA - Kim, John Y S FA - Khavanin, Nima FA - Jordan, Sumanas W FA - ver Halen, Jon P FA - Mlodinow, Alexei S FA - Bethke, Kevin P FA - Khan, Seema A FA - Hansen, Nora M FA - Losken, Albert FA - Fine, Neil A IN - Kim, John Y S. Chicago, Ill.; Memphis, Tenn.; and Atlanta, Ga. From the Division of Plastic and Reconstructive Surgery and the Lynn Sage Comprehensive Breast Center, Northwestern University, Feinberg School of Medicine; the Department of Plastic and Reconstructive Surgery, Baptist Cancer Center/Vanderbilt Ingram Cancer Center; and the Division of Plastic and Reconstructive Surgery, Emory University Hospital. TI - Individualized risk of surgical-site infection: an application of the breast reconstruction risk assessment score. SO - Plastic & Reconstructive Surgery. 134(3):351e-362e, 2014 Sep AS - Plast Reconstr Surg. 134(3):351e-362e, 2014 Sep NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Databases, Factual MH - *Decision Support Techniques MH - Female MH - Humans MH - Logistic Models MH - *Mammaplasty MH - Mastectomy MH - Middle Aged MH - *Precision Medicine MH - ROC Curve MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Surgical Wound Infection/et [Etiology] MH - *Surgical Wound Infection/pc [Prevention & Control] AB - BACKGROUND: Risk factors for surgical-site infection following beast reconstruction have been thoroughly investigated at a population level. However, traditional population-based measures may not always capture the nuances of individual patients. The authors aimed to develop a validated breast reconstruction risk assessment calculator for surgical-site infection that informs risk at an individual level. AB - METHODS: Mastectomies with immediate reconstruction (n = 16,069) from 2005 to 2011 were identified from the National Surgical Quality Improvement Program database. A multiple logistic regression model was created for postoperative surgical-site infection. Hosmer-Lemeshow, C statistic, and Brier score were computed to assess model performance. Bootstrap analysis validated the model. AB - RESULTS: A robust, validated risk model for surgical-site infection was developed using 11 covariates. The model Hosmer-Lemeshow p value was 0.371, the Brier score was 0.0357, and the C statistic was 0.682 (optimism-corrected C statistic, 0.678). The distribution of individual risks demonstrated a positive skew. Population-derived risk underestimated or overestimated individual risk by at least 1.5-fold in nearly one-fifth of all patients. AB - CONCLUSIONS: The breast reconstruction risk assessment score risk calculator for surgical-site infection mitigates the potentially inaccurate interpolation of population-based risk to individual patients. The authors concomitantly developed an online interface-accessible by patients and surgeons alike-to quantify a patient's risk for surgical-site infection, better informing evidence-based decisions and managing patient expectations. AB - CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III. ES - 1529-4242 IL - 0032-1052 DO - https://dx.doi.org/10.1097/PRS.0000000000000439 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24814422 [pubmed] ID - 10.1097/PRS.0000000000000439 [doi] PP - ppublish LG - English DP - 2014 Sep DC - 20140827 EZ - 2014/05/13 06:00 DA - 2014/12/17 06:00 DT - 2014/05/13 06:00 YR - 2014 ED - 20141211 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24814422 <122. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25375000 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wood WC AU - Alvarado M AU - Buchholz DJ AU - Hyams D AU - Hwang S AU - Manders J AU - Park C AU - Solin LJ AU - White J AU - Willey S FA - Wood, William C FA - Alvarado, Michael FA - Buchholz, Daniel J FA - Hyams, David FA - Hwang, Shelley FA - Manders, Jennifer FA - Park, Catherine FA - Solin, Lawrence J FA - White, Julia FA - Willey, Shawna TI - The current clinical value of the DCIS Score. SO - Oncology (Williston Park). 28 Suppl 2:C2, 1-8, C3, 2014 May AS - Oncology (Williston). 28 Suppl 2:C2, 1-8, C3, 2014 May NJ - Oncology (Williston Park, N.Y.) PI - Journal available in: Print PI - Citation processed from: Print JC - 8712059, avp IO - Oncology (Williston Park, N.Y.) SB - Index Medicus CP - United States MH - *Biomarkers, Tumor/ge [Genetics] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/th [Therapy] MH - *Carcinoma, Intraductal, Noninfiltrating/ge [Genetics] MH - Carcinoma, Intraductal, Noninfiltrating/mo [Mortality] MH - Carcinoma, Intraductal, Noninfiltrating/sc [Secondary] MH - Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - *Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Genetic Markers MH - Genetic Predisposition to Disease MH - *Genetic Testing MH - Humans MH - Mastectomy MH - Neoplasm Recurrence, Local MH - Patient Selection MH - Phenotype MH - *Precision Medicine MH - Predictive Value of Tests MH - Radiotherapy, Adjuvant MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome AB - The management of ductal carcinoma in situ (DCIS) can be controversial. Widespread adoption of mammographic screening has made DCIS a more frequent diagnosis, and increasingly smaller, lower-grade lesions are being detected. DCIS is commonly treated with breast-conserving surgery and radiation. However, there is greater recognition that acceptable cancer control outcomes can be achieved for some patients with breast-conserving surgery alone, with radiotherapy reserved for those at higher risk of in-breast recurrence. The primary clinical dilemma is that there are currently no reliable clinicopathologic features that accurately predict which patients will have a recurrence, but risk stratification is an area of active research. Molecular profiling has the potential to assess recurrence risk based on the individual patient's tumor biology and guide treatment decisions. The DCIS Score is a 12-gene assay intended to support personalized treatment planning for patients with DCIS following local excision. It provides information on local failure risk independent of traditional clinicopathologic features. Our group of expert breast surgeons and radiation oncologists met in December 2013 at the San Antonio Breast Cancer Symposium to discuss current controversies in DCIS management and determine the potential value of the DCIS Score in managing these situations. We concluded that the DCIS Score provides clinically relevant information about personal risk that can guide patient discussions and facilitate shared decision making. RN - 0 (Biomarkers, Tumor) RN - 0 (Genetic Markers) IS - 0890-9091 IL - 0890-9091 DI - 202867 PT - Congresses PT - Research Support, Non-U.S. Gov't ID - 25375000 [pubmed] ID - 202867 [pii] PP - ppublish LG - English DP - 2014 May DC - 20141106 EZ - 2014/11/07 06:00 DA - 2014/12/15 06:00 DT - 2014/11/07 06:00 YR - 2014 ED - 20141126 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25375000 <123. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25236990 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bessen T AU - Karnon J FA - Bessen, Taryn FA - Karnon, Jonathan IN - Bessen, Taryn. School of Population Health, University of Adelaide, Adelaide, Australia; Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, Australia. IN - Karnon, Jonathan. School of Population Health, University of Adelaide, Adelaide, Australia. Electronic address: jonathan.karnon@adelaide.edu.au. TI - A patient-level calibration framework for evaluating surveillance strategies: a case study of mammographic follow-up after early breast cancer. SO - Value in Health. 17(6):669-78, 2014 Sep AS - Value Health. 17(6):669-78, 2014 Sep NJ - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research PI - Journal available in: Print PI - Citation processed from: Internet JC - 100883818 IO - Value Health SB - Index Medicus CP - United States MH - Aged MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/ec [Economics] MH - *Breast Neoplasms/ep [Epidemiology] MH - Calibration MH - Decision Support Techniques MH - *Epidemiological Monitoring MH - Female MH - Follow-Up Studies MH - Humans MH - Longitudinal Studies MH - Mammography/ec [Economics] MH - *Mammography/td [Trends] MH - Middle Aged MH - *Neoplasm Recurrence, Local/di [Diagnosis] MH - Neoplasm Recurrence, Local/ec [Economics] MH - *Neoplasm Recurrence, Local/ep [Epidemiology] MH - Retrospective Studies KW - breast cancer; cost-effectiveness; discrete event simulation; surveillance AB - OBJECTIVE: Currently all women who have completed their primary treatment for early breast cancer are invited to receive routine annual mammography. There is no randomized controlled trial evidence to support this schedule, and model-based analysis is required. This paper describes a novel data collection and model calibration process to analyze the cost-effectiveness of alternative follow-up schedules for early breast cancer survivors. AB - METHODS: A discrete event simulation model describes the progression of early breast cancer after the completion of primary treatment, representing impalpable and palpable recurrence and the detection of impalpable disease via follow-up mammography. Retrospective data from the South Australian Cancer Registry and clinical and administrative hospital databases were linked for 407 postmenopausal women diagnosed with moderate-prognosis early breast cancer from 2000 to 2008. These data formed the basis of a patient-level probabilistic calibration process. AB - RESULTS: For 50- to 69-year-old survivors, annual follow-up for 5 years, with visits every 2 years thereafter, appears to be cost-effective. For women aged 70 to 79 years at diagnosis, a surveillance schedule similar to general population screening (2 yearly) appears to be most cost-effective if high rates of adherence can be maintained. AB - CONCLUSIONS: This study demonstrated the potential value of combining linked, retrospective data and decision analytic modeling to provide estimates of costs and health outcomes that are sufficiently robust to inform cancer clinical guidelines and individual patient decisions regarding appropriate follow-up schedules. AB - Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved. ES - 1524-4733 IL - 1098-3015 DI - S1098-3015(14)01896-8 DO - https://dx.doi.org/10.1016/j.jval.2014.07.002 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 25236990 [pubmed] ID - S1098-3015(14)01896-8 [pii] ID - 10.1016/j.jval.2014.07.002 [doi] PP - ppublish PH - 2013/08/04 [received] PH - 2014/06/13 [revised] PH - 2014/07/05 [accepted] LG - English DP - 2014 Sep DC - 20140919 EZ - 2014/09/20 06:00 DA - 2014/12/15 06:00 DT - 2014/09/23 06:00 YR - 2014 ED - 20141121 RD - 20140919 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25236990 <124. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24616329 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Orlando LA AU - Wu RR AU - Beadles C AU - Himmel T AU - Buchanan AH AU - Powell KP AU - Hauser ER AU - Henrich VC AU - Ginsburg GS FA - Orlando, Lori A FA - Wu, R Ryanne FA - Beadles, Chris FA - Himmel, Tiffany FA - Buchanan, Adam H FA - Powell, Karen P FA - Hauser, Elizabeth R FA - Henrich, Vincent C FA - Ginsburg, Geoffrey S TI - Implementing family health history risk stratification in primary care: impact of guideline criteria on populations and resource demand. SO - American Journal of Medical Genetics. Part C, Seminars in Medical Genetics. 166C(1):24-33, 2014 Mar AS - Am J Med Genet C Semin Med Genet. 166C(1):24-33, 2014 Mar NJ - American journal of medical genetics. Part C, Seminars in medical genetics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101235745 IO - Am J Med Genet C Semin Med Genet SB - Index Medicus CP - United States MH - Adult MH - *Decision Support Techniques MH - Genetic Counseling/mt [Methods] MH - *Genetics, Medical/mt [Methods] MH - Genetics, Medical/td [Trends] MH - Humans MH - *Medical History Taking/mt [Methods] MH - Neoplasms/ge [Genetics] MH - North Carolina MH - *Precision Medicine/mt [Methods] MH - Precision Medicine/td [Trends] MH - *Primary Health Care/mt [Methods] MH - Primary Health Care/td [Trends] MH - *Risk Assessment/mt [Methods] MH - Risk Assessment/sn [Statistics & Numerical Data] MH - Thrombosis/ge [Genetics] KW - family history; health services; primary prevention; risk stratification AB - UNLABELLED: The Genomic Medicine Model aims to facilitate patient engagement, patient/provider education of genomics/personalized medicine, and uptake of risk-stratified evidence-based prevention guidelines using MeTree, a patient-facing family health history (FHH) collection and clinical decision support (CDS) program. Here we report the number of increased risk (above population-level risk) patients identified for breast/ovarian cancer, colon cancer, hereditary syndrome risk, and thrombosis; the prevalence of FHH elements triggering increased-risk status; and the resources needed to manage their risk. AB - STUDY DESIGN: hybrid implementation-effectiveness study of adults with upcoming well-visits in 2 primary care practices in Greensboro, NC. AB - PARTICIPANTS: 1,184, mean age=58.8, female=58% (N=694), non-white=20% (N=215). Increased Risk: 44% (N=523). AB - RECOMMENDATIONS: genetic counseling=26% (N=308), breast MRI=0.8% (N=10), breast chemoprophylaxis=5% (N=58), early/frequent colonoscopies=19% (N=221), ovarian cancer screening referral=1% (N=14), thrombosis testing/counseling=2.4% (N=71). FHH elements: 8 FHH elements lead to 37.3% of the increased risk categorizations (by frequency): first-degree-relative (FDR) with polyps age >=60 (7.1%, N=85), three relatives with Lynch-related cancers (5.4%, N=65), FDR with polyps age <60 (5.1%, N=61), three relatives on same side of family with same cancer (4.9%, N=59), Gail score >=1.66% (4.9%, N=58), two relatives with breast cancer (one <=age 50) (4.1%, N=49), one relative with breast cancer <=age 40 (4.1%, N=48), FDR with colon cancer age >=60 (1.7%, N=20). MeTree identifies a high percentage of individuals in the general primary care population needing non-routine risk management/prevention for the selected conditions. Implementing risk-stratification in primary care will likely increase demand for related-resources, particularly colon screening and GC. Understanding the prevalence of FHH elements helps predict resource needs and may aid in guideline development. AB - Copyright © 2014 Wiley Periodicals, Inc. ES - 1552-4876 IL - 1552-4868 DO - https://dx.doi.org/10.1002/ajmg.c.31388 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 24616329 [pubmed] ID - 10.1002/ajmg.c.31388 [doi] PP - ppublish LG - English EP - 20140310 DP - 2014 Mar DC - 20140319 EZ - 2014/03/12 06:00 DA - 2014/11/15 06:00 DT - 2014/03/13 06:00 YR - 2014 ED - 20141114 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24616329 <125. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24892447 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Juraskova I AU - Butow P AU - Bonner C AU - Bell ML AU - Smith AB AU - Seccombe M AU - Boyle F AU - Reaby L AU - Cuzick J AU - Forbes JF FA - Juraskova, I FA - Butow, P FA - Bonner, C FA - Bell, M L FA - Smith, A B FA - Seccombe, M FA - Boyle, F FA - Reaby, L FA - Cuzick, J FA - Forbes, J F IN - Juraskova, I. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia. IN - Butow, P. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia. IN - Bonner, C. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia. IN - Bell, M L. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia. IN - Smith, A B. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia. IN - Seccombe, M. Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia. IN - Boyle, F. 1] Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney 2006, Australia [2] Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia [3] Pam McLean Centre, The University of Sydney, Sydney 2006, Australia. IN - Reaby, L. Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia. IN - Cuzick, J. Cancer Research UK, Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Queen Mary College, University of London, London E1 4NS, UK. IN - Forbes, J F. Australia and New Zealand Breast Cancer Trials Group, Australia University of Newcastle, Newcastle 2306, Australia. TI - Improving decision making about clinical trial participation - a randomised controlled trial of a decision aid for women considering participation in the IBIS-II breast cancer prevention trial. SO - British Journal of Cancer. 111(1):1-7, 2014 Jul 08 AS - Br J Cancer. 111(1):1-7, 2014 Jul 08 NJ - British journal of cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090720 SB - Index Medicus CP - England MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - *Patient Participation/px [Psychology] MH - Patient Satisfaction MH - *Randomized Controlled Trials as Topic/mt [Methods] MH - *Randomized Controlled Trials as Topic/px [Psychology] MH - Surveys and Questionnaires MH - Treatment Outcome AB - BACKGROUND: Decision aids may improve informed consent in clinical trial recruitment, but have not been evaluated in this context. This study investigated whether decision aids (DAs) can reduce decisional difficulties among women considering participation in the International Breast Cancer Intervention Study-II (IBIS-II) trial. AB - METHODS: The IBIS-II trial investigated breast cancer prevention with anastrazole in two cohorts: women with increased risk (Prevention), and women treated for ductal carcinoma in situ (DCIS). Australia, New Zealand and United Kingdom participants were randomised to receive a DA (DA group) or standard trial consent materials (control group). Questionnaires were completed after deciding about participation in IBIS-II (post decision) and 3 months later (follow-up). AB - RESULTS: Data from 112 Prevention and 34 DCIS participants were analysed post decision (73 DA; 73 control); 95 Prevention and 24 DCIS participants were analysed at follow-up (58 DA; 61 control). There was no effect on the primary outcome of decisional conflict. The DCIS-DA group had higher knowledge post decision, and the Prevention-DA group had lower decisional regret at follow-up. AB - CONCLUSIONS: This was the first study to evaluate a DA in the clinical trial setting. The results suggest DAs can potentially increase knowledge and reduce decisional regret about clinical trial participation. ES - 1532-1827 IL - 0007-0920 DI - bjc2014144 DO - https://dx.doi.org/10.1038/bjc.2014.144 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 24892447 [pubmed] ID - bjc2014144 [pii] ID - 10.1038/bjc.2014.144 [doi] ID - PMC4090720 [pmc] PP - ppublish PH - 2013/11/24 [received] PH - 2013/02/11 [revised] PH - 2014/02/24 [accepted] SI - ANZCTR SA - ANZCTR/ACTRN12605000216617 SA - ANZCTR/ACTRN12605000282684 SA - ANZCTR/ACTRN12605000506695 LG - English EP - 20140603 DP - 2014 Jul 08 DC - 20140709 EZ - 2014/06/04 06:00 DA - 2014/11/07 06:00 DT - 2014/06/04 06:00 YR - 2014 ED - 20141106 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24892447 <126. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24422989 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ozanne EM AU - Howe R AU - Omer Z AU - Esserman LJ FA - Ozanne, Elissa M FA - Howe, Rebecca FA - Omer, Zehra FA - Esserman, Laura J IN - Ozanne, Elissa M. Department of Surgery, Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA. elissa.m.ozanne@dartmouth.edu. TI - Development of a personalized decision aid for breast cancer risk reduction and management. SO - BMC Medical Informatics & Decision Making. 14:4, 2014 Jan 14 AS - BMC Med Inf Decis Mak. 14:4, 2014 Jan 14 NJ - BMC medical informatics and decision making PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088682 IO - BMC Med Inform Decis Mak PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899602 SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Decision Support Systems, Clinical/is [Instrumentation] MH - *Decision Support Systems, Clinical/st [Standards] MH - *Decision Support Techniques MH - Disease Management MH - Female MH - Focus Groups MH - Humans MH - Internet/ut [Utilization] MH - Male MH - Middle Aged MH - Patient-Centered Care/st [Standards] MH - Risk Assessment MH - Risk Reduction Behavior AB - BACKGROUND: Breast cancer risk reduction has the potential to decrease the incidence of the disease, yet remains underused. We report on the development a web-based tool that provides automated risk assessment and personalized decision support designed for collaborative use between patients and clinicians. AB - METHODS: Under Institutional Review Board approval, we evaluated the decision tool through a patient focus group, usability testing, and provider interviews (including breast specialists, primary care physicians, genetic counselors). This included demonstrations and data collection at two scientific conferences (2009 International Shared Decision Making Conference, 2009 San Antonio Breast Cancer Symposium). AB - RESULTS: Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (N=34) provided qualitative feedback about format and design; 88% of these participants found the tool useful and 94% found it easy to use. 91% of the providers (N=23) indicated that they would use the tool in their clinical setting. AB - CONCLUSION: BreastHealthDecisions.org represents a new approach to breast cancer prevention care and a framework for high quality preventive healthcare. The ability to integrate risk assessment and decision support in real time will allow for informed, value-driven, and patient-centered breast cancer prevention decisions. The tool is being further evaluated in the clinical setting. ES - 1472-6947 IL - 1472-6947 DI - 1472-6947-14-4 DO - https://dx.doi.org/10.1186/1472-6947-14-4 PT - Duplicate Publication PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 24422989 [pubmed] ID - 1472-6947-14-4 [pii] ID - 10.1186/1472-6947-14-4 [doi] ID - PMC3899602 [pmc] PP - epublish PH - 2013/05/08 [received] PH - 2014/01/02 [accepted] GI - No: R21CA141097 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20140114 DP - 2014 Jan 14 DC - 20140124 EZ - 2014/01/16 06:00 DA - 2014/10/22 06:00 DT - 2014/01/16 06:00 YR - 2014 ED - 20141021 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24422989 <127. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24142513 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Danesh M AU - Belkora J AU - Volz S AU - Rugo HS FA - Danesh, M FA - Belkora, J FA - Volz, S FA - Rugo, H S IN - Danesh, M. 1233 Arguello Blvd, San Francisco, CA 94122, USA. melissa.danesh@ucsf.edu TI - Informational needs of patients with metastatic breast cancer: what questions do they ask, and are physicians answering them?. SO - Journal of Cancer Education. 29(1):175-80, 2014 Mar AS - J Cancer Educ. 29(1):175-80, 2014 Mar NJ - Journal of cancer education : the official journal of the American Association for Cancer Education PI - Journal available in: Print PI - Citation processed from: Internet JC - avy, 8610343 IO - J Cancer Educ SB - Index Medicus CP - England MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/sc [Secondary] MH - Breast Neoplasms/th [Therapy] MH - Decision Making MH - Female MH - *Health Services Needs and Demand MH - Humans MH - Male MH - Middle Aged MH - Palliative Care MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation MH - *Physician-Patient Relations MH - *Physicians/px [Psychology] MH - Prognosis MH - Quality of Life MH - Surveys and Questionnaires AB - In the setting of breast oncology consultations, we sought to understand communication patterns between patients with advanced breast cancer and their oncologists during visits with Decision Support Services. This is a descriptive study analyzing themes and their frequencies of premeditated question lists of patients with metastatic breast cancer. We identified topics physicians most commonly discussed among themes previously found, documenting questions patients with metastatic breast cancer prepare for physician consultations and oncologists' response. Inclusion criteria were as follows: diagnosis of metastatic breast cancer, completion of a question list before meeting with an oncologist, and receipt of a summary of the consultation. We identified 59 women with metastatic breast cancer who received both documents. We reviewed the question lists and consultation summaries of these patients. Of the 59 patients whose documents we reviewed, patients most often asked about prognosis (38), symptom management (31), clinical trials (43), and quality of life (38). Physicians answered questions about prognosis infrequently (37% of the time); other questions that were answered more than commonly are the following: symptom management (81%), clinical trials (79%), and quality of life (66%). Breast cancer patients have many questions regarding their disease, its treatment, and symptoms, which were facilitated in this setting by Decision Support Services. Question lists may be insufficient to bridge the divide between physicians and patient information needs in the setting of metastatic breast cancer, particularly regarding prognosis. Patients may need additional assistance defining question lists, and physicians may benefit from training in communication, particularly regarding discussions of prognosis and end of life. ES - 1543-0154 IL - 0885-8195 DO - https://dx.doi.org/10.1007/s13187-013-0566-x PT - Journal Article ID - 24142513 [pubmed] ID - 10.1007/s13187-013-0566-x [doi] PP - ppublish LG - English DP - 2014 Mar DC - 20140211 EZ - 2013/10/22 06:00 DA - 2014/10/22 06:00 DT - 2013/10/22 06:00 YR - 2014 ED - 20141021 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24142513 <128. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24092532 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Presutti R AU - D'Alimonte L AU - McGuffin M AU - Chen H AU - Chow E AU - Pignol JP AU - Di Prospero L AU - Doherty M AU - Kiss A AU - Wong J AU - Lee J AU - Liu S AU - Warner E AU - Trudeau M AU - Feldman-Stewart D AU - Harth T AU - Szumacher E FA - Presutti, Roseanna FA - D'Alimonte, Laura FA - McGuffin, Merrylee FA - Chen, Hanbert FA - Chow, Edward FA - Pignol, Jean-Philippe FA - Di Prospero, Lisa FA - Doherty, Mary FA - Kiss, Alex FA - Wong, Jennifer FA - Lee, Justin FA - Liu, Stanley FA - Warner, Ellen FA - Trudeau, Maureen FA - Feldman-Stewart, Deb FA - Harth, Tamara FA - Szumacher, Ewa IN - Presutti, Roseanna. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada, M4N 3M5. TI - Decisional support throughout the cancer journey for older women diagnosed with early stage breast cancer: a single institutional study. SO - Journal of Cancer Education. 29(1):129-35, 2014 Mar AS - J Cancer Educ. 29(1):129-35, 2014 Mar NJ - Journal of cancer education : the official journal of the American Association for Cancer Education PI - Journal available in: Print PI - Citation processed from: Internet JC - avy, 8610343 IO - J Cancer Educ SB - Index Medicus CP - England MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Middle Aged MH - *Patient Care Planning MH - Patient Education as Topic MH - Physician-Patient Relations MH - *Stress, Psychological MH - Surveys and Questionnaires AB - To determine if older women with early stage breast cancer have sufficient decisional support during their breast cancer journey, a questionnaire-based study was conducted at the Sunnybrook Odette Cancer Centre, in Toronto, Ontario, Canada. Women with stages I and II breast cancer, >=60 years, were contacted upon completion of their adjuvant treatment. A questionnaire was developed based on focus groups, the literature, and consultation with patients and a multidisciplinary team of experts. The questionnaire was divided into six domains as follows: (1) information support surrounding diagnosis, (2) impact of cancer diagnosis on the patient, (3) quality of interaction with healthcare team, (4) decisional support from the healthcare team, (5) additional information needs surrounding treatment decision, and (6) information support during radiation treatment. Ninety-two of 137 patients approached were included in the analysis. Ninety percent were>60 years at the time of diagnosis and 65% had stage I invasive breast cancer. The majority of women received adequate decisional support during their cancer journey. Approximately 90% of women indicated that they received a high level of support during their cancer diagnosis. We found no significant differences in overall decisional support based on age at diagnosis, education level, ethnicity, or the presence of co-morbidities. However, participants desired additional educational resources such as a worksheet, consultation summary, or workbook to assist in making a treatment decision. The majority of participants felt that they had sufficient support while making a treatment decision for breast cancer. ES - 1543-0154 IL - 0885-8195 DO - https://dx.doi.org/10.1007/s13187-013-0558-x PT - Clinical Trial PT - Journal Article ID - 24092532 [pubmed] ID - 10.1007/s13187-013-0558-x [doi] PP - ppublish LG - English DP - 2014 Mar DC - 20140211 EZ - 2013/10/05 06:00 DA - 2014/10/22 06:00 DT - 2013/10/05 06:00 YR - 2014 ED - 20141021 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24092532 <129. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24422989 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ozanne EM AU - Howe R AU - Omer Z AU - Esserman LJ FA - Ozanne, Elissa M FA - Howe, Rebecca FA - Omer, Zehra FA - Esserman, Laura J IN - Ozanne, Elissa M. Department of Surgery, Institute for Health Policy Studies, University of California at San Francisco, San Francisco, CA, USA. elissa.m.ozanne@dartmouth.edu. TI - Development of a personalized decision aid for breast cancer risk reduction and management. SO - BMC Medical Informatics & Decision Making. 14:4, 2014 Jan 14 AS - BMC Med Inf Decis Mak. 14:4, 2014 Jan 14 NJ - BMC medical informatics and decision making PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088682 IO - BMC Med Inform Decis Mak PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899602 SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Decision Support Systems, Clinical/is [Instrumentation] MH - *Decision Support Systems, Clinical/st [Standards] MH - *Decision Support Techniques MH - Disease Management MH - Female MH - Focus Groups MH - Humans MH - Internet/ut [Utilization] MH - Male MH - Middle Aged MH - Patient-Centered Care/st [Standards] MH - Risk Assessment MH - Risk Reduction Behavior AB - BACKGROUND: Breast cancer risk reduction has the potential to decrease the incidence of the disease, yet remains underused. We report on the development a web-based tool that provides automated risk assessment and personalized decision support designed for collaborative use between patients and clinicians. AB - METHODS: Under Institutional Review Board approval, we evaluated the decision tool through a patient focus group, usability testing, and provider interviews (including breast specialists, primary care physicians, genetic counselors). This included demonstrations and data collection at two scientific conferences (2009 International Shared Decision Making Conference, 2009 San Antonio Breast Cancer Symposium). AB - RESULTS: Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (N=34) provided qualitative feedback about format and design; 88% of these participants found the tool useful and 94% found it easy to use. 91% of the providers (N=23) indicated that they would use the tool in their clinical setting. AB - CONCLUSION: BreastHealthDecisions.org represents a new approach to breast cancer prevention care and a framework for high quality preventive healthcare. The ability to integrate risk assessment and decision support in real time will allow for informed, value-driven, and patient-centered breast cancer prevention decisions. The tool is being further evaluated in the clinical setting. ES - 1472-6947 IL - 1472-6947 DI - 1472-6947-14-4 DO - https://dx.doi.org/10.1186/1472-6947-14-4 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 1472-6947-14-4 [pii] ID - 10.1186/1472-6947-14-4 [doi] ID - PMC3899602 [pmc] PP - epublish PH - 2013/05/08 [received] PH - 2014/01/02 [accepted] GI - No: R21CA141097 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20140114 DP - 2014 Jan 14 DC - 20140124 EZ - 2014/01/16 06:00 DA - 2014/10/22 06:00 DT - 2014/01/16 06:00 YR - 2014 ED - 20141021 RD - 20170505 UP - 20170508 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=24422989 <130. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25068322 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee MR AU - Unger JG AU - Adams WP Jr FA - Lee, Michael R FA - Unger, Jacob G FA - Adams, William P Jr IN - Lee, Michael R. Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center. TI - The tissue-based triad: a process approach to augmentation mastopexy. SO - Plastic & Reconstructive Surgery. 134(2):215-25, 2014 Aug AS - Plast Reconstr Surg. 134(2):215-25, 2014 Aug NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - *Algorithms MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - Outcome and Process Assessment (Health Care) MH - *Patient Care Planning MH - Postoperative Complications/ep [Epidemiology] MH - Prospective Studies MH - Reoperation/sn [Statistics & Numerical Data] AB - BACKGROUND: Among the most exigent operations in plastic surgery is the combination of augmentation and mastopexy. The surgical challenge is related to oppositional forces that complicate the operative predictability. The purpose of this study was to investigate use of the tissue-based triad process approach in patients undergoing augmentation mastopexy. Measured components of the approach include skin stretch, nipple to inframammary fold distance on maximal stretch, and vertical excess. AB - METHODS: Patients were selected for the study if they had been treated with one- or two-stage augmentation mastopexy, or mastopexy alone. Data gathered included preoperative measurements, operative details, complications, and outcomes including reoperation rate. AB - RESULTS: A total of 176 consecutive patients were identified as meeting study inclusion criteria. Mean follow-up was 1.5 years. Seventy-one of 176 patients underwent mastopexy alone. Of the 176 patients included, 105 were treated with augmentation mastopexy. Ninety-one of 105 augmentation mastopexy operations were performed in one stage. The average amount of vertical excess was 5 cm. Nine patients exhibited delayed wound healing, while six (6.5 percent) required reoperations for scar revision (n=1), delayed wound healing requiring revision (n=2), hematoma (n=1), seroma (n=1), and soft-tissue stretch (n=1). Fourteen of 105 patients were treated in two stages. Average vertical excess was 7.5 cm. AB - CONCLUSIONS: Use of the tissue-based triad process approach provided objectivity in determining which patients should undergo one- versus two-stage augmentation mastopexy. Use of this approach helps guide surgical decision making and is associated with lower reoperation rates. AB - CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201408000-00012 DO - https://dx.doi.org/10.1097/PRS.0000000000000387 PT - Clinical Trial PT - Journal Article PT - Video-Audio Media ID - 25068322 [pubmed] ID - 10.1097/PRS.0000000000000387 [doi] ID - 00006534-201408000-00012 [pii] PP - ppublish LG - English DP - 2014 Aug DC - 20140729 EZ - 2014/07/29 06:00 DA - 2014/10/17 06:00 DT - 2014/07/30 06:00 YR - 2014 ED - 20141016 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25068322 <131. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25068319 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hanasono MM FA - Hanasono, Matthew M IN - Hanasono, Matthew M. Houston, Texas From the Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center. TI - Discussion: An algorithmic approach for selective acellular dermal matrix use in immediate two-stage breast reconstruction: indications and outcomes. CM - Comment on: Plast Reconstr Surg. 2014 Aug;134(2):178-88; PMID: 25068318 SO - Plastic & Reconstructive Surgery. 134(2):189-90, 2014 Aug AS - Plast Reconstr Surg. 134(2):189-90, 2014 Aug NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Acellular Dermis MH - *Algorithms MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] ES - 1529-4242 IL - 0032-1052 DI - 00006534-201408000-00005 DO - https://dx.doi.org/10.1097/PRS.0000000000000328 PT - Comment PT - Journal Article ID - 25068319 [pubmed] ID - 10.1097/PRS.0000000000000328 [doi] ID - 00006534-201408000-00005 [pii] PP - ppublish LG - English DP - 2014 Aug DC - 20140729 EZ - 2014/07/29 06:00 DA - 2014/10/17 06:00 DT - 2014/07/30 06:00 YR - 2014 ED - 20141016 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25068319 <132. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25068318 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jordan SW AU - Khavanin N AU - Fine NA AU - Kim JY FA - Jordan, Sumanas W FA - Khavanin, Nima FA - Fine, Neil A FA - Kim, John Y S IN - Jordan, Sumanas W. Chicago, Ill. From the Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine. TI - An algorithmic approach for selective acellular dermal matrix use in immediate two-stage breast reconstruction: indications and outcomes. CM - Comment in: Plast Reconstr Surg. 2014 Aug;134(2):189-90; PMID: 25068319 SO - Plastic & Reconstructive Surgery. 134(2):178-88, 2014 Aug AS - Plast Reconstr Surg. 134(2):178-88, 2014 Aug NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Acellular Dermis/ct [Contraindications] MH - Acellular Dermis/ec [Economics] MH - Acellular Dermis/ut [Utilization] MH - *Acellular Dermis MH - Adult MH - *Algorithms MH - Breast Neoplasms/su [Surgery] MH - Chicago MH - *Decision Support Techniques MH - Esthetics MH - Female MH - Humans MH - Incidence MH - Logistic Models MH - Mammaplasty/ec [Economics] MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Middle Aged MH - Postoperative Complications/ep [Epidemiology] MH - Postoperative Complications/et [Etiology] MH - Retrospective Studies AB - BACKGROUND: Acellular dermal matrix use has gained widespread acceptance--despite higher material costs--because of its ease of use and potential for enhanced cosmesis. The authors developed a resource-sensitive algorithm for selective acellular dermal matrix use with indications and contraindications based on body mass index, breast size, radiation therapy, flap vascularity, and pectoralis anatomy. AB - METHODS: The algorithm incorporates preoperative and intraoperative decision points. Complication rates and aesthetic scores were compared for procedures performed before and after adoption of the algorithm. Multiple logistic regression was used to determine the independent influence of the algorithm on postoperative outcomes. AB - RESULTS: One hundred ninety-three breasts underwent reconstruction before and 179 underwent reconstruction after implementation of the algorithm. Overall complication rates did not differ between the cohorts (22.8 percent versus 20.7 percent; p=0.138). After adjusting for potential confounders, the algorithm did not significantly affect the incidence of infection, seroma, flap necrosis, explantation, or overall complications (all p>0.05). Aesthetic scores were not affected (2.75 of 4 versus 3.03 of 4; p=0.138). Acellular dermal matrix use decreased from 84 percent to 36 percent, resulting in a materials cost savings of $270,000 over the study period. AB - CONCLUSIONS: This algorithm obviated placement of acellular dermal matrix in an estimated 48 percent of immediate tissue-expander reconstructions. Patients treated after adoption of this algorithm experienced similar complication rates and aesthetic outcomes as those who underwent reconstruction before. The authors' preliminary outcomes demonstrate that evidence-based measures can be taken to selectively use acellular dermal matrix without a concomitant worsening of patient outcomes. AB - CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201408000-00004 DO - https://dx.doi.org/10.1097/PRS.0000000000000366 PT - Evaluation Studies PT - Journal Article ID - 25068318 [pubmed] ID - 10.1097/PRS.0000000000000366 [doi] ID - 00006534-201408000-00004 [pii] PP - ppublish LG - English DP - 2014 Aug DC - 20140729 EZ - 2014/07/29 06:00 DA - 2014/10/17 06:00 DT - 2014/07/30 06:00 YR - 2014 ED - 20141016 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25068318 <133. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25160051 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sheehan J AU - Sherman KA AU - Lam T AU - Boyages J FA - Sheehan, Joanne FA - Sherman, Kerry A FA - Lam, Thomas FA - Boyages, John IN - Sheehan, Joanne. a Department of Psychology , Macquarie University , 2109, NSW , Australia. TI - Regret associated with the decision for breast reconstruction: the association of negative body image, distress and surgery characteristics with decision regret. SO - Psychology & Health. 23(2):207-19, 2008 AS - Psychol Health. 23(2):207-19, 2008 NJ - Psychology & health PI - Journal available in: Print PI - Citation processed from: Internet JC - 8807983 IO - Psychol Health SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Body Image/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Emotions MH - Female MH - Humans MH - *Mammaplasty/px [Psychology] MH - Mastectomy MH - Middle Aged MH - Stress, Psychological MH - Surveys and Questionnaires MH - Young Adult KW - Breast reconstruction; decision making; decision regret; intrusion and avoidance; negative body image AB - This study investigated the influence of psychosocial and surgical factors on decision regret among 123 women diagnosed with breast cancer who had undergone immediate (58%) or delayed (42%) breast reconstruction following mastectomy. The majority of participants (52.8%, n=65) experienced no decision regret, 27.6% experienced mild regret and 19.5% moderate to strong regret. Bivariate analyses indicated that decision regret was associated with negative body image and psychological distress-intrusion and avoidance. There were no differences in decision regret either with respect to methods or timing patterns of reconstructive surgery. Multinominal logistic regression analysis showed that, when controlling for mood state and time since last reconstructive procedure, increases in negative body image were associated with increased likelihood of experiencing decision regret. These findings highlight the need for optimal input from surgeons and therapists in order to promote realistic expectations regarding the outcome of breast reconstruction and to reduce the likelihood of women experiencing decision regret. ES - 1476-8321 IL - 0887-0446 DO - https://dx.doi.org/10.1080/14768320601124899 PT - Journal Article ID - 25160051 [pubmed] ID - 10.1080/14768320601124899 [doi] PP - ppublish LG - English DP - 2008 DC - 20140827 EZ - 2014/08/28 06:00 DA - 2014/10/17 06:00 DT - 2008/02/01 00:00 YR - 2008 ED - 20141016 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=25160051 <134. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24395277 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Krontiras H AU - Lancaster RB AU - Urist MM FA - Krontiras, Helen FA - Lancaster, Rachael B FA - Urist, Marshall M IN - Krontiras, Helen. Department of Surgery, University of Alabama School of Medicine, Birmingham, AL, USA, hkrontir@uabmc.edu. TI - What is a clear margin in breast conserving cancer surgery?. [Review] SO - Current Treatment Options in Oncology. 15(1):79-85, 2014 Mar AS - Curr Treat Options Oncol. 15(1):79-85, 2014 Mar NJ - Current treatment options in oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - 100900946 IO - Curr Treat Options Oncol SB - Index Medicus CP - United States MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - *Mastectomy, Segmental MH - Neoplasm Recurrence, Local MH - Treatment Outcome AB - OPINION STATEMENT: Team work is the key to successful breast conservation therapy. Patient education and the informed consent process should include a discussion about the importance of margin status. Specimen management is critically important to obtain the highest quality information about margins. Operating technique should avoid trauma to or disruption of the specimen surface. The specimen should be oriented for the pathologist using standard techniques including sutures, clips, or colored inks. Specimen radiography is mandatory to confirm complete resection of the target tissues and can be used to direct additional margin resections during the initial procedure. With a well-designed and oriented specimen, the pathologist can give an accurate description of the margin distance for both the invasive and in situ components of the cancer. In most cases, decision-making about margins will be straightforward. Positive margins should be re-excised or the treatment is converted to mastectomy. Clear margins (>5 mm) require no further surgical therapy. "Close" margins (1-4 mm) will remain a point of controversy because of conflicting reports from clinical series. At UAB, decision for re-excision is made on a case-by-case basis. Routinely 2 mm is considered adequate, however, volume of disease and intraductal component are important considerations when making recommendations. ES - 1534-6277 IL - 1534-6277 DO - https://dx.doi.org/10.1007/s11864-013-0270-4 PT - Journal Article PT - Review ID - 24395277 [pubmed] ID - 10.1007/s11864-013-0270-4 [doi] PP - ppublish LG - English DP - 2014 Mar DC - 20140221 EZ - 2014/01/08 06:00 DA - 2014/10/10 06:00 DT - 2014/01/08 06:00 YR - 2014 ED - 20141009 RD - 20140221 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24395277 <135. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24393589 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ikander P AU - Drejoe JB AU - Lumholt P AU - Sjostrand H AU - Matzen S AU - Quirinia A AU - Siersen HE AU - Ringberg A AU - Lambaa S AU - Holmich LR FA - Ikander, Peder FA - Drejoe, Jennifer Berg FA - Lumholt, Pavia FA - Sjostrand, Helle FA - Matzen, Steen FA - Quirinia, Anne FA - Siersen, Hans Erik FA - Ringberg, Anita FA - Lambaa, Susanne FA - Holmich, Lisbet Rosenkrantz IN - Ikander, Peder. Kirurgisk Afdeling, Sydvestjysk Sygehus, Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark. peder.ikander@gmail.com. TI - Measurement of breast volume is a useful supplement to select candidates for surgical breast reduction. SO - Danish Medical Journal. 61(1):A4760, 2014 Jan AS - Dan Med J. 61(1):A4760, 2014 Jan NJ - Danish medical journal PI - Journal available in: Print PI - Citation processed from: Internet JC - 101576205 IO - Dan Med J SB - Index Medicus CP - Denmark MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast/ab [Abnormalities] MH - *Breast/pa [Pathology] MH - Breast/su [Surgery] MH - Decision Support Techniques MH - Female MH - Humans MH - Hypertrophy/pa [Pathology] MH - *Hypertrophy/su [Surgery] MH - *Mammaplasty MH - Middle Aged MH - Organ Size MH - Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - *Patient Selection MH - Prospective Studies MH - Young Adult AB - INTRODUCTION: The indication for breast reduction in a public welfare or an insurance paid setting depends on the severity of the subjective symptoms and the clinical evaluation. The purpose of this study was to evaluate the use of breast volume as an objective criterion to establish the indication for breast reduction surgery, thus establishing a standard decision basis that can be shared by surgeons and departments to secure patients fair and equal treatment opportunities. AB - MATERIAL AND METHODS: A total of 427 patients who were referred to three Danish public hospitals with breast hypertrophy in the period from January 2007 to March 2011 were included prospectively in the study. The patients' subjective complaints, height, weight and standard breast measurements were registered as well as the decision for or against surgery. Breast volume was measured using transparent plastic cups. AB - RESULTS: Cut-off values for breast volume were calculated based on whether or not the patients were offered reduction surgery. Most patients (93%) with a breast volume below 800 cc were not offered surgery, while most with a volume exceeding 900 cc were offered surgery (94%). In the grey zone between 800 and 900 cc, the indication seemed to be less clear-cut, and additional parameters need to be included. AB - CONCLUSION: Breast volume can be used as an objective criterion in addition to the presently used criteria. Breast volume can easily be measured and has become appreciated by plastic surgeons dealing with patients with breast hypertrophy as a tool which facilitates their decision-making and patients' acceptance of the decisions made. AB - FUNDING: not relevant. AB - TRIAL REGISTRATION: not relevant. RS - Gigantomastia ES - 2245-1919 IL - 2245-1919 DI - A4760 PT - Clinical Trial PT - Journal Article PT - Multicenter Study ID - 24393589 [pubmed] ID - A4760 [pii] PP - ppublish LG - English DP - 2014 Jan DC - 20140107 EZ - 2014/01/08 06:00 DA - 2014/09/13 06:00 DT - 2014/01/08 06:00 YR - 2014 ED - 20140912 RD - 20140107 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24393589 <136. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25031309 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Pauker SG AU - Alseiari M FA - Pauker, Stephen G FA - Alseiari, Mohamed IN - Pauker, Stephen G. Affiliation of authors: Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA. IN - Alseiari, Mohamed. Affiliation of authors: Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA. TI - How big is big enough? Thinking about contralateral prophylactic mastectomy. CM - Comment on: J Natl Cancer Inst. 2014 Aug;106(8). pii: dju160. doi: 10.1093/jnci/dju160; PMID: 25031308 SO - Journal of the National Cancer Institute. 106(8), 2014 Aug AS - J Natl Cancer Inst. 106(8), 2014 Aug NJ - Journal of the National Cancer Institute PI - Journal available in: Electronic-Print PI - Citation processed from: Internet JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - *Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - *Secondary Prevention/mt [Methods] ES - 1460-2105 IL - 0027-8874 DI - dju175 DO - https://dx.doi.org/10.1093/jnci/dju175 PT - Comment PT - Editorial ID - 25031309 [pubmed] ID - dju175 [pii] ID - 10.1093/jnci/dju175 [doi] PP - epublish LG - English EP - 20140716 DP - 2014 Aug DC - 20140717 EZ - 2014/07/18 06:00 DA - 2014/09/12 06:00 DT - 2014/07/18 06:00 YR - 2014 ED - 20140911 RD - 20140717 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25031309 <137. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25031308 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Portschy PR AU - Kuntz KM AU - Tuttle TM FA - Portschy, Pamela R FA - Kuntz, Karen M FA - Tuttle, Todd M IN - Portschy, Pamela R. Affiliations of authors: Department of Surgery (PRP, TMT) and Division of Health Policy and Management (KMK), University of Minnesota, Minneapolis, MN. IN - Kuntz, Karen M. Affiliations of authors: Department of Surgery (PRP, TMT) and Division of Health Policy and Management (KMK), University of Minnesota, Minneapolis, MN. IN - Tuttle, Todd M. Affiliations of authors: Department of Surgery (PRP, TMT) and Division of Health Policy and Management (KMK), University of Minnesota, Minneapolis, MN. tuttl006@umn.edu. TI - Survival outcomes after contralateral prophylactic mastectomy: a decision analysis. CM - Comment in: J Natl Cancer Inst. 2015 Mar;107(3). doi: 10.1093/jnci/dju507; PMID: 25713151 CM - Comment in: J Natl Cancer Inst. 2015 Mar;107(3). doi: 10.1093/jnci/dju508; PMID: 25713152 CM - Comment in: J Natl Cancer Inst. 2014 Aug;106(8). pii: dju175. doi: 10.1093/jnci/dju175; PMID: 25031309 CM - Comment in: J Natl Cancer Inst. 2015 Apr;107(4). pii: djv093. doi: 10.1093/jnci/djv093; PMID: 25870388 CM - Comment in: J Natl Cancer Inst. 2015 Apr;107(4). pii: djv092. doi: 10.1093/jnci/djv092; PMID: 25870387 SO - Journal of the National Cancer Institute. 106(8), 2014 Aug AS - J Natl Cancer Inst. 106(8), 2014 Aug NJ - Journal of the National Cancer Institute PI - Journal available in: Electronic-Print PI - Citation processed from: Internet JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Humans MH - Life Expectancy MH - Markov Chains MH - Mastectomy/mt [Methods] MH - *Mastectomy MH - Middle Aged MH - Neoplasm Staging MH - Predictive Value of Tests MH - *Secondary Prevention/mt [Methods] MH - United States/ep [Epidemiology] AB - BACKGROUND: Contralateral prophylactic mastectomy (CPM) rates have substantially increased in recent years and may reflect an exaggerated perceived benefit from the procedure. The objective of this study was to evaluate the magnitude of the survival benefit of CPM for women with unilateral breast cancer. AB - METHODS: We developed a Markov model to simulate survival outcomes after CPM and no CPM among women with stage I or II breast cancer without a BRCA mutation. Probabilities for developing contralateral breast cancer (CBC), dying from CBC, dying from primary breast cancer, and age-specific mortality rates were estimated from published studies. We estimated life expectancy (LE) gain, 20-year overall survival, and disease-free survival with each intervention strategy among cohorts of women defined by age, estrogen receptor (ER) status, and stage of cancer. AB - RESULTS: Predicted LE gain from CPM ranged from 0.13 to 0.59 years for women with stage I breast cancer and 0.08 to 0.29 years for those with stage II breast cancer. Absolute 20-year survival differences ranged from 0.56% to 0.94% for women with stage I breast cancer and 0.36% to 0.61% for women with stage II breast cancer. CPM was more beneficial among younger women, stage I, and ER-negative breast cancer. Sensitivity analyses yielded a maximum 20-year survival difference with CPM of only 1.45%. AB - CONCLUSIONS: The absolute 20-year survival benefit from CPM was less than 1% among all age, ER status, and cancer stage groups. Estimates of LE gains and survival differences derived from decision models may provide more realistic expectations of CPM. AB - Copyright © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com. ES - 1460-2105 IL - 0027-8874 DI - dju160 DO - https://dx.doi.org/10.1093/jnci/dju160 PT - Journal Article ID - 25031308 [pubmed] ID - dju160 [pii] ID - 10.1093/jnci/dju160 [doi] PP - epublish LG - English EP - 20140716 DP - 2014 Aug DC - 20140717 EZ - 2014/07/18 06:00 DA - 2014/09/12 06:00 DT - 2014/07/18 06:00 YR - 2014 ED - 20140911 RD - 20150514 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=25031308 <138. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23962673 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Shaffer VA AU - Hulsey L AU - Zikmund-Fisher BJ FA - Shaffer, Victoria A FA - Hulsey, Lukas FA - Zikmund-Fisher, Brian J IN - Shaffer, Victoria A. Department of Health Sciences and Department of Psychological Sciences, University of Missouri, Columbia, USA. Electronic address: shafferv@health.missouri.edu. TI - The effects of process-focused versus experience-focused narratives in a breast cancer treatment decision task. SO - Patient Education & Counseling. 93(2):255-64, 2013 Nov AS - Patient Educ Couns. 93(2):255-64, 2013 Nov NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - Information Seeking Behavior MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - *Narration MH - Patient Satisfaction MH - United States MH - Videotape Recording KW - Breast cancer; Decision making; Decision support; Narratives; Patient decision aids AB - OBJECTIVE: To examine the effect of patient narratives that discuss decision processes versus patient experiences on decisions about treatments for early stage breast cancer. AB - METHODS: We recruited 300 women with no previous history of breast cancer to imagine that they had been diagnosed with early stage breast cancer and to choose between mastectomy and lumpectomy with radiation. Before learning about their treatment options, participants were randomly assigned to one of four conditions with videotaped stories from fictitious cancer survivors, using a 2 (content: experience versus process) x 2 (emotional valence: positive only vs. positive and negative) factorial design, or a control condition with no stories. We measured information search, treatment intentions, and decision satisfaction. AB - RESULTS: Participants viewing process narratives spent more time searching for information. Participants viewing experience narratives reported a greater ability to imagine what it was like to experience the treatments; they also evaluated their decision more positively on several dimensions. AB - CONCLUSIONS: Process narratives appeared to guide information search, and experience narratives improved evaluations of the decision process. AB - PRACTICE IMPLICATIONS: There is no evidence that process and experience narratives 'bias' decisions in the same manner as outcome narratives. Further, their potential to focus patient attention on key information and increase patient confidence in decision making appears significant. AB - Copyright © 2013 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(13)00289-9 DO - https://dx.doi.org/10.1016/j.pec.2013.07.013 PT - Journal Article PT - Randomized Controlled Trial ID - 23962673 [pubmed] ID - S0738-3991(13)00289-9 [pii] ID - 10.1016/j.pec.2013.07.013 [doi] PP - ppublish PH - 2013/02/15 [received] PH - 2013/07/09 [revised] PH - 2013/07/23 [accepted] LG - English EP - 20130817 DP - 2013 Nov DC - 20131018 EZ - 2013/08/22 06:00 DA - 2014/08/27 06:00 DT - 2013/08/22 06:00 YR - 2013 ED - 20140826 RD - 20131018 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23962673 <139. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24368235 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lillie SE AU - Janz NK AU - Friese CR AU - Graff JJ AU - Schwartz K AU - Hamilton AS AU - Gay BB AU - Katz SJ AU - Hawley ST FA - Lillie, Sarah E FA - Janz, Nancy K FA - Friese, Christopher R FA - Graff, John J FA - Schwartz, Kendra FA - Hamilton, Ann S FA - Gay, Brittany Bartol FA - Katz, Steven J FA - Hawley, Sarah T IN - Lillie, Sarah E. Minneapolis Veterans Affairs Medical Center in Minnesota. IN - Janz, Nancy K. Department of Health Behavior and Health Education, University of Michigan in Ann Arbor. IN - Friese, Christopher R. School of Nursing, University of Michigan in Ann Arbor. IN - Graff, John J. Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ. IN - Schwartz, Kendra. Department of Family Medicine, Wayne State University, Detroit, MI. IN - Hamilton, Ann S. Department of Preventive Medicine, University of Southern California in Los Angeles. IN - Gay, Brittany Bartol. Department of Internal Medicine, University of Michigan. IN - Katz, Steven J. Department of Internal Medicine, University of Michigan and Ann Arbor Veterans Affairs Healthcare System. IN - Hawley, Sarah T. Department of Internal Medicine, University of Michigan and Ann Arbor Veterans Affairs Healthcare System. TI - Racial and ethnic variation in partner perspectives about the breast cancer treatment decision-making experience. SO - Oncology Nursing Forum. 41(1):13-20, 2014 Jan 01 AS - Oncol Nurs Forum. 41(1):13-20, 2014 Jan 01 NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Internet JC - 7809033, 7809033 IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Acculturation MH - African Americans/px [Psychology] MH - Attitude to Health MH - *Breast Neoplasms/eh [Ethnology] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant/px [Psychology] MH - Cross-Sectional Studies MH - *Decision Making MH - *Emotions MH - European Continental Ancestry Group/px [Psychology] MH - Female MH - Health Care Surveys MH - Hispanic Americans/px [Psychology] MH - Humans MH - Indians, North American/px [Psychology] MH - Informed Consent MH - Los Angeles MH - Male MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Michigan MH - Patient Education as Topic MH - Patient Participation/px [Psychology] MH - *Patient Participation MH - Radiotherapy, Adjuvant/px [Psychology] MH - SEER Program MH - *Sexual Partners/px [Psychology] MH - Surveys and Questionnaires KW - breast cancer; decision making; family and caregivers AB - PURPOSE/OBJECTIVES: To characterize the perspectives of partners (husbands or significant others) of patients with breast cancer in the treatment decision-making process and to evaluate racial and ethnic differences in decision outcomes. AB - DESIGN: A cross-sectional survey. AB - SETTING: Los Angeles, CA, and Detroit, MI. AB - SAMPLE: 517 partners of a population-based sample of patients with breast cancer four years post-treatment. AB - METHODS: A self-administered mailed questionnaire. Chi-square tests and logistic regression were used to assess associations between race and ethnicity and decision outcomes. AB - MAIN RESEARCH VARIABLES: Decision regret and three elements of the decision process: information received, actual involvement, and desired involvement. AB - FINDINGS: Most partners reported receiving sufficient information (77%), being involved in treatment decisions (74%), and having sufficient involvement (73%). Less-acculturated Hispanic partners were more likely than their Caucasian counterparts to report high decision regret (45% versus 14%, p<0.001). Factors significantly associated (p<0.05) with high decision regret were insufficient receipt of treatment information, low involvement in decision making, and a desire for more involvement. AB - CONCLUSIONS: Partners were generally positive regarding their perspectives about participating in the breast cancer treatment decision-making process. However, less acculturated Hispanic partners were most vulnerable to decision regret. In addition, high decision regret was associated with modifiable elements of the decision-making process. AB - IMPLICATIONS FOR NURSING: Attention should be paid to ensuring racial and ethnic minority partners are sufficiently involved in breast cancer treatment decisions and receive decision support. ES - 1538-0688 IL - 0190-535X DI - 1237673254N7126K DO - https://dx.doi.org/10.1188/14.ONF.13-20 PT - Comparative Study PT - Journal Article PT - Multicenter Study ID - 24368235 [pubmed] ID - PMC5058443 [pmc] ID - 1237673254N7126K [pii] ID - 10.1188/14.ONF.13-20 [doi] ID - NIHMS560810 [mid] PP - ppublish GI - No: R00 NR010750 Organization: (NR) *NINR NIH HHS* Country: United States No: R01 CA088370 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA109696 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2014 Jan 01 DC - 20131225 EZ - 2013/12/26 06:00 DA - 2014/08/19 06:00 DT - 2013/12/26 06:00 YR - 2014 ED - 20140818 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24368235 <140. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24345424 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Shaffer VA AU - Owens J AU - Zikmund-Fisher BJ FA - Shaffer, Victoria A FA - Owens, Justin FA - Zikmund-Fisher, Brian J IN - Shaffer, Victoria A. University of Missouri, Department of Health Sciences, School of Health Professions, Department of Psychological Sciences, College of Arts & Science, Columbia, MO, United States. shafferv@health.missouri.edu. TI - The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study. SO - Journal of Medical Internet Research. 15(12):e273, 2013 Dec 17 AS - J Med Internet Res. 15(12):e273, 2013 Dec 17 NJ - Journal of medical Internet research PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 100959882 IO - J. Med. Internet Res. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875892 SB - Index Medicus CP - Canada MH - Adult MH - Aged MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Support Techniques MH - Eye Movements MH - Female MH - Humans MH - Information Seeking Behavior MH - *Internet MH - Middle Aged MH - Patient Participation MH - *Telemedicine MH - Video Recording KW - breast cancer; decision aids; eye tracking; personal narratives AB - BACKGROUND: Previous research has examined the impact of patient narratives on treatment choices, but to our knowledge, no study has examined the effect of narratives on information search. Further, no research has considered the relative impact of their format (text vs video) on health care decisions in a single study. AB - OBJECTIVE: Our goal was to examine the impact of video and text-based narratives on information search in a Web-based patient decision aid for early stage breast cancer. AB - METHODS: Fifty-six women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were randomly assigned to view one of four versions of a Web decision aid. Two versions of the decision aid included videos of interviews with patients and physicians or videos of interviews with physicians only. To distinguish between the effect of narratives and the effect of videos, we created two text versions of the Web decision aid by replacing the patient and physician interviews with text transcripts of the videos. Participants could freely browse the Web decision aid until they developed a treatment preference. We recorded participants' eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 24 areas of interest (AOIs) in the Web decision aid. These AOIs were either separate pages of the Web decision aid or sections within a single page covering different content. AB - RESULTS: We used multilevel modeling to examine the effect of narrative presence, narrative format, and their interaction on information search. There was a significant main effect of condition, P=.02; participants viewing decision aids with patient narratives spent more time searching for information than participants viewing the decision aids without narratives. The main effect of format was not significant, P=.10. However, there was a significant condition by format interaction on fixation duration, P<.001. When comparing the two video decision aids, participants viewing the narrative version spent more time searching for information than participants viewing the control version of the decision aid. In contrast, participants viewing the narrative version of the text decision aid spent less time searching for information than participants viewing the control version of the text decision aid. Further, narratives appear to have a global effect on information search; these effects were not limited to specific sections of the decision aid that contained topics discussed in the patient stories. AB - CONCLUSIONS: The observed increase in fixation duration with video patient testimonials is consistent with the idea that the vividness of the video content could cause greater elaboration of the message, thereby encouraging greater information search. Conversely, because reading requires more effortful processing than watching, reading patient narratives may have decreased participant motivation to engage in more reading in the remaining sections of the Web decision aid. These findings suggest that the format of patient stories may be equally as important as their content in determining their effect on decision making. More research is needed to understand why differences in format result in fundamental differences in information search. ES - 1438-8871 IL - 1438-8871 DI - v15i12e273 DO - https://dx.doi.org/10.2196/jmir.2784 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24345424 [pubmed] ID - v15i12e273 [pii] ID - 10.2196/jmir.2784 [doi] ID - PMC3875892 [pmc] PP - epublish PH - 2013/06/19 [received] PH - 2013/10/13 [accepted] PH - 2013/09/12 [revised] LG - English EP - 20131217 DP - 2013 Dec 17 DC - 20131218 EZ - 2013/12/19 06:00 DA - 2014/08/15 06:00 DT - 2013/12/19 06:00 YR - 2013 ED - 20140813 RD - 20150422 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24345424 <141. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24816579 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hansson E AU - Manjer J AU - Borren J AU - Levin M AU - Mulder L AU - Ringberg A FA - Hansson, Emma FA - Manjer, Jonas FA - Borren, Jerker FA - Levin, Malin FA - Mulder, Lotta FA - Ringberg, Anita IN - Hansson, Emma. Department of Plastic and Reconstructive Surgery, Skane University Hospital, Malmo, Sweden; Department of Clinical Sciences, Lund University, Malmo, Sweden. Electronic address: emma.hansson@med.lu.se. IN - Manjer, Jonas. Department of Plastic and Reconstructive Surgery, Skane University Hospital, Malmo, Sweden; Department of Clinical Sciences, Lund University, Malmo, Sweden. IN - Borren, Jerker. Department of Biomedical Engineering, Skane University Hospital, Malmo, Sweden. IN - Levin, Malin. Department of Plastic and Reconstructive Surgery, Skane University Hospital, Malmo, Sweden. IN - Mulder, Lotta. Department of Plastic and Reconstructive Surgery, Skane University Hospital, Malmo, Sweden. IN - Ringberg, Anita. Department of Plastic and Reconstructive Surgery, Skane University Hospital, Malmo, Sweden; Department of Clinical Sciences, Lund University, Malmo, Sweden. TI - A feasible computer-based evaluation tool for reduction mammaplasty patients: indications for operation and monitoring of guidelines. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 67(7):927-31, 2014 Jul AS - J Plast Reconstr Aesthet Surg. 67(7):927-31, 2014 Jul NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - Body Mass Index MH - Breast/ah [Anatomy & Histology] MH - *Breast/pa [Pathology] MH - Breast/su [Surgery] MH - *Decision Making, Computer-Assisted MH - Decision Support Techniques MH - Female MH - *Guideline Adherence MH - Humans MH - Hyperplasia/su [Surgery] MH - *Mammaplasty MH - National Health Programs MH - Organ Size MH - *Patient Selection MH - Practice Guidelines as Topic MH - Sweden KW - Breast reduction; Breast surgery; Computer-based evaluation tool; Follow-up; Indication; Reduction mammaplasty AB - In Sweden, evidence-based national guidelines for the indication for reduction mammaplasty in the public health-care system have been developed by a group of experts. They were defined as breast volume>=800 ml at normal weight. Furthermore, a volume asymmetry of 25% or at least 200 ml or an extreme ptosis may be an indication in some cases. The aim of the present paper was to describe an easy-to-use computer-based tool that has been developed to assure that patients with mammary hyperplasia are evaluated and offered care in a standardized fashion and that the adherence to the guidelines is monitored. Included variables were based on a model for priority grouping originally presented by Strombeck and Malm in 1986 and comprise body mass index (BMI), BMI-corrected breast volume, ptosis, asymmetry, and general breast-related factors preoperatively and 1 year postoperatively and complications postoperatively. Between June 2007 and January 2013, 377 patients were evaluated. Of which, 275 qualified for operation. With the help of the computer-based tool, compliance to the indications for operation can be easily followed, and hence the intended patients offered a reduction mammaplasty in the public health-care system. AB - Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(14)00139-9 DO - https://dx.doi.org/10.1016/j.bjps.2014.03.028 PT - Journal Article ID - 24816579 [pubmed] ID - S1748-6815(14)00139-9 [pii] ID - 10.1016/j.bjps.2014.03.028 [doi] PP - ppublish PH - 2013/06/27 [received] PH - 2013/12/18 [revised] PH - 2014/03/15 [accepted] LG - English EP - 20140401 DP - 2014 Jul DC - 20140609 EZ - 2014/05/13 06:00 DA - 2014/07/25 06:00 DT - 2014/05/13 06:00 YR - 2014 ED - 20140724 RD - 20140609 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24816579 <142. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24083961 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bartlett FR AU - Yarnold JR AU - Donovan EM AU - Evans PM AU - Locke I AU - Kirby AM FA - Bartlett, F R FA - Yarnold, J R FA - Donovan, E M FA - Evans, P M FA - Locke, I FA - Kirby, A M IN - Bartlett, F R. Department of Academic Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK. Electronic address: frederick.bartlett@rmh.nhs.uk. TI - Multileaf collimation cardiac shielding in breast radiotherapy: Cardiac doses are reduced, but at what cost?. SO - Clinical Oncology (Royal College of Radiologists). 25(12):690-6, 2013 Dec AS - Clin Oncol (R Coll Radiol). 25(12):690-6, 2013 Dec NJ - Clinical oncology (Royal College of Radiologists (Great Britain)) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ayi, 9002902 IO - Clin Oncol (R Coll Radiol) SB - Index Medicus CP - England MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Female MH - *Heart/re [Radiation Effects] MH - Humans MH - Mastectomy, Segmental MH - *Radiation Injuries/pc [Prevention & Control] MH - Radiation Protection/is [Instrumentation] MH - *Radiation Protection/mt [Methods] MH - Radiography, Interventional MH - *Radiotherapy Planning, Computer-Assisted/mt [Methods] MH - Radiotherapy, Adjuvant MH - Tomography, X-Ray Computed KW - Breast cancer; cardiac dose; cardiac shielding; radiotherapy; target tissue coverage AB - AIMS: To measure cardiac tissue doses in left-sided breast cancer patients receiving supine tangential field radiotherapy with multileaf collimation (MLC) cardiac shielding of the heart and to assess the effect on target volume coverage. AB - MATERIALS AND METHODS: Sixty-seven consecutive patients who underwent adjuvant radiotherapy to the left breast (n = 48) or chest wall (n = 19) in 2009/2010 were analysed. The heart, left anterior descending coronary artery (LAD), whole breast and partial breast clinical target volumes (WBCTV and PBCTV) were outlined retrospectively (the latter only in patients who had undergone breast-conserving surgery [BCS]). The mean heart and LAD NTDmean and maximum LAD doses (LADmax) were calculated for all patients (NTDmean is a biologically weighted mean dose normalised to 2 Gy fractions using a standard linear quadratic model). Coverage of WBCTV and PBCTV by the 95% isodose was assessed (BCS patients only). AB - RESULTS: The mean heart NTDmean (standard deviation) was 0.8 (0.3) Gy, the mean LAD NTDmean 6.7 (4.3) Gy and the mean LADmax 40.3 (10.1) Gy. Coverage of the WBCTV by 95% isodose was <90% in one in three patients and PBCTV coverage <95% (range 78-94%) in one in 10 BCS patients. AB - CONCLUSION: The use of MLC cardiac shielding reduces doses to cardiac tissues at the expense of target tissue coverage. Formal target volume delineation in combination with an assessment of the likelihood of local relapse is recommended in order to aid decisions regarding field and MLC placement. AB - Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved. ES - 1433-2981 IL - 0936-6555 DI - S0936-6555(13)00337-3 DO - https://dx.doi.org/10.1016/j.clon.2013.09.002 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24083961 [pubmed] ID - S0936-6555(13)00337-3 [pii] ID - 10.1016/j.clon.2013.09.002 [doi] PP - ppublish PH - 2013/06/11 [received] PH - 2013/08/06 [revised] PH - 2013/08/23 [accepted] GI - No: 10588 Organization: *Cancer Research UK* Country: United Kingdom No: PB-PG-1010-23003 Organization: *Department of Health* Country: United Kingdom LG - English EP - 20130929 DP - 2013 Dec DC - 20131104 EZ - 2013/10/03 06:00 DA - 2014/07/18 06:00 DT - 2013/10/03 06:00 YR - 2013 ED - 20140717 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24083961 <143. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23962230 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sivell S AU - Elwyn G AU - Edwards A AU - Manstead AS AU - BresDex group FA - Sivell, Stephanie FA - Elwyn, Glyn FA - Edwards, Adrian FA - Manstead, Antony S R FA - BresDex group IN - Sivell, Stephanie. Marie Curie Palliative Care Research Centre, Wales Cancer Trials Unit, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. sivells2@cf.ac.uk. IR - Caldon L IR - Collins K IR - Day TJ IR - Donald A IR - Evans R IR - Patnick J IR - Reed MW IR - Rogers V TI - Factors influencing the surgery intentions and choices of women with early breast cancer: the predictive utility of an extended theory of planned behaviour. SO - BMC Medical Informatics & Decision Making. 13:92, 2013 Aug 20 AS - BMC Med Inf Decis Mak. 13:92, 2013 Aug 20 NJ - BMC medical informatics and decision making PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088682 IO - BMC Med Inform Decis Mak PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849725 SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Choice Behavior/ph [Physiology] MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Intention MH - *Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Neoplasm Staging MH - *Patient Preference/px [Psychology] MH - Psychological Theory AB - BACKGROUND: Women diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided research on this issue highlight the need for further research into the factors influencing women's choices. An extended Theory of Planned Behaviour (TPB) could provide a basis to understand and predict women's surgery choices. The aims of this study were to understand and predict the surgery intentions and choices of women newly diagnosed with early breast cancer, examining the predictive utility of an extended TPB. AB - METHODS: Sixty-two women recruited from three UK breast clinics participated in the study; 48 women, newly diagnosed with early breast cancer, completed online questionnaires both before their surgery and after accessing an online decision support intervention (BresDex). Questionnaires assessed views about breast cancer and the available treatment options using items designed to measure constructs of an extended TPB (i.e., attitudes, subjective norms, perceived behavioural control, and anticipated regret), and women's intentions to choose mastectomy or BCS. Objective data were collected on women's choice of surgery via the clinical breast teams. Multiple and logistic regression analyses examined predictors of surgery intentions and subsequent choice of surgery. AB - RESULTS: The extended TPB accounted for 69.9% of the variance in intentions (p <.001); attitudes and subjective norms were significant predictors. Including additional variables revealed anticipated regret to be a more important predictor than subjective norms. Surgery intentions significantly predicted surgery choices (p <.01). AB - CONCLUSIONS: These findings demonstrate the utility of an extended TPB in predicting and understanding women's surgery intentions and choices for early breast cancer. Understanding these factors should help to identify key components of interventions to support women while considering their surgery options. ES - 1472-6947 IL - 1472-6947 DI - 1472-6947-13-92 DO - https://dx.doi.org/10.1186/1472-6947-13-92 PT - Duplicate Publication PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 23962230 [pubmed] ID - 1472-6947-13-92 [pii] ID - 10.1186/1472-6947-13-92 [doi] ID - PMC3849725 [pmc] PP - epublish PH - 2013/02/01 [received] PH - 2013/08/06 [accepted] GI - No: MCCC-FCO-11-C Organization: *Marie Curie* Country: United Kingdom No: C6475/A7053 Organization: *Cancer Research UK* Country: United Kingdom LG - English EP - 20130820 DP - 2013 Aug 20 DC - 20131115 EZ - 2013/08/22 06:00 DA - 2014/07/16 06:00 DT - 2013/08/22 06:00 YR - 2013 ED - 20140714 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23962230 <144. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23962230 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sivell S AU - Elwyn G AU - Edwards A AU - Manstead AS AU - BresDex group FA - Sivell, Stephanie FA - Elwyn, Glyn FA - Edwards, Adrian FA - Manstead, Antony S R FA - BresDex group IN - Sivell, Stephanie. Marie Curie Palliative Care Research Centre, Wales Cancer Trials Unit, Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK. sivells2@cf.ac.uk. IR - Caldon L IR - Collins K IR - Day TJ IR - Donald A IR - Evans R IR - Patnick J IR - Reed MW IR - Rogers V TI - Factors influencing the surgery intentions and choices of women with early breast cancer: the predictive utility of an extended theory of planned behaviour. SO - BMC Medical Informatics & Decision Making. 13:92, 2013 Aug 20 AS - BMC Med Inf Decis Mak. 13:92, 2013 Aug 20 NJ - BMC medical informatics and decision making PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088682 IO - BMC Med Inform Decis Mak PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849725 SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Choice Behavior/ph [Physiology] MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Intention MH - *Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Neoplasm Staging MH - *Patient Preference/px [Psychology] MH - Psychological Theory AB - BACKGROUND: Women diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided research on this issue highlight the need for further research into the factors influencing women's choices. An extended Theory of Planned Behaviour (TPB) could provide a basis to understand and predict women's surgery choices. The aims of this study were to understand and predict the surgery intentions and choices of women newly diagnosed with early breast cancer, examining the predictive utility of an extended TPB. AB - METHODS: Sixty-two women recruited from three UK breast clinics participated in the study; 48 women, newly diagnosed with early breast cancer, completed online questionnaires both before their surgery and after accessing an online decision support intervention (BresDex). Questionnaires assessed views about breast cancer and the available treatment options using items designed to measure constructs of an extended TPB (i.e., attitudes, subjective norms, perceived behavioural control, and anticipated regret), and women's intentions to choose mastectomy or BCS. Objective data were collected on women's choice of surgery via the clinical breast teams. Multiple and logistic regression analyses examined predictors of surgery intentions and subsequent choice of surgery. AB - RESULTS: The extended TPB accounted for 69.9% of the variance in intentions (p <.001); attitudes and subjective norms were significant predictors. Including additional variables revealed anticipated regret to be a more important predictor than subjective norms. Surgery intentions significantly predicted surgery choices (p <.01). AB - CONCLUSIONS: These findings demonstrate the utility of an extended TPB in predicting and understanding women's surgery intentions and choices for early breast cancer. Understanding these factors should help to identify key components of interventions to support women while considering their surgery options. ES - 1472-6947 IL - 1472-6947 DI - 1472-6947-13-92 DO - https://dx.doi.org/10.1186/1472-6947-13-92 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 1472-6947-13-92 [pii] ID - 10.1186/1472-6947-13-92 [doi] ID - PMC3849725 [pmc] PP - epublish PH - 2013/02/01 [received] PH - 2013/08/06 [accepted] GI - No: MCCC-FCO-11-C Organization: *Marie Curie* Country: United Kingdom No: C6475/A7053 Organization: *Cancer Research UK* Country: United Kingdom LG - English EP - 20130820 DP - 2013 Aug 20 DC - 20131115 EZ - 2013/08/22 06:00 DA - 2014/07/16 06:00 DT - 2013/08/22 06:00 YR - 2013 ED - 20140714 RD - 20170505 UP - 20170508 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=23962230 <145. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24188788 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Garvelink MM AU - ter Kuile MM AU - Fischer MJ AU - Louwe LA AU - Hilders CG AU - Kroep JR AU - Stiggelbout AM FA - Garvelink, Mirjam M FA - ter Kuile, Moniek M FA - Fischer, Maarten J FA - Louwe, Leoni A FA - Hilders, Carina G J M FA - Kroep, Judith R FA - Stiggelbout, Anne M IN - Garvelink, Mirjam M. Department of Gynecology, Leiden University Medical Center (LUMC) , Leiden , the Netherlands . TI - Development of a Decision Aid about fertility preservation for women with breast cancer in The Netherlands. SO - Journal of Psychosomatic Obstetrics & Gynecology. 34(4):170-8, 2013 Dec AS - J Psychosom Obstet Gynaecol. 34(4):170-8, 2013 Dec NJ - Journal of psychosomatic obstetrics and gynaecology PI - Journal available in: Print PI - Citation processed from: Internet JC - bu1, 8308648 IO - J Psychosom Obstet Gynaecol SB - Index Medicus CP - England MH - Adult MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Fertility Preservation/px [Psychology] MH - Humans MH - Netherlands MH - Surveys and Questionnaires MH - Women AB - OBJECTIVES: To improve information provision about fertility preservation for breast cancer patients in the Netherlands, a web-based Decision Aid (DA) with additional values clarification exercise was developed according to the International Patient Decision Aid Standards criteria. This study reports on development of the DA. AB - METHODS: Development consisted of four stages: (I) development of a draft DA, (II) acceptability of the draft DA to patients, (III) understanding (knowledge) in healthy populations, (IV) acceptability of the revised DA among patients and physicians. The study population consisted of 185 participants: 20 patients, 17 physicians and 148 healthy volunteers. AB - RESULTS: The draft DA was considered to be relevant and understandable by patients, physicians and healthy volunteers. The values clarification exercise needed adaptation in explanation and navigation, which was done after stage II. Knowledge scores improved by 18% for lower educated women (from 4.1 (41%) to 5.9 (59%) correct answers), and by 34% for higher educated women after viewing the website (from 3.9 (39%) to 7.3 (73%) correct answers). Design of the DA was evaluated to be clear, but not always very appealing. AB - CONCLUSIONS: The DA was regarded as a relevant source of information that seemed coherent and understandable. ES - 1743-8942 IL - 0167-482X DO - https://dx.doi.org/10.3109/0167482X.2013.851663 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 24188788 [pubmed] ID - 10.3109/0167482X.2013.851663 [doi] PP - ppublish LG - English DP - 2013 Dec DC - 20131105 EZ - 2013/11/06 06:00 DA - 2014/07/11 06:00 DT - 2013/11/06 06:00 YR - 2013 ED - 20140710 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24188788 <146. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24576583 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Temple WJ AU - Chin-Lenn L AU - Mack LA AU - Cancer Surgery Alberta FA - Temple, Walley J FA - Chin-Lenn, Laura FA - Mack, Lloyd A FA - Cancer Surgery Alberta IN - Temple, Walley J. Department of Surgery and Oncology, University of Calgary, Calgary, AB, Canada. IN - Chin-Lenn, Laura. Department of Surgery and Oncology, University of Calgary, Calgary, AB, Canada. IN - Mack, Lloyd A. Department of Surgery and Oncology, University of Calgary, Calgary, AB, Canada. Electronic address: lloyd.mack@albertahealthservices.ca. TI - Evaluating population-based breast cancer surgical practice in real time with a web-based synoptic operative reporting system. SO - American Journal of Surgery. 207(5):693-6; discussion 696-7, 2014 May AS - Am J Surg. 207(5):693-6; discussion 696-7, 2014 May NJ - American journal of surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 3z4, 0370473 IO - Am. J. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Alberta MH - *Breast Neoplasms/su [Surgery] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - Decision Support Techniques MH - Female MH - *Guideline Adherence/sn [Statistics & Numerical Data] MH - Guideline Adherence/td [Trends] MH - Humans MH - *Internet MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - Mastectomy, Segmental/td [Trends] MH - Mastectomy, Segmental/ut [Utilization] MH - Mastectomy, Simple/sn [Statistics & Numerical Data] MH - Mastectomy, Simple/td [Trends] MH - *Mastectomy, Simple/ut [Utilization] MH - *Medical Records Systems, Computerized MH - Patient Preference MH - Practice Guidelines as Topic MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] MH - Practice Patterns, Physicians'/td [Trends] MH - Registries KW - Breast cancer; Population-based; Web-based synoptic operative reporting AB - BACKGROUND: A Web-based synoptic operative reporting system (WebSMR) incorporates implicit guidelines and real-time feedback of a surgeon's practice compared with provincial data. This study compares rates of total mastectomy (TM) between the overall provincial and WebSMR patients and examines decision-making factors in WebSMR patients. AB - METHODS: Patients treated for invasive breast cancer (2007 to 2011) were identified from WebSMR and the Alberta Cancer Registry. Reports include surgery type and reasons for TM. AB - RESULTS: Among 5,787 patients in WebSMR (2007 to 2011), TM rate decreased from 48% to 42% (P < .001). In 2011, the provincial cancer registry recorded a 56% TM rate compared to 42% in WebSMR patients. Patient preference accounted for 36% in the latter group. AB - CONCLUSIONS: In WebSMR patients, TM rates were lower than the overall provincial rate and decreased significantly during the study period. Reasons are unclear, but guidelines and real-time feedback likely plays a role. AB - Copyright © 2014 Elsevier Inc. All rights reserved. ES - 1879-1883 IL - 0002-9610 DI - S0002-9610(14)00072-5 DO - https://dx.doi.org/10.1016/j.amjsurg.2013.12.013 PT - Evaluation Studies PT - Journal Article ID - 24576583 [pubmed] ID - S0002-9610(14)00072-5 [pii] ID - 10.1016/j.amjsurg.2013.12.013 [doi] PP - ppublish PH - 2013/11/02 [received] PH - 2013/12/16 [revised] PH - 2013/12/16 [accepted] LG - English EP - 20140205 DP - 2014 May DC - 20140505 EZ - 2014/03/01 06:00 DA - 2014/06/27 06:00 DT - 2014/03/01 06:00 YR - 2014 ED - 20140626 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24576583 <147. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24772626 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Semiglazov VF AU - Semiglazov VV AU - Paltuev PM AU - Dashian GA AU - Donskikh RV AU - Komiakhov AV AU - Krivorot'ko PV AU - Nikolaev KS AU - Nikitina IV AU - Semiglazova TIu FA - Semiglazov, V F FA - Semiglazov, V V FA - Paltuev, P M FA - Dashian, G A FA - Donskikh, R V FA - Komiakhov, A V FA - Krivorot'ko, P V FA - Nikolaev, K S FA - Nikitina, I V FA - Semiglazova, T Iu TI - [Adjuvant chemotherapy for breast cancer: search for new ways of planning]. [Russian] SO - Voprosy Onkologii. 60(1):102-8, 2014 AS - Vopr Onkol. 60(1):102-8, 2014 NJ - Voprosy onkologii PI - Journal available in: Print PI - Citation processed from: Print JC - xju, 0413775 IO - Vopr Onkol SB - Index Medicus CP - Russia (Federation) MH - Age Factors MH - Antineoplastic Agents/ad [Administration & Dosage] MH - Antineoplastic Agents/ae [Adverse Effects] MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - *Biomarkers, Tumor/me [Metabolism] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/me [Metabolism] MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/dt [Drug Therapy] MH - Carcinoma, Ductal, Breast/me [Metabolism] MH - *Chemotherapy, Adjuvant MH - Decision Support Techniques MH - Female MH - Humans MH - Mastectomy, Segmental MH - MicroRNAs/me [Metabolism] MH - Neoplasm Staging MH - Receptor, ErbB-2/me [Metabolism] MH - Risk Assessment MH - Risk Factors AB - A decision regarding adjuvant chemotherapy in early (operable) breast cancer in the past was made entirely on the basis of clinical and pathological features. However with the growing awareness of tumor biology and the possibility of the genomic analysis to determine the molecular subtypes of breast cancer it is getting real to identify patients whose tumors are resistant to chemotherapy or vice versa benefit from its addition. Despite the fact that genomic analysis allows some patients avoiding chemotherapy (especially patients with localized breast cancer), such studies do not indicate the most appropriate chemotherapy regimens. Therefore treatment decisions should be based on a combination of biological features of the tumor, its stage and signs that characterize the patient such as age and tolerance to the side effects of therapy. RN - 0 (Antineoplastic Agents) RN - 0 (Biomarkers, Tumor) RN - 0 (MicroRNAs) RN - EC 2-7-10-1 (ERBB2 protein, human) RN - EC 2-7-10-1 (Receptor, ErbB-2) IS - 0507-3758 IL - 0507-3758 PT - English Abstract PT - Journal Article ID - 24772626 [pubmed] PP - ppublish LG - Russian DP - 2014 DC - 20140429 EZ - 2014/04/30 06:00 DA - 2014/05/30 06:00 DT - 2014/04/30 06:00 YR - 2014 ED - 20140529 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24772626 <148. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23462681 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Pleijhuis RG AU - Kwast AB AU - Jansen L AU - de Vries J AU - Lanting R AU - Bart J AU - Wiggers T AU - van Dam GM AU - Siesling S FA - Pleijhuis, Rick G FA - Kwast, Annemiek B G FA - Jansen, Liesbeth FA - de Vries, Jakob FA - Lanting, Rosanne FA - Bart, Joost FA - Wiggers, Theo FA - van Dam, Gooitzen M FA - Siesling, Sabine IN - Pleijhuis, Rick G. Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. TI - A validated web-based nomogram for predicting positive surgical margins following breast-conserving surgery as a preoperative tool for clinical decision-making. SO - Breast. 22(5):773-9, 2013 Oct AS - BREAST. 22(5):773-9, 2013 Oct NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Breast Neoplasms/co [Complications] MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/th [Therapy] MH - Calcinosis/co [Complications] MH - Carcinoma/co [Complications] MH - *Carcinoma/pa [Pathology] MH - *Carcinoma/th [Therapy] MH - Decision Support Techniques MH - Female MH - Humans MH - Internet MH - Magnetic Resonance Imaging MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Grading MH - *Neoplasm Recurrence, Local/pa [Pathology] MH - Neoplasm Staging MH - Neoplasm, Residual MH - *Nomograms MH - Preoperative Period MH - Radiotherapy, Adjuvant KW - AUROC; BCT; Breast cancer; Breast-conserving surgery; CNB; LR; MVA; Nomogram; OR; Surgical margin status; area under the receiver-operating characteristic curve; breast-conserving therapy; core needle biopsy; local recurrence; multivariate regression analysis; odds ratio AB - BACKGROUND: Breast-conserving therapy, consisting of lumpectomy and adjuvant radiotherapy, is considered standard treatment for early-stage breast cancer. One of the most important risk factors of local recurrence is the presence of positive surgical margins following lumpectomy. We aimed to develop and validate a predictive model (nomogram) to predict for positive margins following the first attempt at lumpectomy as a preoperative tool for clinical decision-making. AB - METHODS: Patients with clinical T1-2N0-1Mx-0 histology-proven invasive breast carcinoma who underwent BCT throughout the North-East region of The Netherlands between June 2008 and July 2009 were selected from the Netherlands Cancer Registry (n = 1185). Results from multivariate logistic regression analyses served as the basis for development of the nomogram. Nomogram calibration and discrimination were assessed graphically and by calculation of a concordance index, respectively. Nomogram performance was validated on an external independent dataset (n = 331) from the University Medical Center Groningen. AB - RESULTS: The final multivariate regression model included clinical, radiological, and pathological variables. Concordance indices were calculated of 0.70 (95% CI: 0.66-0.74) and 0.69 (95% CI: 0.63-0.76) for the modeling and the validation group, respectively. Calibration of the model was considered adequate in both groups. A nomogram was developed as a graphical representation of the model. Moreover, a web-based application (http://www.breastconservation.com) was build to facilitate the use of our nomogram in a clinical setting. AB - CONCLUSION: We developed and validated a nomogram that enables estimation of the preoperative risk of positive margins in breast-conserving surgery. Our nomogram provides a valuable tool for identifying high-risk patients who might benefit from preoperative MRI and/or oncoplastic surgery. AB - Copyright © 2013 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(13)00012-X DO - https://dx.doi.org/10.1016/j.breast.2013.01.010 PT - Journal Article ID - 23462681 [pubmed] ID - S0960-9776(13)00012-X [pii] ID - 10.1016/j.breast.2013.01.010 [doi] PP - ppublish PH - 2012/09/06 [received] PH - 2013/01/08 [revised] PH - 2013/01/19 [accepted] LG - English EP - 20130223 DP - 2013 Oct DC - 20130917 EZ - 2013/03/07 06:00 DA - 2014/05/16 06:00 DT - 2013/03/07 06:00 YR - 2013 ED - 20140514 RD - 20130917 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23462681 <149. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24378846 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schonberg MA AU - Hamel MB AU - Davis RB AU - Griggs MC AU - Wee CC AU - Fagerlin A AU - Marcantonio ER FA - Schonberg, Mara A FA - Hamel, Mary Beth FA - Davis, Roger B FA - Griggs, M Cecilia FA - Wee, Christina C FA - Fagerlin, Angela FA - Marcantonio, Edward R IN - Schonberg, Mara A. Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts. IN - Hamel, Mary Beth. Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts. IN - Davis, Roger B. Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts. IN - Griggs, M Cecilia. Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts. IN - Wee, Christina C. Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts. IN - Fagerlin, Angela. Center for Bioethics and Social Sciences in Medicine, Departments of Internal Medicine and Psychology, University of Michigan, and Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan. IN - Marcantonio, Edward R. Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts. TI - Development and evaluation of a decision aid on mammography screening for women 75 years and older. SO - JAMA Internal Medicine. 174(3):417-24, 2014 Mar AS - JAMA Intern Med. 174(3):417-24, 2014 Mar NJ - JAMA internal medicine PI - Journal available in: Print PI - Citation processed from: Internet JC - 101589534 IO - JAMA Intern Med PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017368 OI - Source: NLM. NIHMS569183 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/pc [Prevention & Control] MH - Decision Making MH - *Decision Support Techniques MH - *Early Detection of Cancer MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - *Mammography MH - *Patient Participation MH - Women's Health AB - IMPORTANCE: Guidelines recommend that women 75 years and older should be informed of the benefits and risks of mammography before being screened. However, few are adequately informed. AB - OBJECTIVES: To develop and evaluate a mammography screening decision aid (DA) for women 75 years and older. AB - DESIGN: We designed the DA using international standards. Between July 14, 2010, and April 10, 2012, participants completed a pretest survey and read the DA before an appointment with their primary care physician. They completed a posttest survey after their appointment. Medical records were reviewed for follow-up information. AB - SETTING AND PARTICIPANTS: Boston, Massachusetts, academic primary care practice. Eligible women were aged 75 to 89 years, English speaking, had not had a mammogram in 9 months but had been screened within the past 3 years, and did not have a history of dementia or invasive or noninvasive breast cancer. Of 84 women approached, 27 declined to participate, 12 were unable to complete the study for logistical reasons, and 45 participated. AB - INTERVENTIONS: The DA includes information on breast cancer risk, life expectancy, competing mortality risks, possible outcomes of screening, and a values clarification exercise. AB - MAIN OUTCOMES AND MEASURES: Knowledge of the benefits and risks of screening, decisional conflict, and screening intentions; documentation in the medical record of a discussion of the risks and benefits of mammography with a primary care physician within 6 months; and the receipt of screening within 15 months. We used the Wilcoxon signed rank test and McNemar test to compare pretest-posttest information. AB - RESULTS: The median age of participants was 79 years, 69% (31 of 45) were of non-Hispanic white race/ethnicity, and 60% (27 of 45) had attended at least some college. Comparison of posttest results with pretest results demonstrated 2 findings. First, knowledge of the benefits and risks of screening improved (P <.001). Second, fewer participants intended to be screened (56% [25 of 45] afterward compared with 82% [37 of 45] before, P =.03). Decisional conflict declined but not significantly (P =.10). In the following 6 months, 53% (24 of 45) of participants had a primary care physician note that documented the discussion of the risks and benefits of screening compared with 11% (5 of 45) in the previous 5 years (P <.001). While 84% (36 of 43) had been screened within 2 years of participating, 60% (26 of 43) were screened within 15 months after participating (>= 2 years since their last mammogram) (P =.01). Overall, 93% (42 of 45) found the DA helpful. AB - CONCLUSIONS AND RELEVANCE: A DA may improve older women's decision making about mammography screening. ES - 2168-6114 IL - 2168-6106 DI - 1792914 DO - https://dx.doi.org/10.1001/jamainternmed.2013.13639 PT - Evaluation Studies PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 24378846 [pubmed] ID - 1792914 [pii] ID - 10.1001/jamainternmed.2013.13639 [doi] ID - PMC4017368 [pmc] ID - NIHMS569183 [mid] PP - ppublish GI - No: K23 AG030964 Organization: (AG) *NIA NIH HHS* Country: United States No: K24 AG035075 Organization: (AG) *NIA NIH HHS* Country: United States No: K23AG028584 Organization: (AG) *NIA NIH HHS* Country: United States No: K23 AG028584 Organization: (AG) *NIA NIH HHS* Country: United States No: UL1 RR025758 Organization: (RR) *NCRR NIH HHS* Country: United States No: K24DK087932 Organization: (DK) *NIDDK NIH HHS* Country: United States No: UL1 RR 025758 Organization: (RR) *NCRR NIH HHS* Country: United States No: K24 DK087932 Organization: (DK) *NIDDK NIH HHS* Country: United States LG - English DP - 2014 Mar DC - 20140304 EZ - 2014/01/01 06:00 DA - 2014/05/03 06:00 DT - 2014/01/01 06:00 YR - 2014 ED - 20140501 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24378846 <150. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24508194 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Krishnan NM AU - Chatterjee A AU - Rosenkranz KM AU - Powell SG AU - Nigriny JF AU - Vidal DC FA - Krishnan, Naveen M FA - Chatterjee, Abhishek FA - Rosenkranz, Kari M FA - Powell, Stephen G FA - Nigriny, John F FA - Vidal, Dale C IN - Krishnan, Naveen M. Geisel School of Medicine at Dartmouth, Hanover, NH, USA. Electronic address: Naveen.Krishnan07@gmail.com. IN - Chatterjee, Abhishek. Division of Plastic Surgery, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. IN - Rosenkranz, Kari M. Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. IN - Powell, Stephen G. Tuck School of Business at Dartmouth, Hanover, NH, USA. IN - Nigriny, John F. Division of Plastic Surgery, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. IN - Vidal, Dale C. Division of Plastic Surgery, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. TI - The cost effectiveness of acellular dermal matrix in expander-implant immediate breast reconstruction. [Review] SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 67(4):468-76, 2014 Apr AS - J Plast Reconstr Aesthet Surg. 67(4):468-76, 2014 Apr NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - *Acellular Dermis MH - *Breast Implantation/ec [Economics] MH - Breast Implantation/mt [Methods] MH - *Breast Implants/ec [Economics] MH - *Cost-Benefit Analysis MH - Decision Support Techniques MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - *Tissue Expansion/ec [Economics] MH - Tissue Expansion/mt [Methods] KW - Acellular dermal matrix; Cost effectiveness analysis AB - BACKGROUND: Expander-implant breast reconstruction is often supplemented with acellular dermal matrix (ADM). The use of acellular dermal matrix has allowed for faster, less painful expansions and improved aesthetics, but with increased cost. Our goal was to provide the first cost utility analysis of using acellular dermal matrix in two-stage, expander-implant immediate breast reconstruction following mastectomy. AB - METHODS: A comprehensive literature review was conducted to identify complication rates for two-stage, expander-implant immediate breast reconstruction with and without acellular dermal matrix. The probabilities of the most common complications were combined with Medicare Current Procedural Terminology reimbursement codes and expert utility estimates to fit into a decision model. The decision model evaluated the cost effectiveness of acellular dermal matrix relative to reconstructions without it. Retail costs for ADM were derived from the LifeCell 2012 company catalogue for Alloderm. AB - RESULTS: The overall complication rates were 30% and 34.5% with and without ADM. The decision model revealed a baseline cost increase of $361.96 when acellular dermal matrix is used. The increase in Quality-Adjusted Life Years (QALYs) is 1.37 in the population with acellular dermal matrix. This yields a cost effective incremental cost-utility ratio (ICUR) of $264.20/QALY. Univariate sensitivity analysis confirmed that using acellular dermal matrix is cost effective even when using retail costs for unilateral and bilateral reconstructions. AB - CONCLUSIONS: Our study shows that, despite an increased cost, acellular dermal matrix is a cost effective technology for patients undergoing two-stage, expander-implant immediate breast reconstruction due to its increased utility in successful procedures. AB - Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved. ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(13)00699-2 DO - https://dx.doi.org/10.1016/j.bjps.2013.12.035 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 24508194 [pubmed] ID - S1748-6815(13)00699-2 [pii] ID - 10.1016/j.bjps.2013.12.035 [doi] PP - ppublish PH - 2013/02/08 [received] PH - 2013/10/26 [revised] PH - 2013/12/21 [accepted] LG - English EP - 20140123 DP - 2014 Apr DC - 20140317 EZ - 2014/02/11 06:00 DA - 2014/04/29 06:00 DT - 2014/02/11 06:00 YR - 2014 ED - 20140428 RD - 20140317 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24508194 <151. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24025652 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mlodinow AS AU - Ver Halen JP AU - Lim S AU - Nguyen KT AU - Gaido JA AU - Kim JY FA - Mlodinow, Alexei S FA - Ver Halen, Jon P FA - Lim, Seokchun FA - Nguyen, Khang T FA - Gaido, Jessica A FA - Kim, John Y S IN - Mlodinow, Alexei S. From the *Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL; +Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, TN; and ++Rosalind Franklin University of Medicine and Science, Chicago Medical School, North Chicago, IL. TI - Predictors of readmission after breast reconstruction: a multi-institutional analysis of 5012 patients.[Erratum appears in Ann Plast Surg. 2013 Nov;71(5):627 Note: Lim, Seokchum [corrected to Lim, Seokchun]] SO - Annals of Plastic Surgery. 71(4):335-41, 2013 Oct AS - Ann Plast Surg. 71(4):335-41, 2013 Oct NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Adult MH - Breast Implantation/is [Instrumentation] MH - Breast Implants MH - Breast Neoplasms/su [Surgery] MH - Databases, Factual MH - Decision Support Techniques MH - Female MH - Humans MH - Logistic Models MH - Mammaplasty/is [Instrumentation] MH - Mammaplasty/mt [Methods] MH - *Mammaplasty MH - Mastectomy MH - Middle Aged MH - Multivariate Analysis MH - *Patient Readmission/sn [Statistics & Numerical Data] MH - Postoperative Complications/ep [Epidemiology] MH - Postoperative Complications/su [Surgery] MH - Reoperation/sn [Statistics & Numerical Data] MH - Retrospective Studies MH - Risk Factors MH - Surgical Flaps/tr [Transplantation] MH - Tissue Expansion Devices MH - Treatment Outcome AB - BACKGROUND: Recent health care legislation institutes penalties for surgical readmissions secondary to complications. There is a paucity of evidence describing risk factors for readmission after breast reconstruction procedures. AB - METHODS: Patients undergoing breast reconstruction in 2011 were identified in the National Surgical Quality Improvement Program database. Patients were grouped as purely immediate implant/tissue-expander reconstructions or purely autologous reconstruction for analysis. Reconstructions involving multiple types of procedures were excluded due to difficulty with classification. Perioperative variables were analyzed using chi and Student t test as appropriate. Multivariate regression modeling was used to identify risk factors for readmission. AB - RESULTS: Of 5012 patients meeting inclusion criteria, 3960 and 1052 underwent implant/expander and autologous reconstructions, respectively. Implant/expander and autologous cohorts experienced similar readmission rates (4.34% vs 5.32%, respectively; P = 0.18). However, autologous reconstructions experienced a higher rate of overall complications than implant/expander reconstructions (19.96% vs 5.86%, respectively; P < 0.05), as well as higher rates of reoperation (9.7% vs 6.5%, respectively; P < 0.05). Common predictors of readmission for implant/expander and autologous cohorts included operative time, American Society of Anesthesiologist class 3 and 4, and superficial surgical site infection. Smoking, sepsis, deep wound infection, organ space infection, and wound disruption were predictive of readmission for implant/expander reconstruction only, whereas hypertension was predictive of readmission after autologous reconstruction only. AB - CONCLUSIONS: This is the first study of readmission rates after breast reconstruction. Knowledge of specific risk factors for readmission may improve patient outcomes, steer strategies for optimizing reconstructive outcomes, and minimize readmissions. ES - 1536-3708 IL - 0148-7043 DI - 00000637-201310000-00006 DO - https://dx.doi.org/10.1097/SAP.0b013e3182a0df25 PT - Evaluation Studies PT - Journal Article PT - Multicenter Study ID - 24025652 [pubmed] ID - 10.1097/SAP.0b013e3182a0df25 [doi] ID - 00000637-201310000-00006 [pii] PP - ppublish LG - English DP - 2013 Oct DC - 20130912 EZ - 2013/09/13 06:00 DA - 2014/04/26 06:00 DT - 2013/09/13 06:00 YR - 2013 ED - 20140425 RD - 20130912 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24025652 <152. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23339645 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Iskandarsyah A AU - de Klerk C AU - Suardi DR AU - Soemitro MP AU - Sadarjoen SS AU - Passchier J FA - Iskandarsyah, Aulia FA - de Klerk, Cora FA - Suardi, Dradjat R FA - Soemitro, Monty P FA - Sadarjoen, Sawitri S FA - Passchier, Jan IN - Iskandarsyah, Aulia. Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre. IN - de Klerk, Cora. Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre. IN - Suardi, Dradjat R. Department of Surgical Oncology, Hasan Sadikin Hospital. IN - Soemitro, Monty P. Department of Surgical Oncology, Hasan Sadikin Hospital. IN - Sadarjoen, Sawitri S. Department of Clinical Psychology, Padjadjaran University. IN - Passchier, Jan. Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre. TI - Psychosocial and cultural reasons for delay in seeking help and nonadherence to treatment in Indonesian women with breast cancer: a qualitative study. SO - Health Psychology. 33(3):214-21, 2014 Mar AS - Health Psychol. 33(3):214-21, 2014 Mar NJ - Health psychology : official journal of the Division of Health Psychology, American Psychological Association PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ejl, 8211523 IO - Health Psychol SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - Communication MH - Consumer Health Information MH - *Cultural Characteristics MH - Female MH - Health Knowledge, Attitudes, Practice MH - Health Services Needs and Demand MH - Humans MH - Indonesia MH - Middle Aged MH - *Patient Acceptance of Health Care/px [Psychology] MH - *Patient Compliance/px [Psychology] MH - Physician-Patient Relations MH - Qualitative Research MH - Socioeconomic Factors MH - *Time-to-Treatment/sn [Statistics & Numerical Data] AB - OBJECTIVE: The aim of this study was to explore reasons for delay in seeking medical help and nonadherence to treatment in Indonesian women with breast cancer. AB - METHOD: Semistructured interviews were conducted by purposive sampling, using a consecutive sample of 50 breast cancer patients who were treated at the Outpatient Surgical Oncology Clinic of Hasan Sadikin Hospital in Bandung, Indonesia. Interviews were recorded, transcribed verbatim, and coded using qualitative software. Codes were merged into main themes that were subsequently mapped onto the study's aim. AB - RESULTS: Eight main themes concerning reasons for delay in seeking medical help and treatment nonadherence emerged, namely: lack of awareness and knowledge, cancer beliefs, treatment beliefs, financial problems, emotional burden, severe side effects, paternalistic style of communication, and unmet information needs. AB - CONCLUSION: This study has identified several modifiable psychosocial and cultural factors related to delay in seeking help and nonadherence to treatment in breast cancer patients. We suggest that the provision of extensive information through media campaigns, treatment decision aids, and caregiver and patient education are needed to change the illness behaviors of Indonesian breast cancer patients. AB - Copyright PsycINFO Database Record (c) 2014 APA, all rights reserved. ES - 1930-7810 IL - 0278-6133 DI - 2013-01793-001 DO - https://dx.doi.org/10.1037/a0031060 PT - Journal Article ID - 23339645 [pubmed] ID - 2013-01793-001 [pii] ID - 10.1037/a0031060 [doi] PP - ppublish LG - English EP - 20130121 DP - 2014 Mar DC - 20140311 EZ - 2013/01/24 06:00 DA - 2014/04/24 06:00 DT - 2013/01/24 06:00 YR - 2014 ED - 20140423 RD - 20140311 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23339645 <153. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23934224 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jung H AU - Sinnarajah A AU - Enns B AU - Voroney JP AU - Murray A AU - Pelletier G AU - Wu JS FA - Jung, Hellen FA - Sinnarajah, Aynharan FA - Enns, Bert FA - Voroney, Jon-Paul FA - Murray, Alison FA - Pelletier, Guy FA - Wu, Jackson Sai-Yiu IN - Jung, Hellen. Department of Nursing, Tom Baker Cancer Centre, Alberta Health Services Cancer Care, Calgary, Canada. TI - Managing brain metastases patients with and without radiotherapy: initial lessonsfrom a team-based consult service through a multidisciplinary integrated palliative oncology clinic. SO - Supportive Care in Cancer. 21(12):3379-86, 2013 Dec AS - Support Care Cancer. 21(12):3379-86, 2013 Dec NJ - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9302957, b1l IO - Support Care Cancer SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - *Brain Neoplasms/rt [Radiotherapy] MH - *Brain Neoplasms/sc [Secondary] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - Carcinoma, Non-Small-Cell Lung/pa [Pathology] MH - Carcinoma, Non-Small-Cell Lung/rt [Radiotherapy] MH - Decision Making MH - Female MH - Humans MH - Lung Neoplasms/pa [Pathology] MH - Lung Neoplasms/rt [Radiotherapy] MH - Male MH - Middle Aged MH - *Palliative Care/mt [Methods] MH - *Patient Care Team MH - Prognosis MH - Referral and Consultation MH - Terminal Care AB - PURPOSE: A new ambulatory consultative clinic with integrated assessments by palliative care, radiation oncology, and allied health professionals was introduced to (1) assess patients with brain metastases at a regional comprehensive cancer center and (2) inform and guide patients on management strategies, including palliative radiotherapy, symptom control, and end-of-life care issues. We conducted a quality assurance study to inform clinical program development. AB - METHODS: Between January 2011 and May 2012, 100 consecutive brain metastases patients referred and assessed through a multidisciplinary clinic were evaluated for baseline characteristics, radiotherapy use, and supportive care decisions. Overall survival was examined by known prognostic groups. Proportion of patients receiving end-of-life radiotherapy (death within 30 and 14 days of brain radiotherapy) was used as a quality metric. AB - RESULTS: The median age was 65 years, with non-small cell lung cancer (n=38) and breast cancer (n=23) being the most common primary cancers. At least 57 patients were engaged in advance care planning discussions at first consult visit. In total, 75 patients eventually underwent brain radiotherapy, whereas 25 did not. The most common reasons for nonradiotherapy management were patient preference and rapid clinical deterioration. Overall survival for prognostic subgroups was consistent with literature reports. End-of-life brain radiotherapy was observed in 9 % (death within 30 days) and 1 % (within 14 days) of treated patients. AB - CONCLUSIONS: By integrating palliative care expertise to address the complex needs of patients with newly diagnosed brain metastases, end-of-life radiotherapy use appears acceptable and improved over historical rates at our institution. An appreciable proportion of patients are not suitable for palliative brain radiotherapy or opt against this treatment option, but the team approach involving nurses, palliative care experts, allied health, and clinical oncologists facilitates patient-centered decision making and transition to end-of-life care. ES - 1433-7339 IL - 0941-4355 DO - https://dx.doi.org/10.1007/s00520-013-1917-1 PT - Journal Article ID - 23934224 [pubmed] ID - 10.1007/s00520-013-1917-1 [doi] PP - ppublish PH - 2013/03/05 [received] PH - 2013/07/22 [accepted] LG - English EP - 20130810 DP - 2013 Dec DC - 20131108 EZ - 2013/08/13 06:00 DA - 2014/04/20 06:00 DT - 2013/08/13 06:00 YR - 2013 ED - 20140418 RD - 20131108 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23934224 <154. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23945529 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cleveland EC AU - Fischer JP AU - Nelson JA AU - Sieber B AU - Low DW AU - Kovach SJ 3rd AU - Wu LC AU - Serletti JM FA - Cleveland, Emily C FA - Fischer, John P FA - Nelson, Jonas A FA - Sieber, Brady FA - Low, David W FA - Kovach, Stephen J 3rd FA - Wu, Liza C FA - Serletti, Joseph M IN - Cleveland, Emily C. Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. TI - Optimizing the fascial closure: an analysis of 1261 abdominally based free flap reconstructions. SO - Annals of Plastic Surgery. 71(3):255-60, 2013 Sep AS - Ann Plast Surg. 71(3):255-60, 2013 Sep NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Abdominal Wound Closure Techniques/is [Instrumentation] MH - *Abdominal Wound Closure Techniques MH - Algorithms MH - Decision Support Techniques MH - *Fasciotomy MH - Female MH - *Free Tissue Flaps MH - Humans MH - Logistic Models MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - Multivariate Analysis MH - Outcome Assessment (Health Care) MH - Postoperative Complications/pc [Prevention & Control] MH - Reoperation MH - Retrospective Studies MH - Surgical Mesh AB - BACKGROUND: Donor-site morbidity continues to be a significant complication in patients undergoing abdominally based breast reconstruction. The purposes of our study were to critically examine abdominal donor-site morbidity and to present our algorithm for optimizing donor site closure to reduce these complications. AB - METHODS: We performed a retrospective cohort study examining all patients undergoing abdominally based free tissue transfer for breast reconstruction from 2005 to 2011 at our institution. Data were analyzed for overall donor site morbidity, as defined by hernia/bulge or reoperation for debridement and/or mesh removal and for hernia/bulge alone. AB - RESULTS: A total of 812 patients underwent 1261 free tissue transfers. Fifty-three patients (6.5%) experienced donor-site morbidity, including 27 hernias/bulges (3.3%). No significant difference in overall abdominal morbidity was found between unilateral and bilateral reconstructions (P = 0.39) or the use of muscle in the flap (P = 0.11 unilateral msfTRAM, P = 0.76 bilateral). Prior lower abdominal surgery was associated with higher rates of donor-site morbidity (P = 0.04); hypertension (P = 0.012) and multiple medical comorbidities (P < 0.001) were also significantly more common in these patients. Obesity was the only patient characteristic associated with higher rates of hernia/bulge (P = 0.04). Delayed abdominal would healing was associated with hernia/bulge (P < 0.001); these patients were significantly more likely to develop this complication (odds ratio = 6.3, P < 0.001). AB - CONCLUSIONS: Particular attention must be provided to donor-site closure in obese patients and those with hypertension and multiple medical comorbidities. Low rates of abdominal wall morbidity result from meticulous fascial reconstruction and reinforcement and careful attention to tension-free soft tissue closure. ES - 1536-3708 IL - 0148-7043 DI - 00000637-201309000-00003 DO - https://dx.doi.org/10.1097/SAP.0b013e318286380e PT - Evaluation Studies PT - Journal Article ID - 23945529 [pubmed] ID - 10.1097/SAP.0b013e318286380e [doi] ID - 00000637-201309000-00003 [pii] PP - ppublish LG - English DP - 2013 Sep DC - 20130815 EZ - 2013/08/16 06:00 DA - 2014/04/12 06:00 DT - 2013/08/16 06:00 YR - 2013 ED - 20140411 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23945529 <155. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24645229 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Faermann R AU - Sperber F AU - Schneebaum S AU - Barsuk D FA - Faermann, Renata FA - Sperber, Fani FA - Schneebaum, Schlomo FA - Barsuk, Daphna TI - Tumor-to-breast volume ratio as measured on MRI: a possible predictor of breast-conserving surgery versus mastectomy. SO - Israel Medical Association Journal: Imaj. 16(2):101-5, 2014 Feb AS - Isr Med Assoc J. 16(2):101-5, 2014 Feb NJ - The Israel Medical Association journal : IMAJ PI - Journal available in: Print PI - Citation processed from: Print JC - dk6, 100930740 IO - Isr. Med. Assoc. J. SB - Index Medicus CP - Israel MH - Adult MH - Aged MH - Breast/pa [Pathology] MH - Breast/su [Surgery] MH - *Breast MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - Decision Support Techniques MH - Female MH - Humans MH - Magnetic Resonance Imaging/mt [Methods] MH - Magnetic Resonance Imaging/sn [Statistics & Numerical Data] MH - *Magnetic Resonance Imaging MH - Mastectomy, Segmental/mt [Methods] MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - *Mastectomy, Segmental MH - Mastectomy, Simple/mt [Methods] MH - Mastectomy, Simple/sn [Statistics & Numerical Data] MH - *Mastectomy, Simple MH - Middle Aged MH - Organ Size MH - Organ Sparing Treatments MH - Patient Care Planning MH - Predictive Value of Tests MH - Retrospective Studies MH - Statistics as Topic MH - Tumor Burden AB - BACKGROUND: The surgical approach to breast cancer changed dramatically in the past 20 years. The surgical objective today is to remove the tumor, ensuring negative margins and good cosmetic results, and preserving the breast when possible. Magnetic resonance imaging of the breast has become an essential imaging tool prior to surgery, diagnosing additional tumors and assessing tumor extent. Tumor-to-breast volume ratio, an important predictor of breast conservation, can be measured with MRI and may change the surgical decision. AB - OBJECTIVES: To measure the tumor-to-breast volume ratio using MRI in order to assess whether there is a correlation between this ratio and the type of surgery selected (breast-conserving or mastectomy). AB - METHODS: The volumes of the tumor and the breast and the tumor-to-breast volume ratio were retrospectively calculated using preoperative breast MRI in 76 patients who underwent breast-conserving surgery or mastectomy. AB - RESULTS: Breast-conserving surgery (lumpectomy) was performed in 64 patients and mastectomy in 12. The average tumor-to-breast volume ratio was 0.06 (6%) in the lumpectomy group and 0.30 (30%) in the mastectomy group (P < 0.0001). AB - CONCLUSION: The tumor-to-breast volume ratio correlated with the type of surgery. As measured on MRI, this ratio is an accurate means of determining the type of surgery best suited for a given patient. It is recommended that MRI-determined tumor-to-breast volume ratio become part of the surgical planning protocol for patients diagnosed with breast cancer. IS - 1565-1088 PT - Journal Article ID - 24645229 [pubmed] PP - ppublish LG - English DP - 2014 Feb DC - 20140320 EZ - 2014/03/21 06:00 DA - 2014/04/08 06:00 DT - 2014/03/22 06:00 YR - 2014 ED - 20140407 RD - 20140320 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24645229 <156. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24469159 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tsoi B AU - Ziolkowski NI AU - Thoma A AU - Campbell K AU - O'Reilly D AU - Goeree R FA - Tsoi, Bernice FA - Ziolkowski, Natalia I FA - Thoma, Achilleas FA - Campbell, Kaitryn FA - O'Reilly, Daria FA - Goeree, Ron IN - Tsoi, Bernice. Hamilton, Ontario, Canada; and Warsaw, Poland From the Department of Clinical Epidemiology and Biostatistics, the Division of Plastic Surgery, Department of Surgery, and the Surgical Outcomes Research Center, Department of Surgery, McMaster University; Programs for Assessment of Technology in Health Research Institute, St. Joseph's Healthcare Hamilton; and the Second Department of General, Vascular, and Oncologic Surgery, Medical University of Warsaw. TI - Safety of tissue expander/implant versus autologous abdominal tissue breast reconstruction in postmastectomy breast cancer patients: a systematic review and meta-analysis. [Review] SO - Plastic & Reconstructive Surgery. 133(2):234-49, 2014 Feb AS - Plast Reconstr Surg. 133(2):234-49, 2014 Feb NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Abdominal Fat/tr [Transplantation] MH - *Breast Implants/ae [Adverse Effects] MH - *Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Mastectomy MH - *Tissue Expansion Devices/ae [Adverse Effects] AB - BACKGROUND: Breast reconstruction after mastectomy for breast cancer should be informed by evidence-based knowledge, such as complication rates. The authors compared the safety of tissue expander/implant reconstruction with that of autologous abdominal tissue reconstruction. AB - METHODS: A systematic literature review identified peer-reviewed studies published from January of 2000 to October of 2012 that compared tissue expander/implant against autologous abdominal tissue reconstruction in the MEDLINE, EMBASE, Cochrane Library, PubMed, and ProQuest Dissertations and Theses databases. Two reviewers independently screened all reports and selected the relevant articles using specific inclusion criteria. Data were extracted from the relevant articles using a standardized abstraction form. AB - RESULTS: Fourteen observational studies were identified that included more than 3000 reconstructed breasts. Significant differences were found between these two approaches. The relative risk associated with reconstructive failure favored autologous abdominal tissue (relative risk, 0.14; 95 percent CI, 0.06 to 0.32; I = 0 percent). Surgical-site infection was significantly lower in autologous abdominal tissue reconstruction compared with tissue expander/implant (relative risk, 0.37; 95 percent CI, 0.25 to 0.55; I = 0 percent), although skin or flap necrosis was higher in autologous abdominal tissue reconstruction compared with tissue expander/implant (relative risk, 2.79; 95 percent CI, 1.87 to 4.17). Studies were of low to moderate quality according to the Newcastle-Ottawa scale. AB - CONCLUSIONS: This study suggests that tissue expander/implant reconstruction has a higher risk of reconstructive failure and surgical-site infection compared with autologous abdominal tissue reconstruction. With the lack of long-term safety studies on different approaches to breast reconstruction, additional long-term comparative studies are needed to support evidence-based decision-making. AB - CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201402000-00005 DO - https://dx.doi.org/10.1097/01.prs.0000436847.94408.11 PT - Comparative Study PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Review ID - 24469159 [pubmed] ID - 10.1097/01.prs.0000436847.94408.11 [doi] ID - 00006534-201402000-00005 [pii] PP - ppublish LG - English DP - 2014 Feb DC - 20140128 EZ - 2014/01/29 06:00 DA - 2014/03/25 06:00 DT - 2014/01/29 06:00 YR - 2014 ED - 20140324 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24469159 <157. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23664232 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rupert DJ AU - Squiers LB AU - Renaud JM AU - Whitehead NS AU - Osborn RJ AU - Furberg RD AU - Squire CM AU - Tzeng JP FA - Rupert, Douglas J FA - Squiers, Linda B FA - Renaud, Jeanette M FA - Whitehead, Nedra S FA - Osborn, Roger J FA - Furberg, Robert D FA - Squire, Claudia M FA - Tzeng, Janice P IN - Rupert, Douglas J. Health Communication Program, RTI International, Research Triangle Park, NC 27709, USA. drupert@rti.org TI - Communicating risk of hereditary breast and ovarian cancer with an interactive decision support tool. SO - Patient Education & Counseling. 92(2):188-96, 2013 Aug AS - Patient Educ Couns. 92(2):188-96, 2013 Aug NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/ge [Genetics] MH - Decision Support Systems, Clinical MH - Female MH - Genetic Predisposition to Disease MH - Genetic Testing MH - *Health Communication MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Ovarian Neoplasms/di [Diagnosis] MH - *Ovarian Neoplasms/ge [Genetics] MH - Risk MH - *Risk Assessment/mt [Methods] MH - Socioeconomic Factors KW - Artificial intelligence; BRCA; Breast cancer; Genetic testing; Ovarian cancer; Risk communication AB - OBJECTIVE: Women with hereditary breast and ovarian cancer syndrome (HBOC) face a higher risk of earlier, more aggressive cancer. Because of HBOC's rarity, screening is recommended only for women with strong cancer family histories. However, most patients do not have accurate history available and struggle to understand genetic concepts. AB - METHODS: Cancer in the Family, an online clinical decision support tool, calculated women's HBOC risk and promoted shared patient-provider decisions about screening. A pilot evaluation (n=9 providers, n=48 patients) assessed the tool's impact on knowledge, attitudes, and screening decisions. Patients used the tool before wellness exams and completed three surveys. Providers accessed the tool during exams, completed exam checklists, and completed four surveys. AB - RESULTS: Patients entered complete family histories (67%), calculated personal risk (96%), and shared risk printouts with providers (65%). HBOC knowledge increased dramatically for patients and providers, and many patients (75%) perceived tool results as valid. The tool prompted patient-provider discussions about HBOC risk and cancer family history (88%). AB - CONCLUSIONS: The tool was effective in increasing knowledge, collecting family history, and sparking patient-provider discussions about HBOC screening. AB - PRACTICE IMPLICATIONS: Interactive tools can effectively communicate personalized risk and promote shared decisions, but they are not a substitute for patient-provider discussions. AB - Copyright © 2013 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(13)00166-3 DO - https://dx.doi.org/10.1016/j.pec.2013.04.008 PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 23664232 [pubmed] ID - S0738-3991(13)00166-3 [pii] ID - 10.1016/j.pec.2013.04.008 [doi] PP - ppublish PH - 2012/06/27 [received] PH - 2013/03/11 [revised] PH - 2013/04/09 [accepted] LG - English EP - 20130509 DP - 2013 Aug DC - 20130722 EZ - 2013/05/14 06:00 DA - 2014/02/26 06:00 DT - 2013/05/15 06:00 YR - 2013 ED - 20140225 RD - 20130722 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23664232 <158. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23972534 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Joyce CW AU - Morrison CM AU - Sgarzani R AU - Blondeel PN FA - Joyce, C W FA - Morrison, C M FA - Sgarzani, R FA - Blondeel, P N IN - Joyce, C W. Department of Plastic and Reconstructive Surgery, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: cjoyce78@hotmail.com. TI - Patient preferences in an online breast reconstruction resource. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 66(12):e380-1, 2013 Dec AS - J Plast Reconstr Aesthet Surg. 66(12):e380-1, 2013 Dec NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - Breast Neoplasms/su [Surgery] MH - Databases, Bibliographic MH - *Databases, Factual MH - Decision Making MH - Female MH - Humans MH - *Information Dissemination MH - *Internet MH - *Mammaplasty MH - Middle Aged MH - *Patient Education as Topic MH - Physician's Role MH - Surgery, Plastic ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(13)00431-2 DO - https://dx.doi.org/10.1016/j.bjps.2013.07.016 PT - Letter ID - 23972534 [pubmed] ID - S1748-6815(13)00431-2 [pii] ID - 10.1016/j.bjps.2013.07.016 [doi] PP - ppublish PH - 2013/06/04 [received] PH - 2013/07/02 [revised] PH - 2013/07/07 [accepted] LG - English EP - 20130822 DP - 2013 Dec DC - 20131125 EZ - 2013/08/27 06:00 DA - 2014/02/18 06:00 DT - 2013/08/27 06:00 YR - 2013 ED - 20140217 RD - 20131125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23972534 <159. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23973103 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fischer JP AU - Wes AM AU - Tuggle CT 3rd AU - Serletti JM AU - Wu LC FA - Fischer, John P FA - Wes, Ari M FA - Tuggle, Charles T 3rd FA - Serletti, Joseph M FA - Wu, Liza C IN - Fischer, John P. Divisions of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA. Electronic address: John.Fischer2@uphs.upenn.edu. TI - Risk analysis of early implant loss after immediate breast reconstruction: a review of 14,585 patients. SO - Journal of the American College of Surgeons. 217(6):983-90, 2013 Dec AS - J Am Coll Surg. 217(6):983-90, 2013 Dec NJ - Journal of the American College of Surgeons PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - bzb, 9431305 IO - J. Am. Coll. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - *Breast Implantation/is [Instrumentation] MH - *Breast Implants MH - Databases, Factual MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Logistic Models MH - Mastectomy MH - Middle Aged MH - Multivariate Analysis MH - Odds Ratio MH - Outcome Assessment (Health Care) MH - *Prosthesis Failure/et [Etiology] MH - Risk Assessment MH - Risk Factors KW - BMI; CPT; Current Procedural Terminology; DTI; IBR; OR; TE; body mass index; direct-to-implant; immediate breast reconstruction; odds ratio; tissue expander AB - BACKGROUND: Early prosthesis loss is an infrequent but serious complication after breast reconstruction. We assessed perioperative risk factors associated with early device loss after immediate breast reconstruction (IBR) using the ACS-NSQIP datasets. AB - STUDY DESIGN: We reviewed the 2005 to 2011 ACS-NSQIP databases identifying encounters for CPT codes 19357 and 19340. Patients were identified as experiencing a "loss of graft/prosthetic" based on a standard dataset variable. Patients who experienced a device loss were compared with those who did not with respect to perioperative characteristics. AB - RESULTS: We identified 14,585 patients with an average age of 50.9 +/- 10.6 years. A multivariate regression analysis determined that age (>55 years) (odds ratio [OR] 1.66, p = 0.013) (risk score = 1), class II obesity (OR 3.17, p < 0.001) (risk score = 3), class III obesity (OR 2.41, p = 0.014) (risk score = 3), active smoking (OR 2.95, p < 0.001) (risk score = 3), bilateral reconstruction (OR 1.67, p = 0.007) (risk score = 1), and direct-to-implant (DTI) reconstruction (OR 1.69, p = 0.024) (risk score = 1) were associated with early device loss. Odds ratios were used to assign weighted risk scores to each patient, and risk categories were broken into low risk (0 to 1, n = 9,349), intermediate risk (2 to 5, n = 5,001), and high risk (>= 6, n = 233) groups. The risk of device loss was significantly higher with increased risk score (0.39% vs 1.48% vs 3.86%, p < 0.001). AB - CONCLUSIONS: Early device loss following IBR is a complex multifactorial process related to identifiable preoperative risk factors. This study demonstrated that age, obesity, smoking, bilateral procedures, and DTI reconstructions are associated with increased risk of implant loss. AB - Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved. ES - 1879-1190 IL - 1072-7515 DI - S1072-7515(13)00898-3 DO - https://dx.doi.org/10.1016/j.jamcollsurg.2013.07.389 PT - Evaluation Studies PT - Journal Article ID - 23973103 [pubmed] ID - S1072-7515(13)00898-3 [pii] ID - 10.1016/j.jamcollsurg.2013.07.389 [doi] PP - ppublish PH - 2013/06/06 [received] PH - 2013/07/10 [revised] PH - 2013/07/10 [accepted] LG - English EP - 20130821 DP - 2013 Dec DC - 20131119 EZ - 2013/08/27 06:00 DA - 2014/01/15 06:00 DT - 2013/08/27 06:00 YR - 2013 ED - 20140113 RD - 20131119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23973103 <160. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23886556 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Nelson JA AU - Fischer JP AU - Radecki MA AU - Pasick C AU - McGrath J AU - Serletti JM AU - Wu LC FA - Nelson, Jonas A FA - Fischer, John P FA - Radecki, M Anne FA - Pasick, Christina FA - McGrath, Jennifer FA - Serletti, Joseph M FA - Wu, Liza C IN - Nelson, Jonas A. Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States. Electronic address: jonas.nelson@uphs.upenn.edu. TI - Delayed autologous breast reconstruction: factors which influence patient decision making. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 66(11):1513-20, 2013 Nov AS - J Plast Reconstr Aesthet Surg. 66(11):1513-20, 2013 Nov NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Delivery of Health Care, Integrated MH - Female MH - Health Services Accessibility MH - Humans MH - Income MH - *Mammaplasty/px [Psychology] MH - Mastectomy MH - Middle Aged MH - Neoplasm Staging MH - Patient Education as Topic MH - *Patient Participation MH - Patient Satisfaction MH - Retrospective Studies MH - Time Factors KW - Autologous; Breast reconstruction; Decision making; Delayed reconstruction; Free flap; Survey AB - BACKGROUND: Autologous breast reconstruction timing continues to be controversial. The purpose of this study was to examine delayed autologous breast reconstruction at a center favouring immediate reconstruction to better understand factors driving the decision to delay reconstruction. AB - METHODS: We performed a retrospective cohort study of all free autologous breast reconstruction patients between 2005 and 2009, focussing on ethnicity, cancer stage, unilateral or bilateral reconstructions, initial management, distance from the institution, and average income. Delayed reconstructions were compared to immediate reconstructions. All delayed reconstructions were surveyed to examine treatment and reconstruction decisions and satisfaction. AB - RESULTS: Of 709 patients, 169 (24%) underwent delayed treatment. Delayed reconstruction patients had higher cancer stages (p < 0.001), higher rates of pre-reconstruction radiation therapy (64% vs. 20%, p < 0.0001) and higher rates of unilateral reconstruction (64% vs. 48%, p < 0.001). Seventy delayed patients responded to the survey (41%), with 75% having had their initial mastectomy at an outside health system. Only 51% discussed immediate reconstruction prior to electing delayed treatment and 41% had no discussion regarding advantages or disadvantages to reconstructive options. Approximately 30% noted no choice in their reconstructive timing. Forty five percent would elect immediate reconstruction if given the option. AB - CONCLUSIONS: This study demonstrates that women may not be receiving all available information prior to undergoing mastectomy for initial breast cancer treatment. As a significant portion of women electing delayed reconstruction would elect immediate autologous reconstruction if given the option again, there is room for improvement in pre-operative patient education and in the education of our oncology colleagues. AB - Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(13)00357-4 DO - https://dx.doi.org/10.1016/j.bjps.2013.06.020 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 23886556 [pubmed] ID - S1748-6815(13)00357-4 [pii] ID - 10.1016/j.bjps.2013.06.020 [doi] PP - ppublish PH - 2012/12/14 [received] PH - 2013/03/20 [revised] PH - 2013/06/04 [accepted] LG - English EP - 20130722 DP - 2013 Nov DC - 20131008 EZ - 2013/07/27 06:00 DA - 2013/12/24 06:00 DT - 2013/07/28 06:00 YR - 2013 ED - 20131223 RD - 20131008 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23886556 <161. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23835709 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lam WW AU - Chan M AU - Or A AU - Kwong A AU - Suen D AU - Fielding R FA - Lam, Wendy W T FA - Chan, Miranda FA - Or, Amy FA - Kwong, Ava FA - Suen, Dacita FA - Fielding, Richard IN - Lam, Wendy W T. Centre for Psycho-Oncological Research and Training, Department of Community Medicine and Unit for Behavioural Sciences, School of Public Health, The University of Hong Kong, 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Rd, Pokfulam, Hong Kong; Special Administrative Region, People's Republic of China. wwtlam@hku.hk TI - Reducing treatment decision conflict difficulties in breast cancer surgery: a randomized controlled trial. SO - Journal of Clinical Oncology. 31(23):2879-85, 2013 Aug 10 AS - J Clin Oncol. 31(23):2879-85, 2013 Aug 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - Neoplasm Staging MH - *Patient Education as Topic/mt [Methods] MH - Patient Satisfaction MH - Surveys and Questionnaires MH - Treatment Outcome AB - PURPOSE: Breast cancer (BC) decision aid (DA) randomized studies are limited to DA use in consultations among Western populations and for primary surgery. Their effectiveness beyond consultations, for reconstructive surgery and in other populations, has not been evaluated. We developed a DA administered after consultation for Chinese women deciding on BC surgery and, where relevant, immediate breast reconstruction, which was evaluated in this randomized controlled trial (RCT). AB - PATIENTS AND METHODS: Overall, 276 women considering BC surgery for early-stage BC were randomly assigned to receive a DA (take-home booklet) or the standard information booklet (control condition) after the initial consultation, wherein surgeons disclosed the diagnosis and discussed treatment options with patients. Using block random assignment by week, 138 women were assigned to the DA arm and 138 to the control arm. Participants completed interview-based questionnaires 1 week after consultation and then 1, 4, and 10 months after surgery. Primary outcome measures were decisional conflict, decision-making difficulties, BC knowledge 1 week after consultation, and decision regret 1 month after surgery. Secondary outcome measures were treatment decision, decision regret 4 and 10 months after surgery, and postsurgical anxiety and depression. AB - RESULTS: The DA group reported significantly lower decisional conflict scores 1 week after consultation (P = .016) compared with women in the control arm. Women receiving the DA had significantly lower decision regret scores 4 (P = .026) and 10 months (P = .014) after surgery and lower depression scores 10 months after surgery (P = .001). AB - CONCLUSION: This RCT demonstrated DAs may benefit Chinese patients in Hong Kong by reducing decisional conflict and subsequent regret and enhance clinical services for this population. ES - 1527-7755 IL - 0732-183X DI - JCO.2012.45.1856 DO - https://dx.doi.org/10.1200/JCO.2012.45.1856 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 23835709 [pubmed] ID - JCO.2012.45.1856 [pii] ID - 10.1200/JCO.2012.45.1856 [doi] PP - ppublish LG - English EP - 20130708 DP - 2013 Aug 10 DC - 20130809 EZ - 2013/07/10 06:00 DA - 2013/12/16 06:00 DT - 2013/07/10 06:00 YR - 2013 ED - 20131204 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23835709 <162. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24079102 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Trossman S FA - Trossman, Susan TI - Risk management: Jolie's decision sparks debate, need for more education. SO - American Nurse. 45(4):1, 6, 2013 Jul-Aug AS - Am Nurse. 45(4):1, 6, 2013 Jul-Aug NJ - The American nurse PI - Journal available in: Print PI - Citation processed from: Print JC - 40d, 7506499 IO - Am Nurse SB - Nursing Journal CP - United States MH - Decision Making MH - Female MH - Humans MH - *Mastectomy/mt [Methods] MH - *Patient Education as Topic MH - *Risk Management MH - United States IS - 0098-1486 IL - 0098-1486 PT - Journal Article ID - 24079102 [pubmed] PP - ppublish LG - English DP - 2013 Jul-Aug DC - 20131001 EZ - 2013/10/02 06:00 DA - 2013/11/02 06:00 DT - 2013/10/02 06:00 YR - 2013 ED - 20131101 RD - 20131001 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24079102 <163. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23542852 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wagner IJ AU - Tong WM AU - Halvorson EG FA - Wagner, I Janelle FA - Tong, Winnie M FA - Halvorson, Eric Glenn IN - Wagner, I Janelle. Division of Plastic Surgery, Department of Surgery, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA. TI - A classification system for fat necrosis in autologous breast reconstruction. CM - Comment in: Ann Plast Surg. 2015 Feb;74(2):269; PMID: 25590246 SO - Annals of Plastic Surgery. 70(5):553-6, 2013 May AS - Ann Plast Surg. 70(5):553-6, 2013 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Algorithms MH - Debridement MH - *Decision Support Techniques MH - *Fat Necrosis/cl [Classification] MH - Fat Necrosis/di [Diagnosis] MH - Fat Necrosis/et [Etiology] MH - Fat Necrosis/su [Surgery] MH - Female MH - Humans MH - Mammaplasty/mt [Methods] MH - *Mammaplasty MH - *Postoperative Complications/cl [Classification] MH - Postoperative Complications/di [Diagnosis] MH - Postoperative Complications/et [Etiology] MH - Postoperative Complications/su [Surgery] MH - Reoperation MH - Reproducibility of Results MH - Retrospective Studies MH - Risk Factors MH - Surgical Flaps AB - PURPOSE: Fat necrosis (FN) is a common complication of autologous breast reconstruction, yet no classification system exists to describe it. We sought to develop and validate a tool for meaningful reporting, comparison of techniques, and treatment planning. Our hypothesis was that a valid classification system would demonstrate higher grades of FN for pedicled transverse rectus abdominus myocutaneous (pTRAM) flaps as compared to free flaps (FF). AB - METHODS: A classification system for FN was developed: grade I, radiologic evidence only; grade II, palpable but not visible FN; grade III, palpable and visible FN; and grade IV, symptomatic FN. For validation, we applied this system to patients who had undergone pTRAM flaps from 2002 to 2006 and FF from 2006 to 2010 at our institution. AB - RESULTS: We performed 93 pTRAM flaps in 69 patients and 102 FF in 69 patients. One patient had grade I FN and was observed. Of the 29 patients with grade II FN, 48% were observed, 17% had biopsy, and 35% underwent debridement. Of the 9 patients with grade III FN, 11% underwent biopsy and 89% had debridement. All patients with grade IV FN underwent debridement. The distribution of FN differed between pTRAM and FF. The mean FN grade for patients undergoing pTRAM was 1.4 versus 0.4 for those undergoing FF (P < 0.05). Fat necrosis requiring reoperation was more frequent in the pTRAM group (23.7% vs 5.9%, P < 0.05). AB - CONCLUSIONS: Our validation study confirmed that FN grade was associated with the need for surgery and was higher for pedicled flaps as compared to FFs. As it is similar to the Baker grading system for capsular contracture, this classification system is familiar to all plastic surgeons. It is simple, easy to remember, clinically oriented, and could be readily incorporated into outcome studies of autologous breast reconstruction. ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/SAP.0b013e31827ead1b PT - Evaluation Studies PT - Journal Article ID - 23542852 [pubmed] ID - 10.1097/SAP.0b013e31827ead1b [doi] PP - ppublish LG - English DP - 2013 May DC - 20130412 EZ - 2013/04/02 06:00 DA - 2013/10/26 06:00 DT - 2013/04/02 06:00 YR - 2013 ED - 20131025 RD - 20150302 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23542852 <164. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23542838 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Newman MI AU - Jack MC AU - Samson MC FA - Newman, Martin I FA - Jack, Megan C FA - Samson, Michel C IN - Newman, Martin I. Department of Plastic Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA. newmanm@ccf.org TI - SPY-Q analysis toolkit values potentially predict mastectomy flap necrosis. SO - Annals of Plastic Surgery. 70(5):595-8, 2013 May AS - Ann Plast Surg. 70(5):595-8, 2013 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - *Decision Support Techniques MH - Female MH - Fluorescent Dyes MH - Graft Survival MH - Humans MH - *Image Processing, Computer-Assisted/mt [Methods] MH - Indocyanine Green MH - *Intraoperative Care/mt [Methods] MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Middle Aged MH - Necrosis/di [Diagnosis] MH - Necrosis/et [Etiology] MH - *Optical Imaging MH - *Postoperative Complications/di [Diagnosis] MH - Retrospective Studies MH - Risk Assessment MH - Software MH - Surgical Flaps/bs [Blood Supply] MH - *Surgical Flaps/pa [Pathology] MH - Treatment Outcome AB - BACKGROUND: Previously, we and other investigators have reported the benefits of using SPY Intraoperative Perfusion Assessment System to assist in the prediction of mastectomy flap necrosis. To date, analysis of the SPY images has been subjective. However, the new SPY-Q postprocessing software allows for objective quantification of SPY images through the application of absolute and relative values of fluorescence intensity. This study seeks to determine the use of these objective, numerical data and their role in potentially predicting mastectomy flap necrosis. AB - METHODS: In a retrospective fashion, 20 SPY images from immediate breast reconstructions were randomly selected from a database of more than 100 images: 10 from breasts that developed flap necrosis and 10 from breasts that demonstrated adequate healing. Groups were matched for age, body mass index, and comorbidities. The points of necrosis and points of adequate healing were evaluated using the postprocessing software, and the groups were compared. AB - RESULTS: The mean "relative" fluorescence of the necrosis and the adequate healing groups was 25.2% and 43.3%, respectively (P < 0.001). The mean absolute fluorescence of the 2 groups was 18.5 and 25.0, respectively (P = 0.07). AB - CONCLUSIONS: These findings suggest that quantitative "relative" perfusion values as generated by the postprocessing software may augment clinical judgment of flap viability in an objective and reproducible fashion. RN - 0 (Fluorescent Dyes) RN - IX6J1063HV (Indocyanine Green) ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/SAP.0b013e3182650b4e PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 23542838 [pubmed] ID - 10.1097/SAP.0b013e3182650b4e [doi] PP - ppublish LG - English DP - 2013 May DC - 20130412 EZ - 2013/04/02 06:00 DA - 2013/10/26 06:00 DT - 2013/04/02 06:00 YR - 2013 ED - 20131025 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23542838 <165. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23829442 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Platt J AU - Baxter N AU - Jones J AU - Metcalfe K AU - Causarano N AU - Hofer SO AU - O'Neill A AU - Cheng T AU - Starenkyj E AU - Zhong T FA - Platt, Jennica FA - Baxter, Nancy FA - Jones, Jennifer FA - Metcalfe, Kelly FA - Causarano, Natalie FA - Hofer, Stefan O P FA - O'Neill, Anne FA - Cheng, Terry FA - Starenkyj, Elizabeth FA - Zhong, Toni IN - Platt, Jennica. UHN Breast Restoration Program, Division of Plastic and Reconstructive Surgery, 8N 871, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada. TI - Pre-consultation educational group intervention to improve shared decision-making in postmastectomy breast reconstruction: study protocol for a pilot randomized controlled trial. SO - Trials [Electronic Resource]. 14:199, 2013 Jul 06 AS - Trials. 14:199, 2013 Jul 06 NJ - Trials PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101263253 IO - Trials PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708760 SB - Index Medicus CP - England MH - *Breast Implantation MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Clinical Protocols MH - *Decision Making MH - Feasibility Studies MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - *Mastectomy MH - Ontario MH - *Patient Education as Topic MH - Patient Participation MH - Patient Satisfaction MH - Pilot Projects MH - *Referral and Consultation MH - *Research Design MH - Self Efficacy MH - Treatment Outcome AB - BACKGROUND: The Pre-Consultation Educational Group INTERVENTION pilot study seeks to assess the feasibility and inform the optimal design for a definitive randomized controlled trial that aims to improve the quality of decision-making in postmastectomy breast reconstruction patients. AB - METHODS/DESIGN: This is a mixed-methods pilot feasibility randomized controlled trial that will follow a single-center, 1:1 allocation, two-arm parallel group superiority design. AB - SETTING: The University Health Network, a tertiary care cancer center in Toronto, Canada. AB - PARTICIPANTS: Adult women referred to one of three plastic and reconstructive surgeons for delayed breast reconstruction or prophylactic mastectomy with immediate breast reconstruction. AB - INTERVENTION: We designed a multi-disciplinary educational group workshop that incorporates the key components of shared decision-making, decision-support, and psychosocial support for cancer survivors prior to the initial surgical consult. The intervention consists of didactic lectures by a plastic surgeon and nurse specialist on breast reconstruction choices, pre- and postoperative care; a value-clarification exercise led by a social worker; and discussions with a breast reconstruction patient. AB - CONTROL: Usual care includes access to an informational booklet, website, and patient volunteer if desired. AB - OUTCOMES: Expected pilot outcomes include feasibility, recruitment, and retention targets. Acceptability of intervention and full trial outcomes will be established through qualitative interviews. Trial outcomes will include decision-quality measures, patient-reported outcomes, and service outcomes, and the treatment effect estimate and variability will be used to inform the sample size calculation for a full trial. AB - DISCUSSION: Our pilot study seeks to identify the (1) feasibility, acceptability, and design of a definitive RCT and (2) the optimal content and delivery of our proposed educational group intervention. Thirty patients have been recruited to date (8 April 2013), of whom 15 have been randomized to one of three decision support workshops. The trial will close as planned in May 2013. AB - TRIAL REGISTRATION: NCT01857882. ES - 1745-6215 IL - 1745-6215 DI - 1745-6215-14-199 DO - https://dx.doi.org/10.1186/1745-6215-14-199 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 23829442 [pubmed] ID - 1745-6215-14-199 [pii] ID - 10.1186/1745-6215-14-199 [doi] ID - PMC3708760 [pmc] PP - epublish PH - 2013/05/18 [received] PH - 2013/06/26 [accepted] SI - ClinicalTrials.gov SA - ClinicalTrials.gov/NCT01857882 SA - ClinicalTrials.gov/NCT01857882 SL - https://clinicaltrials.gov/search/term=NCT01857882 SL - https://clinicaltrials.gov/search/term=NCT01857882 GI - Organization: *Canadian Institutes of Health Research* Country: Canada LG - English EP - 20130706 DP - 2013 Jul 06 DC - 20130711 EZ - 2013/07/09 06:00 DA - 2013/10/18 06:00 DT - 2013/07/09 06:00 YR - 2013 ED - 20131017 RD - 20161206 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23829442 <166. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23576067 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sheppard VB AU - Wallington SF AU - Willey SC AU - Hampton RM AU - Lucas W AU - Jennings Y AU - Horton S AU - Muzeck N AU - Cocilovo C AU - Isaacs C FA - Sheppard, Vanessa B FA - Wallington, Sherrie F FA - Willey, Shawna C FA - Hampton, Regina M FA - Lucas, W FA - Jennings, Y FA - Horton, S FA - Muzeck, N FA - Cocilovo, C FA - Isaacs, C IN - Sheppard, Vanessa B. Georgetown University Medical Center, Washington, DC, 20007, USA. vls3@georgetown.edu TI - A peer-led decision support intervention improves decision outcomes in black women with breast cancer. SO - Journal of Cancer Education. 28(2):262-9, 2013 Jun AS - J Cancer Educ. 28(2):262-9, 2013 Jun NJ - Journal of cancer education : the official journal of the American Association for Cancer Education PI - Journal available in: Print PI - Citation processed from: Internet JC - avy, 8610343 IO - J Cancer Educ PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180493 OI - Source: NLM. NIHMS466804 SB - Index Medicus CP - England MH - Adult MH - *African Americans/px [Psychology] MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/eh [Ethnology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making MH - District of Columbia MH - Female MH - Follow-Up Studies MH - Humans MH - Middle Aged MH - Patient Acceptance of Health Care/eh [Ethnology] MH - Patient Acceptance of Health Care/px [Psychology] MH - *Patient-Centered Care MH - *Peer Group MH - Physician-Patient Relations MH - Power (Psychology) MH - Self Efficacy MH - *Social Support AB - Previous reports suggest that Black breast cancer patients receive less patient-centered cancer care than their White counterparts. Interventions to improve patient-centered care (PCC) in Black breast cancer patients are lacking. Seventy-six women with histologically confirmed breast cancer were recruited from the Washington, DC area. After a baseline telephone interview, women received an in-person decision support educational session led by a trained survivor coach. The coach used a culturally appropriate guidebook and decision-making model-TALK Back!(©) A follow-up assessment assessed participants' acceptability of the intervention and intermediate outcomes. After the intervention, participants reported increased: self-efficacy in communicating with providers (70 %) and self-efficacy in making treatment decisions (70 %). Compared to baseline scores, post-intervention communication with providers significantly increased (p=.000). This is the first outcome report of an intervention to facilitate PCC in Black breast cancer patients. Testing this intervention using RCTs or similar designs will be important next steps. ES - 1543-0154 IL - 0885-8195 DO - https://dx.doi.org/10.1007/s13187-013-0459-z PT - Journal Article ID - 23576067 [pubmed] ID - 10.1007/s13187-013-0459-z [doi] ID - PMC4180493 [pmc] ID - NIHMS466804 [mid] PP - ppublish GI - No: L60 MD000291 Organization: (MD) *NIMHD NIH HHS* Country: United States No: R01 CA127617 Organization: (CA) *NCI NIH HHS* Country: United States No: UL1 TR000101 Organization: (TR) *NCATS NIH HHS* Country: United States LG - English DP - 2013 Jun DC - 20130528 EZ - 2013/04/12 06:00 DA - 2013/10/18 06:00 DT - 2013/04/12 06:00 YR - 2013 ED - 20131017 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23576067 <167. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23829442 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Platt J AU - Baxter N AU - Jones J AU - Metcalfe K AU - Causarano N AU - Hofer SO AU - O'Neill A AU - Cheng T AU - Starenkyj E AU - Zhong T FA - Platt, Jennica FA - Baxter, Nancy FA - Jones, Jennifer FA - Metcalfe, Kelly FA - Causarano, Natalie FA - Hofer, Stefan O P FA - O'Neill, Anne FA - Cheng, Terry FA - Starenkyj, Elizabeth FA - Zhong, Toni IN - Platt, Jennica. UHN Breast Restoration Program, Division of Plastic and Reconstructive Surgery, 8N 871, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada. TI - Pre-consultation educational group intervention to improve shared decision-making in postmastectomy breast reconstruction: study protocol for a pilot randomized controlled trial. SO - Trials [Electronic Resource]. 14:199, 2013 Jul 06 AS - Trials. 14:199, 2013 Jul 06 NJ - Trials PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101263253 IO - Trials PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708760 SB - Index Medicus CP - England MH - *Breast Implantation MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Clinical Protocols MH - *Decision Making MH - Feasibility Studies MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - *Mastectomy MH - Ontario MH - *Patient Education as Topic MH - Patient Participation MH - Patient Satisfaction MH - Pilot Projects MH - *Referral and Consultation MH - *Research Design MH - Self Efficacy MH - Treatment Outcome AB - BACKGROUND: The Pre-Consultation Educational Group INTERVENTION pilot study seeks to assess the feasibility and inform the optimal design for a definitive randomized controlled trial that aims to improve the quality of decision-making in postmastectomy breast reconstruction patients. AB - METHODS/DESIGN: This is a mixed-methods pilot feasibility randomized controlled trial that will follow a single-center, 1:1 allocation, two-arm parallel group superiority design. AB - SETTING: The University Health Network, a tertiary care cancer center in Toronto, Canada. AB - PARTICIPANTS: Adult women referred to one of three plastic and reconstructive surgeons for delayed breast reconstruction or prophylactic mastectomy with immediate breast reconstruction. AB - INTERVENTION: We designed a multi-disciplinary educational group workshop that incorporates the key components of shared decision-making, decision-support, and psychosocial support for cancer survivors prior to the initial surgical consult. The intervention consists of didactic lectures by a plastic surgeon and nurse specialist on breast reconstruction choices, pre- and postoperative care; a value-clarification exercise led by a social worker; and discussions with a breast reconstruction patient. AB - CONTROL: Usual care includes access to an informational booklet, website, and patient volunteer if desired. AB - OUTCOMES: Expected pilot outcomes include feasibility, recruitment, and retention targets. Acceptability of intervention and full trial outcomes will be established through qualitative interviews. Trial outcomes will include decision-quality measures, patient-reported outcomes, and service outcomes, and the treatment effect estimate and variability will be used to inform the sample size calculation for a full trial. AB - DISCUSSION: Our pilot study seeks to identify the (1) feasibility, acceptability, and design of a definitive RCT and (2) the optimal content and delivery of our proposed educational group intervention. Thirty patients have been recruited to date (8 April 2013), of whom 15 have been randomized to one of three decision support workshops. The trial will close as planned in May 2013. AB - TRIAL REGISTRATION: NCT01857882. ES - 1745-6215 IL - 1745-6215 DI - 1745-6215-14-199 DO - https://dx.doi.org/10.1186/1745-6215-14-199 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 23829442 [pubmed] ID - 1745-6215-14-199 [pii] ID - 10.1186/1745-6215-14-199 [doi] ID - PMC3708760 [pmc] PP - epublish PH - 2013/05/18 [received] PH - 2013/06/26 [accepted] SI - ClinicalTrials.gov SA - ClinicalTrials.gov/NCT01857882 SL - https://clinicaltrials.gov/search/term=NCT01857882 GI - Organization: *Canadian Institutes of Health Research* Country: Canada LG - English EP - 20130706 DP - 2013 Jul 06 DC - 20130711 EZ - 2013/07/09 06:00 DA - 2013/10/18 06:00 DT - 2013/07/09 06:00 YR - 2013 ED - 20131017 RD - 20161215 UP - 20161222 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=23829442 <168. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23881944 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Drug and Therapeutics Bulletin FA - Drug and Therapeutics Bulletin TI - An introduction to patient decision aids. [Review] SO - BMJ. 347:f4147, 2013 Jul 23 AS - BMJ. 347:f4147, 2013 Jul 23 NJ - BMJ (Clinical research ed.) PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 8900488, bmj, 101090866 IO - BMJ SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - Anti-Bacterial Agents/ae [Adverse Effects] MH - Anti-Bacterial Agents/tu [Therapeutic Use] MH - Breast Neoplasms/su [Surgery] MH - Child MH - *Decision Making MH - Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Diarrhea/ci [Chemically Induced] MH - Evidence-Based Medicine MH - Exanthema/ci [Chemically Induced] MH - Female MH - Humans MH - Mastectomy MH - Mastectomy, Segmental MH - Otitis Media/dt [Drug Therapy] MH - Patient Education as Topic MH - *Patient Participation MH - *Physician-Patient Relations MH - Referral and Consultation MH - Risk MH - State Medicine MH - United Kingdom MH - Vomiting/ci [Chemically Induced] RN - 0 (Anti-Bacterial Agents) ES - 1756-1833 IL - 0959-535X DI - bmj.f4147 DO - https://dx.doi.org/10.1136/bmj.f4147 PT - Journal Article PT - Review ID - 23881944 [pubmed] PP - epublish LG - English EP - 20130723 DP - 2013 Jul 23 DC - 20130724 EZ - 2013/07/25 06:00 DA - 2013/09/17 06:00 DT - 2013/07/25 06:00 YR - 2013 ED - 20130916 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23881944 <169. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23642795 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Damen TH AU - Morritt AN AU - Zhong T AU - Ahmad J AU - Hofer SO FA - Damen, Tim H C FA - Morritt, Andrew N FA - Zhong, Toni FA - Ahmad, Jamil FA - Hofer, Stefan O P IN - Damen, Tim H C. Department of Plastic and Reconstructive Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. TI - Improving outcomes in microsurgical breast reconstruction: lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 66(8):1032-8, 2013 Aug AS - J Plast Reconstr Aesthet Surg. 66(8):1032-8, 2013 Aug NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - *Algorithms MH - *Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - Epigastric Arteries MH - Female MH - Free Tissue Flaps/ae [Adverse Effects] MH - *Free Tissue Flaps/bs [Blood Supply] MH - Humans MH - Mammaplasty/ae [Adverse Effects] MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Middle Aged MH - Perforator Flap/ae [Adverse Effects] MH - *Perforator Flap/bs [Blood Supply] MH - Rectus Abdominis/tr [Transplantation] MH - Young Adult KW - Algorithm; Breast reconstruction; Complication; DIEP; Free flap; Microsurgery; TRAM AB - BACKGROUND: Multiple preoperative, intraoperative and postoperative decisions can influence the outcome of microsurgical breast reconstruction. We have simplified the decision-making process by incorporating a number of algorithms into our microsurgical breast reconstruction practice and critically review our results in this study. AB - METHODS: Prospectively maintained databases for all microsurgical breast reconstructions performed by a single surgeon over a nine-year period were examined to determine: patient demographics; operative details including flap choice, donor and recipient vessel selection; and, details of intraoperative and early postoperative ( VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23517401 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Parpia S AU - Thabane L AU - Julian JA AU - Whelan TJ AU - Levine MN FA - Parpia, Sameer FA - Thabane, Lehana FA - Julian, Jim A FA - Whelan, Timothy J FA - Levine, Mark N IN - Parpia, Sameer. Ontario Clinical Oncology Group, Department of Oncology, McMaster University, 711 Concession Street - G (60) Wing 1st Floor, Hamilton, ON L8V 1C3, Canada. parpia@mcmaster.ca TI - Empirical comparison of methods for analyzing multiple time-to-event outcomes in a non-inferiority trial: a breast cancer study. SO - BMC Medical Research Methodology. 13:44, 2013 Mar 21 AS - BMC Med Res Methodol. 13:44, 2013 Mar 21 NJ - BMC medical research methodology PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 100968545 IO - BMC Med Res Methodol PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610213 SB - Index Medicus CP - England MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - Data Interpretation, Statistical MH - Disease-Free Survival MH - Female MH - Humans MH - Mastectomy, Segmental MH - *Models, Statistical MH - Neoplasm Recurrence, Local/su [Surgery] MH - Proportional Hazards Models MH - *Randomized Controlled Trials as Topic MH - Research Design MH - Risk MH - Treatment Outcome AB - BACKGROUND: Subjects with breast cancer enrolled in trials may experience multiple events such as local recurrence, distant recurrence or death. These events are not independent; the occurrence of one may increase the risk of another, or prevent another from occurring. The most commonly used Cox proportional hazards (Cox-PH) model ignores the relationships between events, resulting in a potential impact on the treatment effect and conclusions. The use of statistical methods to analyze multiple time-to-event events has mainly been focused on superiority trials. However, their application to non-inferiority trials is limited. We evaluate four statistical methods for multiple time-to-event endpoints in the context of a non-inferiority trial. AB - METHODS: Three methods for analyzing multiple events data, namely, i) the competing risks (CR) model, ii) the marginal model, and iii) the frailty model were compared with the Cox-PH model using data from a previously-reported non-inferiority trial comparing hypofractionated radiotherapy with conventional radiotherapy for the prevention of local recurrence in patients with early stage breast cancer who had undergone breast conserving surgery. These methods were also compared using two simulated examples, scenario A where the hazards for distant recurrence and death were higher in the control group, and scenario B. where the hazards of distant recurrence and death were higher in the experimental group. Both scenarios were designed to have a non-inferiority margin of 1.50. AB - RESULTS: In the breast cancer trial, the methods produced primary outcome results similar to those using the Cox-PH model: namely, a local recurrence hazard ratio (HR) of 0.95 and a 95% confidence interval (CI) of 0.62 to 1.46. In Scenario A, non-inferiority was observed with the Cox-PH model (HR = 1.04; CI of 0.80 to 1.35), but not with the CR model (HR = 1.37; CI of 1.06 to 1.79), and the average marginal and frailty model showed a positive effect of the experimental treatment. The results in Scenario A contrasted with Scenario B with non-inferiority being observed with the CR model (HR = 1.10; CI of 0.87 to 1.39), but not with the Cox-PH model (HR = 1.46; CI of 1.15 to 1.85), and the marginal and frailty model showed a negative effect of the experimental treatment. AB - CONCLUSION: When subjects are at risk for multiple events in non-inferiority trials, researchers need to consider using the CR, marginal and frailty models in addition to the Cox-PH model in order to provide additional information in describing the disease process and to assess the robustness of the results. In the presence of competing risks, the Cox-PH model is appropriate for investigating the biologic effect of treatment, whereas the CR models yields the actual effect of treatment in the study. ES - 1471-2288 IL - 1471-2288 DI - 1471-2288-13-44 DO - https://dx.doi.org/10.1186/1471-2288-13-44 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 23517401 [pubmed] ID - 1471-2288-13-44 [pii] ID - 10.1186/1471-2288-13-44 [doi] ID - PMC3610213 [pmc] PP - epublish PH - 2012/11/17 [received] PH - 2013/03/12 [accepted] LG - English EP - 20130321 DP - 2013 Mar 21 DC - 20130329 EZ - 2013/03/23 06:00 DA - 2013/08/16 06:00 DT - 2013/03/23 06:00 YR - 2013 ED - 20130815 RD - 20150427 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23517401 <171. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23304357 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Seroussi B AU - Soulet A AU - Messai N AU - Laouenan C AU - Mentre F AU - Bouaud J FA - Seroussi, Brigitte FA - Soulet, Arnaud FA - Messai, Nizar FA - Laouenan, Cedric FA - Mentre, France FA - Bouaud, Jacques IN - Seroussi, Brigitte. UPMC, UFR de Medecine, Paris, France. TI - Patient clinical profiles associated with physician non-compliance despite the use of a guideline-based decision support system: a case study with OncoDoc2 using data mining techniques. SO - AMIA ... Annual Symposium Proceedings/AMIA Symposium. 2012:828-37, 2012 AS - AMIA Annu Symp Proc. 2012:828-37, 2012 NJ - AMIA ... Annual Symposium proceedings. AMIA Symposium PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101209213 IO - AMIA Annu Symp Proc PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540437 SB - Index Medicus CP - United States MH - Algorithms MH - *Breast Neoplasms/su [Surgery] MH - Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant MH - *Data Mining MH - *Decision Support Systems, Clinical MH - Expert Systems MH - *Guideline Adherence MH - Humans MH - Mathematical Concepts MH - Physicians MH - *Practice Guidelines as Topic MH - Preoperative Care MH - Radiotherapy, Adjuvant AB - OncoDoc2 is a guideline-based clinical decision support system (CDSS) applied to the management of breast cancer patients. OncoDoc2 has been routinely used during multidisciplinary staff meetings at the Tenon Hospital (Paris, France) for nearly 3 years. Despite the use of the CDSS that reminds physicians of the recommended treatments, the compliance rate of decisions is not 100%. We have used pattern mining techniques in order to elicit patient clinical profiles associated with non-compliance. We quantified each extracted pattern by three measures (support, growth rate, and unexpected rate) and we introduced a score to prune relevant emerging patterns. Non-compliance has concerned elderly patients in pre-surgery decisions, patients with micro invasive tumor in re-excision decisions, and patients HR+ and Her2+ in adjuvant decisions. In all cases, physician non-compliance with guidelines occurs when scientific evidence is lacking. ES - 1942-597X IL - 1559-4076 PT - Journal Article ID - 23304357 [pubmed] ID - PMC3540437 [pmc] PP - ppublish LG - English EP - 20121103 DP - 2012 DC - 20130110 EZ - 2013/01/11 06:00 DA - 2013/07/31 06:00 DT - 2013/01/11 06:00 YR - 2012 ED - 20130730 RD - 20161018 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=23304357 <172. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23280632 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - King L AU - O'Neill SC AU - Spellman E AU - Peshkin BN AU - Valdimarsdottir H AU - Willey S AU - Leventhal KG AU - DeMarco T AU - Nusbaum R AU - Feldman E AU - Jandorf L AU - Schwartz MD FA - King, Lesley FA - O'Neill, Suzanne C FA - Spellman, Elizabeth FA - Peshkin, Beth N FA - Valdimarsdottir, Heiddis FA - Willey, Shawna FA - Leventhal, Kara Grace FA - DeMarco, Tiffani FA - Nusbaum, Rachel FA - Feldman, Elizabeth FA - Jandorf, Lina FA - Schwartz, Marc D IN - King, Lesley. Department of Oncology, Jess and Mildred Fisher Center for Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia 20007, USA. TI - Intentions for bilateral mastectomy among newly diagnosed breast cancer patients. SO - Journal of Surgical Oncology. 107(7):772-6, 2013 Jun AS - J Surg Oncol. 107(7):772-6, 2013 Jun NJ - Journal of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - k79, 0222643 IO - J Surg Oncol PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687585 OI - Source: NLM. NIHMS480008 SB - Index Medicus CP - United States MH - Adult MH - Anxiety Disorders MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Conflict (Psychology) MH - *Decision Making MH - Educational Status MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Humans MH - *Intention MH - Linear Models MH - Marital Status MH - *Mastectomy, Modified Radical MH - Mastectomy, Segmental MH - Middle Aged MH - *Patient Participation MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Risk MH - Surveys and Questionnaires MH - United States AB - BACKGROUND: Recent trends suggest that bilateral mastectomy (BM) is on the rise among women diagnosed with unilateral breast cancer. Few studies have investigated the factors associated with the decision to have more aggressive surgery among young, high risk patients. AB - METHODS: As part of a larger study, 284 women aged 50 and under completed an initial survey within 6 weeks of a breast cancer diagnosis. We assessed sociodemographics, medical and family history variables, treatment recommendations, preferences and concerns, distress, perceived risk, knowledge, and neuroticism. We used multiple regression with backward entry to assess the relationship between these variables and our outcomes of decisional conflict and intentions for BM. AB - RESULTS: Higher decisional conflict was associated with being less educated, unmarried, more anxious and less likely to have received a surgical recommendation. Preference for BM was associated with higher neuroticism, perceived risk for contralateral breast cancer, pre-testing risk of carrying a BRCA1/2 mutation, having received either a surgical recommendation (vs. no recommendation), and lower preference for lumpectomy. AB - CONCLUSIONS: For younger women, a surgical recommendation is associated with lower decisional conflict and stronger intention for BM. Results highlight the importance of effective risk communication and decision support between a woman and her surgeon. AB - Copyright © 2012 Wiley Periodicals, Inc. RS - Neuroticism ES - 1096-9098 IL - 0022-4790 DO - https://dx.doi.org/10.1002/jso.23307 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 23280632 [pubmed] ID - 10.1002/jso.23307 [doi] ID - PMC3687585 [pmc] ID - NIHMS480008 [mid] PP - ppublish PH - 2012/10/29 [received] PH - 2012/11/26 [accepted] GI - No: P30 CA051008 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA074861 Organization: (CA) *NCI NIH HHS* Country: United States No: P30CA051008 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA74861 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20121227 DP - 2013 Jun DC - 20130528 EZ - 2013/01/03 06:00 DA - 2013/07/26 06:00 DT - 2013/01/03 06:00 YR - 2013 ED - 20130725 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23280632 <173. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23815011 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Nogues C AU - Mouret-Fourme E FA - Nogues, Catherine FA - Mouret-Fourme, Emmanuelle IN - Nogues, Catherine. Institut Curie, Departement de Sante Publique, Oncogenetique, St-Cloud. catherine.nogues@curie.net TI - [Prophylactic surgery in common hereditary cancer syndromes]. [Review] [French] OT - Indications et efficacite de la chirurgie prophylactique des cancers gynecologiques et digestifs avec predis- position genetique. SO - Bulletin de l Academie Nationale de Medecine. 196(7):1237-45, 2012 Oct AS - Bull Acad Natl Med. 196(7):1237-45, 2012 Oct NJ - Bulletin de l'Academie nationale de medecine PI - Journal available in: Print PI - Citation processed from: Print JC - b8g, 7503383 IO - Bull. Acad. Natl. Med. SB - Index Medicus CP - Netherlands MH - Adenomatous Polyposis Coli/ge [Genetics] MH - Adenomatous Polyposis Coli/su [Surgery] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Colorectal Neoplasms, Hereditary Nonpolyposis/ge [Genetics] MH - Colorectal Neoplasms, Hereditary Nonpolyposis/su [Surgery] MH - Digestive System Surgical Procedures MH - Female MH - Genes, Neoplasm MH - Humans MH - Hysterectomy MH - Male MH - Mastectomy MH - *Neoplasms/pc [Prevention & Control] MH - Neoplastic Syndromes, Hereditary/ge [Genetics] MH - *Neoplastic Syndromes, Hereditary/su [Surgery] MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy MH - *Primary Prevention/mt [Methods] MH - Risk Reduction Behavior MH - Stomach Neoplasms/ge [Genetics] MH - Stomach Neoplasms/su [Surgery] MH - Uterine Neoplasms/ge [Genetics] MH - Uterine Neoplasms/pc [Prevention & Control] AB - Preventive surgery is a mainstay of treatment for persons with genetic risk factors for cancer The indications of preventive surgery are based on a thorough risk assessment, clinical characteristics of the different hereditary cancer susceptibility syndromes, the types of mutation, and the possibility of watchful waiting for early cancer detection. Preventive surgery may either be recommended or represent one possible option. Bilateral prophylactic mastectomy can reduce the risk of breast cancer by up to 95% in BRCA1/BRCA2 mutation carriers. Bilateral prophylactic salpingo-oophorectomy is recommended for BRCA1/ BRCA2 carriers: women who undergo this preventive surgery have a reduced risk of ovarian cancer but also of breast cancer (around 50% for breast cancer). Patients with Lynch syndrome are at high risk of endometrial cancer, and prophylactic hysterectomy may be proposed to women for whom surgery is indicated for a uterine disorder (fibroma). Prophylactic surgery may be proposed to patients at risk of hereditary gastrointestinal malignancies, either on a case-by-case basis (Lynch syndrome) or more systematically for patients with the familial adenomatous polyposis syndrome or hereditary difuse gastric cancer Despite its efficacy, prophylactic surgery in a healthy individual, albeit at high risk of cancer, remains a difficult, multidisciplinary decision. Psychological support is needed to anticipate the possible physical psychological and social complications--and benefits. IS - 0001-4079 IL - 0001-4079 PT - English Abstract PT - Journal Article PT - Review ID - 23815011 [pubmed] PP - ppublish LG - French DP - 2012 Oct DC - 20130702 EZ - 2013/07/03 06:00 DA - 2013/07/19 06:00 DT - 2013/07/03 06:00 YR - 2012 ED - 20130717 RD - 20130702 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=23815011 <174. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23629109 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Maruthappu M AU - Duclos A AU - Orgill D AU - Carty MJ FA - Maruthappu, Mahiben FA - Duclos, Antoine FA - Orgill, Dennis FA - Carty, Matthew J IN - Maruthappu, Mahiben. Brigham and Women's Hospital Center for Surgery and Public Health, Boston, MA, USA. TI - A monitoring tool for performance improvement in plastic surgery at the individual level. SO - Plastic & Reconstructive Surgery. 131(5):702e-10e, 2013 May AS - Plast Reconstr Surg. 131(5):702e-10e, 2013 May NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Data Interpretation, Statistical MH - Databases, Factual MH - Female MH - Humans MH - *Mammaplasty/st [Standards] MH - Mammaplasty/sn [Statistics & Numerical Data] MH - Operative Time MH - *Outcome Assessment (Health Care) MH - Postoperative Complications/ep [Epidemiology] MH - Postoperative Complications/pc [Prevention & Control] MH - *Quality Assurance, Health Care/mt [Methods] MH - Retrospective Studies MH - Risk Adjustment/st [Standards] MH - *Surgery, Plastic/st [Standards] MH - Surgery, Plastic/sn [Statistics & Numerical Data] AB - BACKGROUND: The assessment of performance in surgery is expanding significantly. Application of relevant frameworks to plastic surgery, however, has been limited. In this article, the authors present two robust graphic tools commonly used in other industries that may serve to monitor individual surgeon operative time while factoring in patient- and surgeon-specific elements. AB - METHODS: The authors reviewed performance data from all bilateral reduction mammaplasties performed at their institution by eight surgeons between 1995 and 2010. Operative time was used as a proxy for performance. Cumulative sum charts and exponentially weighted moving average charts were generated using a train-test analytic approach, and used to monitor surgical performance. Charts mapped crude, patient case-mix-adjusted, and case-mix and surgical-experience-adjusted performance. AB - RESULTS: Operative time was found to decline from 182 minutes to 118 minutes with surgical experience (p < 0.001). Cumulative sum and exponentially weighted moving average charts were generated using 1995 to 2007 data (1053 procedures) and tested on 2008 to 2010 data (246 procedures). The sensitivity and accuracy of these charts were significantly improved by adjustment for case mix and surgeon experience. AB - CONCLUSIONS: The consideration of patient- and surgeon-specific factors is essential for correct interpretation of performance in plastic surgery at the individual surgeon level. Cumulative sum and exponentially weighted moving average charts represent accurate methods of monitoring operative time to control and potentially improve surgeon performance over the course of a career. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201305000-00010 DO - https://dx.doi.org/10.1097/PRS.0b013e3182865a0c PT - Journal Article ID - 23629109 [pubmed] ID - 10.1097/PRS.0b013e3182865a0c [doi] ID - 00006534-201305000-00010 [pii] PP - ppublish LG - English DP - 2013 May DC - 20130430 EZ - 2013/05/01 06:00 DA - 2013/07/17 06:00 DT - 2013/05/01 06:00 YR - 2013 ED - 20130716 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23629109 <175. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23724453 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Songtish D AU - Hirunwiwatkul P FA - Songtish, Dolrudee FA - Hirunwiwatkul, Prakobkiat IN - Songtish, Dolrudee. Department of Surgery, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand. dsongtish@yahoo.com TI - Development and validation of the body image scale among Thai breast cancer patients. SO - Journal of the Medical Association of Thailand. 96 Suppl 1:S30-9, 2013 Jan AS - J Med Assoc Thai. 96 Suppl 1:S30-9, 2013 Jan NJ - Journal of the Medical Association of Thailand = Chotmaihet thangphaet PI - Journal available in: Print PI - Citation processed from: Print JC - izr, 7507216 IO - J Med Assoc Thai SB - Index Medicus CP - Thailand MH - *Body Image MH - *Breast Neoplasms/px [Psychology] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Middle Aged MH - Psychometrics MH - Reproducibility of Results MH - *Surveys and Questionnaires MH - Thailand AB - OBJECTIVE: To examine the psychometric property of the Thai version of the Body Image Scale (BIS) in breast cancer patients in Thailand. AB - MATERIAL AND METHOD: The authors conducted a cross-culture translation of the BIS into the Thai language and administered it to 242 breast cancer patients who had surgery and had completed chemo-radiation for more than one year. AB - RESULTS: The present study confirmed a good reliability and validity of Thai version of BIS. The questionnaire has high internal and external consistency; Cronbach's alpha was above 0.8 and test-retest reliability was more than 0.7. Content validity was confirmed by expert opinion and cognitive interview with breast cancer patients. Construct validity was examined though factor analysis showed a single-factor solution which excludes one item from the original 10-item scale. Discriminant validity which confirmed by different score between mastectomy and breast conserving surgery group and good response prevalence also supported the clinical validity of the test. AB - CONCLUSION: Thai version of the BIS showed a good psychometric property and can be used as a patient-physician communication and quality of life evaluation tool after breast cancer treatment in Thai women. IS - 0125-2208 IL - 0125-2208 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Studies ID - 23724453 [pubmed] PP - ppublish LG - English DP - 2013 Jan DC - 20130603 EZ - 2013/06/04 06:00 DA - 2013/07/16 06:00 DT - 2013/06/04 06:00 YR - 2013 ED - 20130712 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23724453 <176. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20592778 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Markman M AU - Luce R FA - Markman, Maurie FA - Luce, Ryan IN - Markman, Maurie. The University of Texas M. D. Anderson Cancer Center, Houston, TX, and NexCura, Seattle, WA. TI - Impact of the cost of cancer treatment: an internet-based survey. SO - Journal of oncology practice/American Society of Clinical Oncology. 6(2):69-73, 2010 Mar AS - J Oncol Pract. 6(2):69-73, 2010 Mar NJ - Journal of oncology practice PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101261852 IO - J Oncol Pract PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835484 CP - United States AB - PURPOSE: Despite considerable discussion in the medical literature and lay press regarding the increasing cost of cancer care, there is limited information available on the perceived impact of treatment costs on individual patients and their families. AB - METHODS: To directly address this issue, patients with cancer who had participated in an Internet-based oncology decision-support program and agreed to receive information concerning potential future surveys were asked via e-mail to complete a questionnaire dealing with treatment-related medical expenses. AB - RESULTS: Of 39,882 invitations sent to patients with cancers of the breast, colon, lung, and prostate, 1,767 (4.4%) were returned, which included a wide spectrum of disease, demographics, and annual incomes. Since diagnosis, 20% and 4% of patients reported having spent out of pocket more than $10,000 and more than $50,000, respectively, on treatment and medical care. Overall, 19% of patients and 39% of individuals with a yearly income of less than $40,000 reported the financial costs of treating their cancer had caused a "large amount of distress." Furthermore, although overall, 9% of patients stated they had decided "to not have a recommended cancer treatment because it was too expensive," this percentage increased to 25% for individuals with an income of less than $40,000. AB - CONCLUSION: This survey suggests that a substantial proportion of patients and their families experience considerable distress associated with the cost of cancer care delivery. Furthermore, these costs affect the decision of patients with cancer to receive recommended treatment. This is a particularly serious issue for individuals with a modest annual income. ES - 1935-469X IL - 1554-7477 DO - https://dx.doi.org/10.1200/JOP.091074 PT - Journal Article ID - 20592778 [pubmed] ID - 10.1200/JOP.091074 [doi] ID - PMC2835484 [pmc] PP - ppublish PH - 2009/08/18 [accepted] LG - English EP - 20100219 DP - 2010 Mar DC - 20100701 EZ - 2010/07/02 06:00 DA - 2010/07/02 06:01 DT - 2010/07/02 06:00 YR - 2010 ED - 20130704 RD - 20161020 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=20592778 <177. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23428286 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mac Bride MB AU - Neal L AU - Dilaveri CA AU - Sandhu NP AU - Hieken TJ AU - Ghosh K AU - Wahner-Roedler DL FA - Mac Bride, Maire Brid FA - Neal, Lonzetta FA - Dilaveri, Christina A FA - Sandhu, Nicole P FA - Hieken, Tina J FA - Ghosh, Karthik FA - Wahner-Roedler, Dietlind L IN - Mac Bride, Maire Brid. Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. macbride.maire@mayo.edu TI - Factors associated with surgical decision making in women with early-stage breast cancer: a literature review. [Review] SO - Journal of Women's Health. 22(3):236-42, 2013 Mar AS - J Womens Health (Larchmt). 22(3):236-42, 2013 Mar NJ - Journal of women's health (2002) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101159262, 9208978 IO - J Womens Health (Larchmt) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Female MH - Humans MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged AB - BACKGROUND: Current recommendations for surgical management of early-stage breast cancer include breast-conserving surgery with postoperative irradiation. However, studies show that mastectomy is still being used by women with early-stage breast cancer. AB - METHODS: Review of the medical literature published between 2000 and 2010 to determine the factors associated with the decision of patients for surgical treatment in early-stage breast cancer. AB - RESULTS: The following patient characteristics affect the surgical decision-making process in early-stage breast cancer: age, socioeconomic factors, geographic area in which the patient lives, proximity to a radiation therapy center, testing for BRCA gene, breast imaging, and decision aids. AB - CONCLUSIONS: Of increasing importance in the decision making about treatment of women with early-stage breast cancer are the woman's perception of having a surgical choice and the influence of that choice on postoperative quality of life. ES - 1931-843X IL - 1540-9996 DO - https://dx.doi.org/10.1089/jwh.2012.3969 PT - Journal Article PT - Review ID - 23428286 [pubmed] ID - 10.1089/jwh.2012.3969 [doi] PP - ppublish LG - English EP - 20130221 DP - 2013 Mar DC - 20130313 EZ - 2013/02/23 06:00 DA - 2013/07/03 06:00 DT - 2013/02/23 06:00 YR - 2013 ED - 20130701 RD - 20131116 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23428286 <178. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23051022 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Allen SV AU - Solberg Nes L AU - Marnach ML AU - Polga K AU - Jenkins SM AU - Files JA AU - Croghan IT AU - Ghosh K AU - Pruthi S FA - Allen, Summer V FA - Solberg Nes, Lise FA - Marnach, Mary L FA - Polga, Kristen FA - Jenkins, Sarah M FA - Files, Julia A FA - Croghan, Ivana T FA - Ghosh, Karthik FA - Pruthi, Sandhya IN - Allen, Summer V. Division of General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. TI - Patient understanding of the revised USPSTF screening mammogram guidelines: need for development of patient decision aids. SO - BMC Women's Health. 12:36, 2012 Oct 10 AS - BMC Womens Health. 12:36, 2012 Oct 10 NJ - BMC women's health PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088690 IO - BMC Womens Health PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3517367 SB - Index Medicus CP - England MH - Adult MH - Advisory Committees MH - Aged MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Centers for Disease Control and Prevention (U.S.) MH - *Early Detection of Cancer/px [Psychology] MH - Female MH - Humans MH - Mammography/px [Psychology] MH - *Mammography/st [Standards] MH - Mass Screening/px [Psychology] MH - *Mass Screening/st [Standards] MH - Middle Aged MH - *Patient Acceptance of Health Care/px [Psychology] MH - *Practice Guidelines as Topic MH - United States MH - Young Adult AB - BACKGROUND: The purpose of the study was to examine patients' understanding of the revised screening mammogram guidelines released by the United States Preventive Services Task Force (USPSTF) in 2009 addressing age at initiation and frequency of screening mammography. AB - METHODS: Patients from the Departments of Family Medicine, Internal Medicine, and Obstetrics and Gynecology (n = 150) at a tertiary care medical center in the United States completed a survey regarding their understanding of the revised USPSTF guidelines following their release, within four to six months of their scheduled mammogram (March 2010 to May 2010). AB - RESULTS: Of the patients surveyed, 97/147 (67%) indicated increased confusion regarding the age and frequency of screening mammography, 61/148 (41%) reported increased anxiety about mammograms, and 58/146 (40%) reported anxiety about their own health status following the release of the revised screening guidelines. Most of the patients surveyed, 111/148 (75%), did not expect to change their timing or frequency of screening mammograms in the future. AB - CONCLUSION: Results from this survey suggested increased confusion and possibly an increase in patients' anxiety related to screening mammography and their own health status following the release of the revised USPSTF screening mammogram guidelines to the public and subsequent media portrayal of the revised guidelines. Although the study did not specifically address causality for these findings, the results highlight the need for improvements in the communication of guidelines to patients and the public. Development of shared decision-making tools and outcomes should be considered to address the communication challenge. ES - 1472-6874 IL - 1472-6874 DI - 1472-6874-12-36 DO - https://dx.doi.org/10.1186/1472-6874-12-36 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 23051022 [pubmed] ID - 1472-6874-12-36 [pii] ID - 10.1186/1472-6874-12-36 [doi] ID - PMC3517367 [pmc] PP - epublish PH - 2012/01/12 [received] PH - 2012/10/01 [accepted] LG - English EP - 20121010 DP - 2012 Oct 10 DC - 20121210 EZ - 2012/10/12 06:00 DA - 2013/07/03 06:00 DT - 2012/10/12 06:00 YR - 2012 ED - 20130628 RD - 20150222 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=23051022 <179. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23504675 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jimbo M AU - Rana GK AU - Hawley S AU - Holmes-Rovner M AU - Kelly-Blake K AU - Nease DE Jr AU - Ruffin MT 4th FA - Jimbo, Masahito FA - Rana, Gurpreet K FA - Hawley, Sarah FA - Holmes-Rovner, Margaret FA - Kelly-Blake, Karen FA - Nease, Donald E Jr FA - Ruffin, Mack T 4th IN - Jimbo, Masahito. Department of Family Medicine, University of Michigan, Ann Arbor, MI 48104-1213, USA. mjimbo@med.umich.edu TI - What is lacking in current decision aids on cancer screening?. [Review] SO - CA: a Cancer Journal for Clinicians. 63(3):193-214, 2013 May AS - CA Cancer J Clin. 63(3):193-214, 2013 May NJ - CA: a cancer journal for clinicians PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - cb5, 0370647 IO - CA Cancer J Clin PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644368 OI - Source: NLM. NIHMS438825 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/di [Diagnosis] MH - *Colorectal Neoplasms/di [Diagnosis] MH - *Decision Support Techniques MH - Early Detection of Cancer/mt [Methods] MH - Early Detection of Cancer/px [Psychology] MH - Early Detection of Cancer/st [Standards] MH - *Early Detection of Cancer MH - Female MH - Humans MH - Male MH - Outcome and Process Assessment (Health Care) MH - *Patient Participation MH - Practice Guidelines as Topic MH - *Prostatic Neoplasms/di [Diagnosis] MH - Risk Assessment MH - *Uterine Cervical Neoplasms/di [Diagnosis] AB - Recent guidelines on cancer screening have provided not only more screening options but also conflicting recommendations. Thus, patients, with their clinicians' support, must decide whether to get screened, which modality to use, and how often to undergo screening. Decision aids could potentially lead to better shared decision-making regarding screening between the patient and the clinician. A total of 73 decision aids concerning screening for breast, cervical, colorectal, and prostate cancers were reviewed. The goal of this review was to assess the effectiveness of such decision aids, examine areas in need of more research, and determine how the decision aids can be currently applied in the real-world setting. Most studies used sound study designs. Significant variation existed in the setting, theoretical framework, and measured outcomes. Just over one-third of the decision aids included an explicit values clarification. Other than knowledge, little consistency was noted with regard to which patient attributes were measured as outcomes. Few studies actually measured shared decision-making. Little information was available regarding the feasibility and outcomes of integrating decision aids into practice. In this review, the implications for future research, as well as what clinicians can do now to incorporate decision aids into their practice, are discussed. AB - Copyright © 2013 American Cancer Society, Inc. ES - 1542-4863 IL - 0007-9235 DO - https://dx.doi.org/10.3322/caac.21180 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Review ID - 23504675 [pubmed] ID - 10.3322/caac.21180 [doi] ID - PMC3644368 [pmc] ID - NIHMS438825 [mid] PP - ppublish GI - No: R01 CA152413 Organization: (CA) *NCI NIH HHS* Country: United States No: R01CA152413 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20130315 DP - 2013 May DC - 20130503 EZ - 2013/03/19 06:00 DA - 2013/06/26 06:00 DT - 2013/03/19 06:00 YR - 2013 ED - 20130624 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23504675 <180. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23271776 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hamilton AS AU - Wu XC AU - Lipscomb J AU - Fleming ST AU - Lo M AU - Wang D AU - Goodman M AU - Ho A AU - Owen JB AU - Rao C AU - German RR FA - Hamilton, Ann S FA - Wu, Xiao-Cheng FA - Lipscomb, Joseph FA - Fleming, Steven T FA - Lo, Mary FA - Wang, Dian FA - Goodman, Michael FA - Ho, Alex FA - Owen, Jean B FA - Rao, Chandrika FA - German, Robert R IN - Hamilton, Ann S. Keck School of Medicine of University of Southern California, 2001 N. Soto St 318E, Los Angeles, CA 90089-9239, USA. ahamilt@med.usc.edu TI - Regional, provider, and economic factors associated with the choice of active surveillance in the treatment of men with localized prostate cancer. SO - Journal of the National Cancer Institute. Monographs. 2012(45):213-20, 2012 Dec AS - J Natl Cancer Inst Monogr. 2012(45):213-20, 2012 Dec NJ - Journal of the National Cancer Institute. Monographs PI - Journal available in: Print PI - Citation processed from: Internet JC - atr, 9011255 IO - J. Natl. Cancer Inst. Monographs PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540885 SB - Index Medicus CP - United States MH - Aged MH - *Choice Behavior MH - *Decision Making MH - Decision Support Techniques MH - Early Detection of Cancer MH - Humans MH - Male MH - Middle Aged MH - Patient Participation MH - Physician-Patient Relations MH - Prostate-Specific Antigen/bl [Blood] MH - Prostatectomy MH - Prostatic Neoplasms/di [Diagnosis] MH - Prostatic Neoplasms/su [Surgery] MH - Prostatic Neoplasms/th [Therapy] MH - *Prostatic Neoplasms MH - Social Support MH - *Watchful Waiting AB - Data on initial treatment of 8232 cases of localized prostate cancer diagnosed in 2004 were obtained by medical record abstraction (including hospital and outpatient locations) from seven state cancer registries participating in the Centers for Disease Control and Prevention's Breast and Prostate Cancer Data Quality and Patterns of Care Study. Distinction was made between men receiving no therapy with no monitoring plan (no therapy/no plan [NT/NP]) and those receiving active surveillance (AS). Overall, 8.6% received NT/NP and 4.7% received AS. Older age at diagnosis, lower clinical risk group, and certain registry locations were significant predictors of use of both AS and NT/NP. AS was also related to having more severe comorbidities, whereas nonwhite race was predicted receiving NT/NP. Men receiving AS lived in areas with a higher number of urologists per 100 000 men than those receiving NT/NP. In summary, physician and clinical factors were stronger predictors of AS, whereas demographic and regional factors were related to receiving NT/NP. Physicians appear reluctant to recommend AS for younger patients with no comorbidities. RN - EC 3-4-21-77 (Prostate-Specific Antigen) ES - 1745-6614 IL - 1052-6773 DI - lgs033 DO - https://dx.doi.org/10.1093/jncimonographs/lgs033 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 23271776 [pubmed] ID - lgs033 [pii] ID - 10.1093/jncimonographs/lgs033 [doi] ID - PMC3540885 [pmc] PP - ppublish GI - No: 1-U01-DP000264 Organization: (DP) *NCCDPHP CDC HHS* Country: United States No: 1-U01-DP000259 Organization: (DP) *NCCDPHP CDC HHS* Country: United States No: 1-U01-DP000258 Organization: (DP) *NCCDPHP CDC HHS* Country: United States No: 1-U01-DP000261 Organization: (DP) *NCCDPHP CDC HHS* Country: United States No: 1-U01-DP000253 Organization: (DP) *NCCDPHP CDC HHS* Country: United States No: 1-U01-DP000251 Organization: (DP) *NCCDPHP CDC HHS* Country: United States No: 1-U01-DP000260 Organization: (DP) *NCCDPHP CDC HHS* Country: United States LG - English DP - 2012 Dec DC - 20121228 EZ - 2012/12/29 06:00 DA - 2013/06/25 06:00 DT - 2012/12/29 06:00 YR - 2012 ED - 20130621 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=23271776 <181. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23269778 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jones RA AU - Steeves R AU - Ropka ME AU - Hollen P FA - Jones, Randy A FA - Steeves, Richard FA - Ropka, Mary E FA - Hollen, Patricia IN - Jones, Randy A. School of Nursing, University of Virginia, Charlottesville, VA, USA. raj9c@virginia.edu TI - Capturing treatment decision making among patients with solid tumors and their caregivers. SO - Oncology Nursing Forum. 40(1):E24-31, 2013 Jan AS - Oncol Nurs Forum. 40(1):E24-31, 2013 Jan NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Internet JC - 7809033, 7809033 IO - Oncol Nurs Forum PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634347 OI - Source: NLM. NIHMS453716 SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - *Caregivers/px [Psychology] MH - *Decision Making MH - Feasibility Studies MH - Female MH - Humans MH - Interviews as Topic MH - Lung Neoplasms/nu [Nursing] MH - Lung Neoplasms/px [Psychology] MH - Male MH - *Neoplasms/nu [Nursing] MH - *Neoplasms/px [Psychology] MH - Nurse-Patient Relations MH - Nursing Methodology Research MH - *Oncology Nursing/mt [Methods] MH - Outpatients/px [Psychology] MH - Patient Participation/px [Psychology] MH - Prostatic Neoplasms/nu [Nursing] MH - Prostatic Neoplasms/px [Psychology] AB - PURPOSE/OBJECTIVES: To examine the feasibility and acceptability of using a decision aid with an interactive decision-making process in patients with solid tumors and their caregivers during cancer-related treatment. AB - RESEARCH APPROACH: A phenomenologic approach was used to analyze qualitative data, with a focus on the meaning of participants' lived experiences. Interviews were conducted by telephone or in person. AB - SETTING: Outpatient clinics at two regional cancer centers. AB - PARTICIPANTS: 160 total individuals; 80 patients with newly diagnosed breast (n = 22), advanced-stage prostate (n = 19), or advanced-stage lung (n = 39) cancer, and their caregivers (n = 80). AB - METHODOLOGIC APPROACH: Twenty-seven of the 80 pairs engaged in audio recorded interviews that were conducted using a semistructured interview guide. Continuous text immersion revealed themes. Validity of qualitative analysis was achieved by member checking. AB - FINDINGS: Significant findings included three themes: (a) the decision aid helped patients and caregivers understand treatment decisions better, (b) the decision aid helped patients and caregivers to be more involved in treatment decisions, and (c) frequent contact with the study nurse was valuable. AB - CONCLUSIONS: Decision making was more complex than participants expected. The decision aid helped patients and caregivers make satisfying treatment decisions and become integral in a shared treatment decision-making process. AB - INTERPRETATION: Decision aids can help patients and their caregivers make difficult treatment decisions affecting quantity and quality of life during cancer treatment. The findings provide valuable information for healthcare providers helping patients and their caregivers make treatment decisions through a shared, informed, decision-making process. AB - KNOWLEDGE TRANSLATION: Decision aids can be helpful with treatment choices. Caregivers' understanding about treatment is just as important in the decision-making process as the patients' understanding. Incorporating decision aids that are delivered by healthcare providers or trained personnel has the potential to improve patients' decision satisfaction. ES - 1538-0688 IL - 0190-535X DI - W2466736W4T36HR8 DO - https://dx.doi.org/10.1188/13.ONF.E24-E31 PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 23269778 [pubmed] ID - W2466736W4T36HR8 [pii] ID - 10.1188/13.ONF.E24-E31 [doi] ID - PMC3634347 [pmc] ID - NIHMS453716 [mid] PP - ppublish GI - No: R21 NR009346 Organization: (NR) *NINR NIH HHS* Country: United States No: 1 R21 NR009346-01A1 Organization: (NR) *NINR NIH HHS* Country: United States No: 1R21CA131754-01 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA044579 Organization: (CA) *NCI NIH HHS* Country: United States No: K07 CA088989 Organization: (CA) *NCI NIH HHS* Country: United States No: R21 CA131754 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA 44579 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2013 Jan DC - 20121227 EZ - 2012/12/28 06:00 DA - 2013/06/14 06:00 DT - 2012/12/28 06:00 YR - 2013 ED - 20130613 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23269778 <182. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22789490 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - O'Flynn EA AU - Currie RJ AU - Mohammed K AU - Allen SD AU - Michell MJ FA - O'Flynn, E A M FA - Currie, R J FA - Mohammed, K FA - Allen, S D FA - Michell, M J IN - O'Flynn, E A M. Department of Radiology, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom. lizoflynn@doctors.org.uk TI - Pre-operative factors indicating risk of multiple operations versus a single operation in women undergoing surgery for screen detected breast cancer. SO - Breast. 22(1):78-82, 2013 Feb AS - BREAST. 22(1):78-82, 2013 Feb NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - Biopsy, Large-Core Needle MH - Breast/pa [Pathology] MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/dg [Diagnostic Imaging] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/dg [Diagnostic Imaging] MH - Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - *Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Carcinoma, Lobular/dg [Diagnostic Imaging] MH - Carcinoma, Lobular/pa [Pathology] MH - *Carcinoma, Lobular/su [Surgery] MH - Decision Support Techniques MH - Early Detection of Cancer MH - Female MH - Humans MH - Logistic Models MH - *Lymph Node Excision/sn [Statistics & Numerical Data] MH - Mammography MH - Mastectomy/mt [Methods] MH - *Mastectomy/sn [Statistics & Numerical Data] MH - Middle Aged MH - Multivariate Analysis MH - Neoplasm Grading MH - Reoperation/sn [Statistics & Numerical Data] MH - Risk Factors MH - Tumor Burden AB - We aim to identify preoperative factors at diagnosis which could predict whether women undergoing wide local excision (WLE) would require further operations. 1593 screen-detected invasive and non-invasive breast cancers were reviewed. Age, presence of ductal carcinoma in situ (DCIS), invasive cancer size on mammography, mammographic sign, tumour type, grade and confidence of the radiologist in malignancy were compared. 83%(1315/1593) of women had a WLE. Of these, 70%(919/1315) had a single operation, and 30%(396/1315) multiple operations. These included repeat WLE to clear margins (60%(238/396)), mastectomy (34%(133/396)) and axillary dissection (6%(25/396)). The presence of mammographic microcalcification, lobular carcinoma and grade 2 malignancy on core biopsy were independent risk factors for multiple operations on multivariate analysis. Women with mammographic DCIS >30 mm were 3.4 times more likely to undergo repeat surgery than those with smaller foci. The multidisciplinary team should pay particular attention to these factors when planning surgery. AB - Copyright © 2012 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(12)00129-4 DO - https://dx.doi.org/10.1016/j.breast.2012.06.011 PT - Evaluation Studies PT - Journal Article ID - 22789490 [pubmed] ID - S0960-9776(12)00129-4 [pii] ID - 10.1016/j.breast.2012.06.011 [doi] PP - ppublish PH - 2012/02/23 [received] PH - 2012/05/31 [revised] PH - 2012/06/20 [accepted] LG - English EP - 20120710 DP - 2013 Feb DC - 20121231 EZ - 2012/07/14 06:00 DA - 2013/06/01 06:00 DT - 2012/07/14 06:00 YR - 2013 ED - 20130530 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=22789490 <183. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23516764 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fowler FJ Jr AU - Gallagher PM AU - Drake KM AU - Sepucha KR FA - Fowler, Floyd J Jr FA - Gallagher, Patricia M FA - Drake, Keith M FA - Sepucha, Karen R IN - Fowler, Floyd J Jr. Center for Survey Research, University of Massachusetts, Boston, USA. floyd.fowler@umb.edu TI - Decision dissonance: evaluating an approach to measuring the quality of surgical decision making. SO - Joint Commission Journal on Quality & Patient Safety. 39(3):136-44, 2013 Mar AS - Jt Comm J Qual Patient Saf. 39(3):136-44, 2013 Mar NJ - Joint Commission journal on quality and patient safety PI - Journal available in: Print PI - Citation processed from: Print JC - 101238023 IO - Jt Comm J Qual Patient Saf PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615253 OI - Source: NLM. NIHMS450965 SB - Index Medicus CP - Netherlands MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass MH - Data Interpretation, Statistical MH - *Decision Making MH - Female MH - Health Care Surveys MH - Humans MH - Insurance Claim Review MH - Male MH - Mastectomy/mt [Methods] MH - Medicare MH - Patient Education as Topic/st [Standards] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - *Physician-Patient Relations MH - Prostatic Neoplasms/su [Surgery] MH - *Surgical Procedures, Operative/st [Standards] MH - United States AB - BACKGROUND: Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. AB - METHODS: For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail-survey of selected patients was carried out about one year after the procedures. Patients' goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A decision dissonance score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the decision dissonance score was then assessed. AB - RESULTS: When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. AB - CONCLUSIONS: Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality. IS - 1553-7250 IL - 1553-7250 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 23516764 [pubmed] ID - PMC3615253 [pmc] ID - NIHMS450965 [mid] PP - ppublish GI - No: P01 AG019783 Organization: (AG) *NIA NIH HHS* Country: United States No: P01-AG19783 Organization: (AG) *NIA NIH HHS* Country: United States LG - English DP - 2013 Mar DC - 20130322 EZ - 2013/03/23 06:00 DA - 2013/05/09 06:00 DT - 2013/03/23 06:00 YR - 2013 ED - 20130508 RD - 20161208 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23516764 <184. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23516764 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fowler FJ Jr AU - Gallagher PM AU - Drake KM AU - Sepucha KR FA - Fowler, Floyd J Jr FA - Gallagher, Patricia M FA - Drake, Keith M FA - Sepucha, Karen R IN - Fowler, Floyd J Jr. Center for Survey Research, University of Massachusetts, Boston, USA. floyd.fowler@umb.edu TI - Decision dissonance: evaluating an approach to measuring the quality of surgical decision making. SO - Joint Commission Journal on Quality & Patient Safety. 39(3):136-44, 2013 Mar AS - Jt Comm J Qual Patient Saf. 39(3):136-44, 2013 Mar NJ - Joint Commission journal on quality and patient safety PI - Journal available in: Print PI - Citation processed from: Print JC - 101238023 IO - Jt Comm J Qual Patient Saf PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615253 OI - Source: NLM. NIHMS450965 SB - Index Medicus CP - Netherlands MH - Aged MH - Aged, 80 and over MH - Coronary Artery Bypass MH - Data Interpretation, Statistical MH - *Decision Making MH - Female MH - Health Care Surveys MH - Humans MH - Insurance Claim Review MH - Male MH - Mastectomy/mt [Methods] MH - Medicare MH - Patient Education as Topic/st [Standards] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - *Physician-Patient Relations MH - Prostatic Neoplasms/su [Surgery] MH - *Surgical Procedures, Operative/st [Standards] MH - United States AB - BACKGROUND: Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. AB - METHODS: For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail-survey of selected patients was carried out about one year after the procedures. Patients' goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A decision dissonance score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the decision dissonance score was then assessed. AB - RESULTS: When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. AB - CONCLUSIONS: Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality. IS - 1553-7250 IL - 1553-7250 DI - S1553-7250(13)39020-5 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - PMC3615253 [pmc] ID - NIHMS450965 [mid] ID - S1553-7250(13)39020-5 [pii] PP - ppublish GI - No: P01 AG019783 Organization: (AG) *NIA NIH HHS* Country: United States No: P01-AG19783 Organization: (AG) *NIA NIH HHS* Country: United States LG - English DP - 2013 Mar DC - 20130322 EZ - 2013/03/23 06:00 DA - 2013/05/09 06:00 DT - 2013/03/23 06:00 YR - 2013 ED - 20130508 RD - 20170317 UP - 20170320 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=23516764 <185. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23079561 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Georgiou CA AU - Ihrai T AU - Chamorey E AU - Flipo B AU - Chignon-Sicard B FA - Georgiou, Charalambos A FA - Ihrai, Tarik FA - Chamorey, Emmanuel FA - Flipo, Bernard FA - Chignon-Sicard, Berengere IN - Georgiou, Charalambos A. Breast Cancer and Reconstructive Surgery Unit, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice cedex 2, France. char.georgiou@gmail.com TI - A formula for implant volume choice in breast reconstruction after nipple sparing mastectomy. SO - Breast. 21(6):781-2, 2012 Dec AS - BREAST. 21(6):781-2, 2012 Dec NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Implantation/is [Instrumentation] MH - *Breast Implants MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Linear Models MH - *Mastectomy, Subcutaneous MH - Middle Aged MH - Retrospective Studies MH - *Tumor Burden AB - Implant choice after Nipple Sparing Mastectomy (NSM) is a problematic perioperative issue. In this retrospective study, the authors searched for a correlation between mastectomy weight and implant volume choice after NSM. A mathematical expression of this correlation was found that might help surgeons decide implant volume after NSM. AB - Copyright © 2012 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(12)00193-2 DO - https://dx.doi.org/10.1016/j.breast.2012.09.007 PT - Evaluation Studies PT - Journal Article ID - 23079561 [pubmed] ID - S0960-9776(12)00193-2 [pii] ID - 10.1016/j.breast.2012.09.007 [doi] PP - ppublish PH - 2012/03/26 [received] PH - 2012/09/22 [accepted] LG - English EP - 20121016 DP - 2012 Dec DC - 20121119 EZ - 2012/10/20 06:00 DA - 2013/05/02 06:00 DT - 2012/10/20 06:00 YR - 2012 ED - 20130501 RD - 20121119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=23079561 <186. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22901975 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lovrics PJ AU - Gordon M AU - Cornacchi SD AU - Farrokhyar F AU - Ramsaroop A AU - Hodgson N AU - Quan ML AU - Wright F AU - Porter G FA - Lovrics, Peter J FA - Gordon, Maggie FA - Cornacchi, Sylvie D FA - Farrokhyar, Forough FA - Ramsaroop, Amanda FA - Hodgson, Nicole FA - Quan, May Lynn FA - Wright, Francis FA - Porter, Geoffrey IN - Lovrics, Peter J. Department of Surgery, McMaster University, Canada. lovricsp@mcmaster.ca TI - Practice patterns and perceptions of margin status for breast conserving surgery for breast carcinoma: National Survey of Canadian General Surgeons. SO - Breast. 21(6):730-4, 2012 Dec AS - BREAST. 21(6):730-4, 2012 Dec NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - *Attitude of Health Personnel MH - Biopsy/mt [Methods] MH - Biopsy/ut [Utilization] MH - Breast/pa [Pathology] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Canada MH - Decision Support Techniques MH - Female MH - *General Surgery MH - Health Care Surveys MH - Humans MH - Mastectomy MH - Mastectomy, Segmental/mt [Methods] MH - *Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] MH - Preoperative Care/mt [Methods] MH - Preoperative Care/sn [Statistics & Numerical Data] MH - Referral and Consultation/ut [Utilization] MH - Reoperation AB - BACKGROUND: We surveyed Canadian General Surgeons to examine decision-making in early stage breast cancer. AB - METHODS: A modified Dillman Method was used for this mail survey of 1443 surgeons. Practice patterns and factors that influence management choices for: preoperative assessment, definition of margin status, surgical techniques and recommendations for re-excision were assessed. AB - RESULTS: The response rate was 51% with 41% treating breast cancer. Most (80%) were community surgeons, with equal distribution of low/medium/high volume and years of practice categories. Approximately 25% of surgeons "sometimes or frequently" performed diagnostic excisional biopsies while 90% report "frequently" or "always" performing preoperative core biopsies. There was marked variation in defining negative and close margins, in the use of intra-operative margin assessment techniques and recommendations for re-excision. AB - CONCLUSIONS: Responses revealed significant variation in attitudes and practices. These findings likely reflect an absence of consensus in the literature and potential gaps between best evidence and practice. AB - Copyright © 2012 Elsevier Ltd. All rights reserved. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(12)00168-3 DO - https://dx.doi.org/10.1016/j.breast.2012.07.017 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 22901975 [pubmed] ID - S0960-9776(12)00168-3 [pii] ID - 10.1016/j.breast.2012.07.017 [doi] PP - ppublish PH - 2012/01/24 [received] PH - 2012/04/16 [revised] PH - 2012/07/29 [accepted] LG - English EP - 20120816 DP - 2012 Dec DC - 20121119 EZ - 2012/08/21 06:00 DA - 2013/05/02 06:00 DT - 2012/08/21 06:00 YR - 2012 ED - 20130501 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22901975 <187. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21401958 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hack TF AU - Ruether JD AU - Weir LM AU - Grenier D AU - Degner LF FA - Hack, Thomas F FA - Ruether, J Dean FA - Weir, Lorna M FA - Grenier, Debjani FA - Degner, Lesley F IN - Hack, Thomas F. Faculty of Nursing, University of Manitoba, Winnipeg, Canada. thack@sbrc.ca TI - Study protocol: addressing evidence and context to facilitate transfer and uptake of consultation recording use in oncology: a knowledge translation implementation study. SO - Implementation Science. 6:20, 2011 Mar 14 AS - Implement Sci. 6:20, 2011 Mar 14 NJ - Implementation science : IS PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101258411 IO - Implement Sci PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068117 SB - Index Medicus CP - England MH - *Breast Neoplasms/px [Psychology] MH - Canada MH - Communication MH - Evidence-Based Medicine MH - Female MH - Focus Groups MH - Humans MH - Interviews as Topic MH - Male MH - *Medical Oncology MH - Patient Education as Topic MH - *Physician-Patient Relations MH - *Prostatic Neoplasms/px [Psychology] MH - *Referral and Consultation MH - *Tape Recording/is [Instrumentation] AB - BACKGROUND: The time period from diagnosis to the end of treatment is challenging for newly diagnosed cancer patients. Patients have a substantial need for information, decision aids, and psychosocial support. Recordings of initial oncology consultations improve information recall, reduce anxiety, enhance patient satisfaction with communication, and increase patients' perceptions that the essential aspects of their disease and treatment have been addressed during the consultation. Despite the research evidence supporting the provision of consultation recordings, uptake of this intervention into oncology practice has been slow. The primary aim of this project is to conduct an implementation study to explicate the contextual factors, including use of evidence, that facilitate and impede the transfer and uptake of consultation-recording use in a sample of patients newly diagnosed with breast or prostate cancer. AB - METHODS: Sixteen oncologists from cancer centres in three Canadian cities will participate in this three-phase study. The preimplementation phase will be used to identify and address those factors that are fundamental to facilitating the smooth adoption and delivery of the intervention during the implementation phase. During the implementation phase, breast and prostate cancer patients will receive a recording of their initial oncology consultation to take home. Patient interviews will be conducted in the days following the consultation to gather feedback on the benefits of the intervention. Patients will complete the Digital Recording Use Semi-Structured Interview (DRUSSI) and be invited to participate in focus groups in which their experiences with the consultation recording will be explored. Oncologists will receive a summary letter detailing the benefits voiced by their patients. The postimplementation phase includes a conceptual framework development meeting and a seven-point dissemination strategy. AB - DISCUSSION: Consultation recording has been used in oncology, family medicine, and other medicine specialties, and despite affirming evidence and probable applications to a large number of diseases and a variety of clinical contexts, clinical adoption of this intervention has been slow. The proposed study findings will advance our conceptual knowledge of the ways to enhance uptake of consultation recordings in oncology. NT - Original DateCompleted: 20110714 ES - 1748-5908 IL - 1748-5908 DI - 1748-5908-6-20 DO - https://dx.doi.org/10.1186/1748-5908-6-20 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 21401958 [pubmed] ID - 1748-5908-6-20 [pii] ID - 10.1186/1748-5908-6-20 [doi] ID - PMC3068117 [pmc] PP - epublish PH - 2010/11/22 [received] PH - 2011/03/14 [accepted] LG - English EP - 20110314 DP - 2011 Mar 14 DC - 20110331 EZ - 2011/03/16 06:00 DA - 2011/03/16 06:01 DT - 2011/03/16 06:00 YR - 2011 ED - 20130405 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21401958 <188. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23211118 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gart MS AU - Smetona JT AU - Hanwright PJ AU - Fine NA AU - Bethke KP AU - Khan SA AU - Wang E AU - Kim JY FA - Gart, Michael S FA - Smetona, John T FA - Hanwright, Philip J FA - Fine, Neil A FA - Bethke, Kevin P FA - Khan, Seema A FA - Wang, Edward FA - Kim, John Y S IN - Gart, Michael S. Northwestern Memorial Hospital, Department of Surgery, Division of Plastic and Reconstructive Surgery, Chicago, IL, USA. TI - Autologous options for postmastectomy breast reconstruction: a comparison of outcomes based on the American College of Surgeons National Surgical Quality Improvement Program.[Erratum appears in J Am Coll Surg. 2013 May;216(5):1034-5] CM - Comment in: J Am Coll Surg. 2013 Jul;217(1):172-4; PMID: 23791293 CM - Comment in: J Am Coll Surg. 2013 Jul;217(1):174-5; PMID: 23791294 SO - Journal of the American College of Surgeons. 216(2):229-38, 2013 Feb AS - J Am Coll Surg. 216(2):229-38, 2013 Feb NJ - Journal of the American College of Surgeons PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - bzb, 9431305 IO - J. Am. Coll. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Analysis of Variance MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - Logistic Models MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Middle Aged MH - *Outcome and Process Assessment (Health Care) MH - Postoperative Complications/ep [Epidemiology] MH - Quality Improvement MH - Reoperation/sn [Statistics & Numerical Data] MH - Retrospective Studies MH - Societies, Medical MH - *Surgical Flaps MH - Transplantation, Autologous MH - United States/ep [Epidemiology] AB - BACKGROUND: The postmastectomy patient faces a plethora of choices when opting for autologous breast reconstruction; however, multi-institutional data comparing the available techniques are lacking. The National Surgical Quality Improvement Program (NSQIP) database provides a robust patient cohort for comparing outcomes and determining independent predictors of complications for each autologous method. AB - STUDY DESIGN: The NSQIP database was retrospectively reviewed from 2006 to 2010, identifying 3,296 autologous breast reconstruction patients. Univariate analyses compared complication and reoperation rates. Multivariable logistic regression analyses of 4 cohorts (free flaps, pedicled transverse rectus abdominis myocutaeous (TRAM) flaps, latissimus, and all flaps in aggregate) determined complication rates and independent risk factors for complications and specific outcomes of interest (surgical site infection [SSI], flap failure, reoperation) in all flap types. AB - RESULTS: American Society of Anesthesiologists (ASA) classification >= 3, body mass index > 30 kg/m(2), recent surgery, delayed reconstruction, and prolonged operative times are significant predictors of increased complications in autologous reconstructions. Rates of complications, flap failure, and reoperation were highest in the free tissue transfer group (p < 0.001). Latissimus flaps showed significantly lower rates of complications than other autologous methods (p < 0.001). Pedicled TRAM patients had the highest incidences of venous thromboembolic disease and SSI. AB - CONCLUSIONS: This large-scale, multicenter evaluation of outcomes in autologous breast reconstruction found that free flaps have the highest captured 30-day complication and reoperation rates of any autologous reconstructive method; complications in latissimus flaps were surprisingly few. Pedicled TRAM and latissimus flaps remain the most commonly used autologous reconstructive methods. In addition to providing statistically robust outcomes data, this study contributes significantly to patient education and preoperative planning discussions. AB - Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved. ES - 1879-1190 IL - 1072-7515 DI - S1072-7515(12)01311-7 DO - https://dx.doi.org/10.1016/j.jamcollsurg.2012.11.003 PT - Comparative Study PT - Journal Article PT - Multicenter Study ID - 23211118 [pubmed] ID - S1072-7515(12)01311-7 [pii] ID - 10.1016/j.jamcollsurg.2012.11.003 [doi] PP - ppublish PH - 2012/09/11 [received] PH - 2012/11/02 [revised] PH - 2012/11/05 [accepted] LG - English EP - 20121202 DP - 2013 Feb DC - 20130115 EZ - 2012/12/06 06:00 DA - 2013/03/13 06:00 DT - 2012/12/06 06:00 YR - 2013 ED - 20130312 RD - 20130815 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23211118 <189. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23017936 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Beier JP AU - Horch RE AU - Arkudas A AU - Dragu A AU - Schmitz M AU - Kneser U FA - Beier, Justus P FA - Horch, Raymund E FA - Arkudas, Andreas FA - Dragu, Adrian FA - Schmitz, Marweh FA - Kneser, Ulrich IN - Beier, Justus P. Department of Plastic and Hand Surgery, University Hospital of Erlangen, Friedrich-Alexander-University of Erlangen-Nurnberg, Krankenhausstr. 12, 91054 Erlangen, Germany. justus.beier@uk-erlangen.de TI - Decision-making in DIEP and ms-TRAM flaps: the potential role for a combined laser Doppler spectrophotometry system. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 66(1):73-9, 2013 Jan AS - J Plast Reconstr Aesthet Surg. 66(1):73-9, 2013 Jan NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - *Abdominal Wall/bs [Blood Supply] MH - Abdominal Wall/su [Surgery] MH - Adult MH - Anastomosis, Surgical MH - Angiography MH - Decision Making MH - *Epigastric Arteries/su [Surgery] MH - Female MH - Graft Survival MH - Hemoglobins/me [Metabolism] MH - Humans MH - *Hyperemia/di [Diagnosis] MH - Intraoperative Care MH - Laser-Doppler Flowmetry MH - Mammaplasty MH - Middle Aged MH - Oxygen/bl [Blood] MH - *Perforator Flap/bs [Blood Supply] MH - Perforator Flap/tr [Transplantation] MH - Regional Blood Flow MH - Spectrophotometry MH - Time Factors MH - Veins/su [Surgery] AB - BACKGROUND: Three-dimensional (3D)-imaging modalities for pre-operative mapping of perforators in DIEP and ms-TRAM flap surgery are well established. While zonal perfusion of such flaps has been extensively studied pre-, intra- and post-operatively, the role of objective perfusion assessment for decision making between different possible perforator configurations has not been investigated yet. In this study, a combined lased Doppler spectrophotometry (CLDS) system was applied intra-operatively to support the surgeon's decision-making process. AB - METHODS: In this prospective study, 25 consecutive unilateral abdominal flaps were included. Computed tomographic angiography (CTA) was performed prior to surgery. By CLDS the post-capillary oxygen saturation, relative haemoglobin content and relative bloodflow were determined at different time points and in four standardised zones in dependence of different possible perforator/pedicle vessel configurations (with selective clamping of different perforators and/or the superficial inferior epigastric vein). Results were correlated with clinical findings and late results were evaluated after 6-16 months. AB - RESULTS: Ninety-six percent of the flaps survived. No significant fat necrosis was observed. While there was a high correlation between clinical findings and CLDS results, CLDS was more sensitive in identification of venous congestion of DIEP flaps. The technique helped to identify the dominant perforator(s) in flaps where perfusion patterns were unclear. CLDS influenced intra-operative decision making in five cases (two venous and one arterial in-flap anastomosis and inclusion of additional perforators in two flaps). AB - CONCLUSION: Intra-operative use of CLDS helps to objectively determine perfusion patterns in abdominal flaps. CLDS might be applicable in 'complex' abdominal flaps (e.g., after previous abdominal surgery or when preoperative CTA does not provide conclusive results) and supports, in these cases, intra-operative decision-making. AB - Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. RN - 0 (Hemoglobins) RN - S88TT14065 (Oxygen) ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(12)00499-8 DO - https://dx.doi.org/10.1016/j.bjps.2012.08.040 PT - Journal Article ID - 23017936 [pubmed] ID - S1748-6815(12)00499-8 [pii] ID - 10.1016/j.bjps.2012.08.040 [doi] PP - ppublish PH - 2012/08/08 [received] PH - 2012/08/27 [accepted] LG - English EP - 20120925 DP - 2013 Jan DC - 20121221 EZ - 2012/09/29 06:00 DA - 2013/03/05 06:00 DT - 2012/09/29 06:00 YR - 2013 ED - 20130304 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23017936 <190. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23271543 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Liem AA AU - Ramakrishnan V FA - Liem, Anita A FA - Ramakrishnan, Venkat IN - Liem, Anita A. St. Andrews Center for Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK. TI - The St. Andrews recipient algorithm for breast reconstruction: a comparison analysis with other microsurgical units in the world. SO - Plastic & Reconstructive Surgery. 131(1):127e-8e, 2013 Jan AS - Plast Reconstr Surg. 131(1):127e-8e, 2013 Jan NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Algorithms MH - Anastomosis, Surgical MH - *Decision Support Techniques MH - Epigastric Arteries/su [Surgery] MH - Female MH - Free Tissue Flaps/bs [Blood Supply] MH - *Free Tissue Flaps/tr [Transplantation] MH - Humans MH - *Mammaplasty/mt [Methods] MH - Mammary Arteries/su [Surgery] MH - *Microsurgery/mt [Methods] MH - Outcome Assessment (Health Care) MH - Retrospective Studies MH - United Kingdom ES - 1529-4242 IL - 0032-1052 DI - 00006534-201301000-00048 DO - https://dx.doi.org/10.1097/PRS.0b013e318272a16f PT - Comparative Study PT - Evaluation Studies PT - Journal Article ID - 23271543 [pubmed] ID - 10.1097/PRS.0b013e318272a16f [doi] ID - 00006534-201301000-00048 [pii] PP - ppublish LG - English DP - 2013 Jan DC - 20121228 EZ - 2012/12/29 06:00 DA - 2013/02/26 06:00 DT - 2012/12/29 06:00 YR - 2013 ED - 20130225 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=23271543 <191. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22833001 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fisher CS AU - Martin-Dunlap T AU - Ruppel MB AU - Gao F AU - Atkins J AU - Margenthaler JA FA - Fisher, Carla S FA - Martin-Dunlap, Tonya FA - Ruppel, Megan Baker FA - Gao, Feng FA - Atkins, Jordan FA - Margenthaler, Julie A IN - Fisher, Carla S. Department of Surgery, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. carla.fisher@uphs.upenn.edu TI - Fear of recurrence and perceived survival benefit are primary motivators for choosing mastectomy over breast-conservation therapy regardless of age. SO - Annals of Surgical Oncology. 19(10):3246-50, 2012 Oct AS - Ann Surg Oncol. 19(10):3246-50, 2012 Oct NJ - Annals of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Decision Making MH - *Fear/px [Psychology] MH - Female MH - Follow-Up Studies MH - Humans MH - Mastectomy/mo [Mortality] MH - *Mastectomy/px [Psychology] MH - Mastectomy, Segmental/mo [Mortality] MH - *Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Motivation MH - Neoplasm Recurrence, Local/mo [Mortality] MH - *Neoplasm Recurrence, Local/px [Psychology] MH - Neoplasm Recurrence, Local/su [Surgery] MH - *Perception MH - Prognosis MH - Retrospective Studies MH - Surveys and Questionnaires MH - Survival Rate AB - INTRODUCTION: Recent studies have reported increases in the rate of mastectomy and contralateral prophylactic mastectomy (CPM). We hypothesized that there would be different reasons for choosing mastectomy for women aged <50 compared with those aged >=50 years. AB - METHODS: A questionnaire was administered to 332 patients who underwent unilateral or bilateral mastectomy for breast cancer from 2006 to 2010. The survey queried on demographics, surgical choices, and rationale for those choices. A retrospective chart review was performed to determine tumor characteristics. Responses and clinical characteristics were described by contingency tables and compared using Fisher exact test or chi(2) test, as appropriate. AB - RESULTS: Of 332 patients surveyed, 310 were evaluable. Median age was 55 years, including 88 patients <50 (28 %) and 222 patients >=50 (72 %) at time of diagnosis. Forty-four percent of women <50 and 41 % of women >=50 were given the option of breast conservation and chose mastectomy (p > 0.63). The two groups did not differ in their reason for choosing mastectomy, with lower recurrence risk and improved survival cited as the two most common reasons. Younger patients were more likely to undergo reconstruction and CPM (p < 0.0001) as well as have estrogen receptor-negative tumors, undergo neoadjuvant chemotherapy, and have higher magnetic resonance imaging utilization (p < 0.05). AB - CONCLUSIONS: Choosing mastectomy and the reasons for doing so were the same for women aged <50 and >=50 years. Prospective studies are needed to determine whether patient education regarding perceived versus actual recurrence risk and survival would alter this decision-making process. ES - 1534-4681 IL - 1068-9265 DO - https://dx.doi.org/10.1245/s10434-012-2525-x PT - Journal Article ID - 22833001 [pubmed] ID - 10.1245/s10434-012-2525-x [doi] PP - ppublish PH - 2012/04/12 [received] LG - English EP - 20120726 DP - 2012 Oct DC - 20120911 EZ - 2012/07/27 06:00 DA - 2013/02/15 06:00 DT - 2012/07/27 06:00 YR - 2012 ED - 20130214 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22833001 <192. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22940522 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Spittler CA AU - Pallikathayil L AU - Bott M FA - Spittler, Cheryl A FA - Pallikathayil, Leonie FA - Bott, Marjorie IN - Spittler, Cheryl A. Quinn Plastic Surgery Center, Overland Park, KS, USA. cherylaspittler@aol.com TI - Exploration of how women make treatment decisions after a breast cancer diagnosis. SO - Oncology Nursing Forum. 39(5):E425-33, 2012 Sep AS - Oncol Nurs Forum. 39(5):E425-33, 2012 Sep NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Internet JC - 7809033, 7809033 IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Anxiety/px [Psychology] MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - Data Collection MH - *Decision Making MH - Educational Status MH - Emotions MH - Fear MH - Female MH - Focus Groups MH - Health Services Needs and Demand MH - Humans MH - Marital Status MH - Mastectomy/px [Psychology] MH - Patient Education as Topic MH - Patient Preference MH - Patient Satisfaction MH - Stress, Psychological/px [Psychology] MH - Surveys and Questionnaires MH - *Survivors/px [Psychology] MH - United States MH - *Women/px [Psychology] AB - PURPOSE/OBJECTIVES: To examine the information needs of women after receiving a diagnosis of breast cancer, investigate how decisions about treatment options are made, and assess personal responses to the decisions made. AB - DESIGN: Mixed-methods approach using quantitative and qualitative data. AB - SETTING: The University of Kansas Medical Center and Quinn Plastic Surgery Center, both in the midwestern United States. AB - SAMPLE: 102 breast cancer survivors who had completed all forms of treatment for at least three months and less than five years. AB - METHODS: Phase I participants completed five questionnaires about informational needs, confidence and satisfaction with the decision, decisional regret, and conflict. In phase II, 15 participants were purposively sampled from the 102 survivors to participate in a focus group session. Data analysis included frequencies and multiple regression for phase I and qualitative content analysis for phase II. AB - MAIN RESEARCH VARIABLES: Informational needs, confidence and satisfaction with the decision, and decisional regret and conflict. AB - FINDINGS: The variables (widowed, confidence and satisfaction with decision, and decisional conflict and regret) significantly (p = 0.01) accounted for 14% of the variance in informational needs. Two themes emerged from the study: (a) feelings, thoughts, and essential factors that impact treatment considerations, and (b) tips for enhancing treatment consideration options. AB - CONCLUSIONS: The study's results show that women viewed informational needs as very important in making treatment decisions after being diagnosed with breast cancer. AB - IMPLICATIONS FOR NURSING: The treatment team should provide the information, with consideration of the patient's personal preferences, that will assist women to make informed, confident, and satisfied decisions about treatment choices. ES - 1538-0688 IL - 0190-535X DI - 8701N73L24G0V2M5 DO - https://dx.doi.org/10.1188/12.ONF.E425-E433 PT - Journal Article ID - 22940522 [pubmed] ID - 8701N73L24G0V2M5 [pii] ID - 10.1188/12.ONF.E425-E433 [doi] PP - ppublish LG - English DP - 2012 Sep DC - 20120903 EZ - 2012/09/04 06:00 DA - 2013/02/12 06:00 DT - 2012/09/04 06:00 YR - 2012 ED - 20130211 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22940522 <193. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 23190819 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Choudry U AU - Kim N FA - Choudry, Umar FA - Kim, Nicholas IN - Choudry, Umar. Division of Plastic Surgery, University of Minnesota, Minneapolis, Minn 55455, USA. choud008@umn.edu TI - Preoperative assessment preferences and reported reoperation rates for size change in primary breast augmentation: a survey of ASPS members. SO - Plastic & Reconstructive Surgery. 130(6):1352-9, 2012 Dec AS - Plast Reconstr Surg. 130(6):1352-9, 2012 Dec NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Attitude of Health Personnel MH - Breast/ah [Anatomy & Histology] MH - *Breast Implantation/is [Instrumentation] MH - Breast Implantation/mt [Methods] MH - Breast Implantation/sn [Statistics & Numerical Data] MH - *Breast Implants MH - *Decision Support Techniques MH - Dissent and Disputes MH - Female MH - Health Care Surveys MH - Humans MH - Outcome Assessment (Health Care) MH - Patient Education as Topic MH - Physician-Patient Relations MH - *Physicians/px [Psychology] MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] MH - *Preoperative Care/mt [Methods] MH - Preoperative Care/sn [Statistics & Numerical Data] MH - Reoperation/sn [Statistics & Numerical Data] MH - Societies, Medical MH - Surgery, Plastic MH - Surveys and Questionnaires MH - United States AB - BACKGROUND: The purpose of this study was to determine the current preferences of plastic surgeons regarding preoperative assessment and their effect on clinical outcome in primary breast augmentation. AB - METHODS: An eight-question online survey was sent to members of the American Society of Plastic Surgeons. Data collected online were analyzed using Student's t test or Pearson's chi-square test. A value of p < 0.05 was considered statistically significant. AB - RESULTS: The response rate was 20.1 percent (604 respondents). Breast base diameter [n = 286 (47.4 percent)] was ranked the most important consideration vital in choosing implants. Most surgeons chose to reeducate their patients to resolve a conflict between their patient's implant size request and the surgeon's clinical judgment [n = 385 (63.7 percent)], whereas 151 (25 percent) would proceed anyway. Those surgeons who chose reeducation ranked breast base diameter as a vital consideration significantly higher than those who would accommodate their patients (2.03 +/- 1.41 versus 2.31 +/- 1.41; p = 0.041). Similarly, surgeons who reeducated their patients ranked implant volume as the vital consideration significantly lower than those who accommodated their patients (2.90 +/- 1.67 versus 2.44 +/- 1.47; p = 0.002). Regarding size change, 332 surgeons (55 percent) reported their rate was 5 percent or less, whereas 272 (45 percent) reported it was greater than 5 percent. Surgeons who reported a 5 percent or less rate ranked implant volume significantly lower than those with reoperation rates greater than 5 percent (2.93 +/- 1.71 versus 2.55 +/- 1.53; p = 0.004). AB - CONCLUSIONS: Breast base diameter and implant volume were the two most important considerations in choosing an implant for breast augmentation. Reported reoperation rates for size change were significantly lower for surgeons who regarded breast base diameter as more vital than those who valued implant volume more. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201212000-00032 DO - https://dx.doi.org/10.1097/PRS.0b013e31826d9f66 PT - Evaluation Studies PT - Journal Article ID - 23190819 [pubmed] ID - 10.1097/PRS.0b013e31826d9f66 [doi] ID - 00006534-201212000-00032 [pii] PP - ppublish LG - English DP - 2012 Dec DC - 20121129 EZ - 2012/11/30 06:00 DA - 2013/01/29 06:00 DT - 2012/11/30 06:00 YR - 2012 ED - 20130128 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=23190819 <194. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22874236 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bouaud J AU - Messai N AU - Laouenan C AU - Mentre F AU - Seroussi B FA - Bouaud, Jacques FA - Messai, Nizar FA - Laouenan, Cedric FA - Mentre, France FA - Seroussi, Brigitte IN - Bouaud, Jacques. AP-HP, STIM, Paris, France. jacques.bouaud@sap.aphp.fr TI - Elicitating patient patterns of physician non-compliance with breast cancer guidelines using formal concept analysis. SO - Studies in Health Technology & Informatics. 180:477-81, 2012 AS - Stud Health Technol Inform. 180:477-81, 2012 NJ - Studies in health technology and informatics PI - Journal available in: Print PI - Citation processed from: Print JC - ck1, 9214582 IO - Stud Health Technol Inform SB - Health Technology Assessment Journals CP - Netherlands MH - *Decision Support Systems, Clinical/st [Standards] MH - Decision Support Systems, Clinical/sn [Statistics & Numerical Data] MH - Female MH - France/ep [Epidemiology] MH - *Guideline Adherence/sn [Statistics & Numerical Data] MH - Humans MH - *Medical Oncology/st [Standards] MH - Neoplasms/ep [Epidemiology] MH - *Neoplasms/th [Therapy] MH - *Patient Compliance/sn [Statistics & Numerical Data] MH - *Practice Guidelines as Topic MH - Practice Patterns, Physicians'/st [Standards] MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] AB - Because they provide patient-specific guideline-based recommendations, clinical decision support systems (CDSSs) are expected to promote the implementation of clinical practice guidelines (CPGs). OncoDoc2 is a CDSS applied to the management of breast cancer. However, despite it was routinely used during weekly multidisciplinary staff meetings (MSMs) at the Tenon Hospital (Paris, France), the compliance rate of MSMs' decisions with CPGs did not reach 100%. Formal Concept Analysis (FCA) has been applied to elicit formal concepts related to non-compliance. A statistical pre-treatment of attributes has been proposed to leverage FCA and discriminate between compliant and non-compliant decisions. Among the 1,889 decisions made over a 3 year-period, 199 decisions of recommended re-excisions have been considered for analysis. In this sample, non-compliance was explained by uncommon clinical profiles and specific patient-centred clinical criteria. IS - 0926-9630 IL - 0926-9630 PT - Journal Article ID - 22874236 [pubmed] PP - ppublish LG - English DP - 2012 DC - 20120809 EZ - 2012/08/10 06:00 DA - 2013/01/23 06:00 DT - 2012/08/10 06:00 YR - 2012 ED - 20130122 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22874236 <195. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22838957 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Watts KJ AU - Meiser B AU - Mitchell G AU - Kirk J AU - Saunders C AU - Peate M AU - Duffy J AU - Kelly PJ AU - Gleeson M AU - Barlow-Stewart K AU - Rahman B AU - Friedlander M AU - Tucker K AU - TFGT Collaborative Group FA - Watts, Kaaren J FA - Meiser, Bettina FA - Mitchell, Gillian FA - Kirk, Judy FA - Saunders, Christobel FA - Peate, Michelle FA - Duffy, Jessica FA - Kelly, Patrick J FA - Gleeson, Margaret FA - Barlow-Stewart, Kristine FA - Rahman, Belinda FA - Friedlander, Michael FA - Tucker, Kathy FA - TFGT Collaborative Group IN - Watts, Kaaren J. Department of Medical Oncology, Prince of Wales Hospital, High Street, Randwick, NSW, Australia. k.watts@unsw.edu.au IR - Antill Y IR - Gregory P IR - Lipton L IR - McKay L IR - Senior J IR - Lobb EA IR - Crowe P IR - Matthews A IR - Neil G IR - Parasyn A IR - Thomson D IR - Zilliacus E IR - Andrews L IR - Gale J IR - Fox J IR - Harris M IR - Hart S IR - Smythe C IR - White M IR - Creighton L IR - Crowe K IR - D'arcy J IR - Grieve S IR - Secomb E IR - Ciciarelli L IR - Henderson M IR - O Brien J IR - Poliness C IR - Hattam A IR - Susman R IR - Dickson R IR - Field M IR - Moore K IR - Bastick P IR - Inder S IR - Lynch J IR - Schwartz P IR - Zia R IR - Mak C IR - Snook K IR - Spillane A IR - Hopper J IR - Geelhoed L IR - Bowman M IR - Cheung D IR - Edirimanne S IR - Edwards E IR - Elder E IR - French J IR - Moon D TI - How should we discuss genetic testing with women newly diagnosed with breast cancer? Design and implementation of a randomized controlled trial of two models of delivering education about treatment-focused genetic testing to younger women newly diagnosed with breast cancer. SO - BMC Cancer. 12:320, 2012 Jul 28 AS - BMC Cancer. 12:320, 2012 Jul 28 NJ - BMC cancer PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 100967800 IO - BMC Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3472271 SB - Index Medicus CP - England MH - Age Factors MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Clinical Protocols MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Counseling/es [Ethics] MH - *Genetic Counseling MH - Genetic Testing/es [Ethics] MH - *Genetic Testing MH - Humans MH - Mutation AB - BACKGROUND: Germline BRCA1 and BRCA2 mutation testing offered shortly after a breast cancer diagnosis to inform women's treatment choices - treatment-focused genetic testing 'TFGT' - has entered clinical practice in specialist centers and is likely to be soon commonplace in acute breast cancer management, especially for younger women. Yet the optimal way to deliver information about TFGT to younger women newly diagnosed with breast cancer is not known, particularly for those who were not suspected of having a hereditary breast cancer syndrome prior to their cancer diagnosis. Also, little is known about the behavioral and psychosocial impact or cost effectiveness of educating patients about TFGT. This trial aims to examine the impact and efficiency of two models of educating younger women newly diagnosed with breast cancer about genetic testing in order to provide evidence for a safe and effective future clinical pathway for this service. AB - DESIGN/METHODS: In this non-inferiority randomized controlled trial, 140 women newly diagnosed with breast cancer (aged less than 50years) are being recruited from nine cancer centers in Australia. Eligible women with either a significant family history of breast and/or ovarian cancer or with other high risk features suggestive of a mutation detection rate of>10% are invited by their surgeon prior to mastectomy or radiotherapy. After completing the first questionnaire, participants are randomized to receive either: (a) an educational pamphlet about genetic testing (intervention) or (b) a genetic counseling appointment at a family cancer center (standard care). Each participant is offered genetic testing for germline BRCA mutations. Decision-related and psychosocial outcomes are assessed over 12months and include decisional conflict (primary outcome);uptake of bilateral mastectomy and/or risk-reducing salpingo-oophorectomy; cancer-specific- and general distress; family involvement in decision making; and decision regret. A process-oriented retrospective online survey will examine health professionals' attitudes toward TFGT; a health economic analysis will determine the cost effectiveness of the intervention. AB - DISCUSSION: This trial will provide crucial information about the impact, efficiency and cost effectiveness of an educational pamphlet designed to inform younger women newly diagnosed with breast cancer about genetic testing. Issues regarding implementation of the trial are discussed. ES - 1471-2407 IL - 1471-2407 DI - 1471-2407-12-320 DO - https://dx.doi.org/10.1186/1471-2407-12-320 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 22838957 [pubmed] ID - 1471-2407-12-320 [pii] ID - 10.1186/1471-2407-12-320 [doi] ID - PMC3472271 [pmc] PP - epublish PH - 2012/07/04 [received] PH - 2012/07/13 [accepted] LG - English EP - 20120728 DP - 2012 Jul 28 DC - 20121016 EZ - 2012/07/31 06:00 DA - 2013/01/18 06:00 DT - 2012/07/31 06:00 YR - 2012 ED - 20130117 RD - 20150224 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22838957 <196. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22658808 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mazouni C AU - Spyratos F AU - Romain S AU - Fina F AU - Bonnier P AU - Ouafik LH AU - Martin PM FA - Mazouni, C FA - Spyratos, F FA - Romain, S FA - Fina, F FA - Bonnier, P FA - Ouafik, L H FA - Martin, P M IN - Mazouni, C. Laboratoire de transfert d'oncologie biologique, Assistance Publique - Hopitaux de Marseille, Faculte de Medecine Nord, Marseille, France. chafika.mazouni@igr.fr TI - A nomogram to predict individual prognosis in node-negative breast carcinoma. SO - European Journal of Cancer. 48(16):2954-61, 2012 Nov AS - Eur J Cancer. 48(16):2954-61, 2012 Nov NJ - European journal of cancer (Oxford, England : 1990) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - arv, 9005373 IO - Eur. J. Cancer SB - Index Medicus CP - England MH - Age Factors MH - Biomarkers, Tumor/an [Analysis] MH - Breast Neoplasms/ch [Chemistry] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma/ch [Chemistry] MH - Carcinoma/mo [Mortality] MH - Carcinoma/pa [Pathology] MH - *Carcinoma/su [Surgery] MH - Chemotherapy, Adjuvant MH - *Decision Support Techniques MH - Disease-Free Survival MH - Female MH - France MH - Humans MH - Kaplan-Meier Estimate MH - Lymph Node Excision MH - *Lymph Nodes/pa [Pathology] MH - Mastectomy, Modified Radical/ae [Adverse Effects] MH - Mastectomy, Modified Radical/mo [Mortality] MH - *Mastectomy, Modified Radical MH - Mastectomy, Segmental/ae [Adverse Effects] MH - Mastectomy, Segmental/mo [Mortality] MH - *Mastectomy, Segmental MH - Middle Aged MH - Multivariate Analysis MH - *Nomograms MH - Patient Selection MH - Plasminogen Activator Inhibitor 1/an [Analysis] MH - Proportional Hazards Models MH - Radiotherapy, Adjuvant MH - Receptors, Progesterone/an [Analysis] MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Tumor Burden AB - BACKGROUND: Currently, the benefit of chemotherapy (CT) in node-negative breast carcinoma (NNBC) is discussed. The evaluation of classical clinical and histological factors is limited to assess individual outcome. A statistical model was developed to improve the prognostic accuracy of NNBC. AB - METHODS: A total of 305 node-negative breast carcinomas who underwent surgery (+/- radiotherapy) but no adjuvant treatment were selected. Putative prognosis factors including age, tumour size, oestrogen receptor (ER), progesterone receptor (PgR), Scarff-Bloom-Richardon (SBR) grading, urokinase plasminogen activator (uPA), plasminogen activator inhibitor 1 (PAI-1) and thymidine kinase (TK) were evaluated. The developed model was internally validated using Harrell's concordance index. A prognosis index (PI) was proposed and compared with Adjuvant! Online program. AB - RESULTS: Age (p < 0.001), pathological tumour size (pT) (p < 0.001), PgR (p = 0.02), and PAI-1 (p <= 0.001) were included in the Cox regression model predicting Breast cancer specific survival (BCSS) at 5-years. Internal validation revealed a concordance index of 0.71. A PI score was derived from our nomogram. The PI score was significantly associated with BCSS (hazard ratio (HR): 4.1 for intermediate, p=0.02, HR: 8.8, p < 0.001 for high group) as compared to Adjuvant! Online score (HR: 1.4, p=0.14). AB - CONCLUSION: A nomogram can be used to predict probability survival curves for individual breast cancer patients. AB - Copyright © 2012 Elsevier Ltd. All rights reserved. RN - 0 (Biomarkers, Tumor) RN - 0 (Plasminogen Activator Inhibitor 1) RN - 0 (Receptors, Progesterone) RN - 0 (SERPINE1 protein, human) ES - 1879-0852 IL - 0959-8049 DI - S0959-8049(12)00369-3 DO - https://dx.doi.org/10.1016/j.ejca.2012.04.018 PT - Comparative Study PT - Journal Article PT - Multicenter Study ID - 22658808 [pubmed] ID - S0959-8049(12)00369-3 [pii] ID - 10.1016/j.ejca.2012.04.018 [doi] PP - ppublish PH - 2011/12/16 [received] PH - 2012/03/22 [revised] PH - 2012/04/27 [accepted] LG - English EP - 20120531 DP - 2012 Nov DC - 20121015 EZ - 2012/06/05 06:00 DA - 2012/12/22 06:00 DT - 2012/06/05 06:00 YR - 2012 ED - 20121221 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22658808 <197. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22556274 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sigal BM AU - Munoz DF AU - Kurian AW AU - Plevritis SK FA - Sigal, Bronislava M FA - Munoz, Diego F FA - Kurian, Allison W FA - Plevritis, Sylvia K IN - Sigal, Bronislava M. Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA. TI - A simulation model to predict the impact of prophylactic surgery and screening on the life expectancy of BRCA1 and BRCA2 mutation carriers. SO - Cancer Epidemiology, Biomarkers & Prevention. 21(7):1066-77, 2012 Jul AS - Cancer Epidemiol Biomarkers Prev. 21(7):1066-77, 2012 Jul NJ - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - bnj, 9200608 IO - Cancer Epidemiol. Biomarkers Prev. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146524 OI - Source: NLM. NIHMS404694 SB - Index Medicus CP - United States MH - Adult MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/su [Surgery] MH - Computer Simulation MH - *Decision Support Techniques MH - Female MH - Heterozygote MH - Humans MH - *Life Expectancy MH - Mastectomy MH - Middle Aged MH - *Models, Statistical MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovarian Neoplasms/su [Surgery] MH - *Ovariectomy AB - BACKGROUND: Women with inherited mutations in the BRCA1 or BRCA2 (BRCA1/2) genes are recommended to undergo a number of intensive cancer risk-reducing strategies, including prophylactic mastectomy, prophylactic oophorectomy, and screening. We estimate the impact of different risk-reducing options at various ages on life expectancy. AB - METHODS: We apply our previously developed Monte Carlo simulation model of screening and prophylactic surgery in BRCA1/2 mutation carriers. Here, we present the mathematical formulation to compute age-specific breast cancer incidence in the absence of prophylactic oophorectomy, which is an input to the simulation model, and provide sensitivity analysis on related model parameters. AB - RESULTS: The greatest gains in life expectancy result from conducting prophylactic mastectomy and prophylactic oophorectomy immediately after BRCA1/2 mutation testing; these gains vary with age at testing, from 6.8 to 10.3 years for BRCA1 and 3.4 to 4.4 years for BRCA2 mutation carriers. Life expectancy gains from delaying prophylactic surgery by 5 to 10 years range from 1 to 9.9 years for BRCA1 and 0.5 to 4.2 years for BRCA2 mutation carriers. Adding annual breast screening provides gains of 2.0 to 9.9 years for BRCA1 and 1.5 to 4.3 years for BRCA2. Results were most sensitive to variations in our assumptions about the magnitude and duration of breast cancer risk reduction due to prophylactic oophorectomy. AB - CONCLUSIONS: Life expectancy gains depend on the type of BRCA mutation and age at interventions. Sensitivity analysis identifies the degree of breast cancer risk reduction due to prophylactic oophorectomy as a key determinant of life expectancy gain. AB - IMPACT: Further study of the impact of prophylactic oophorectomy on breast cancer risk in BRCA1/2 mutation carriers is warranted. AB - Copyright ©2012 AACR RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) RN - 0 (BRCA2 Protein) RN - 0 (BRCA2 protein, human) ES - 1538-7755 IL - 1055-9965 DI - 1055-9965.EPI-12-0149 DO - https://dx.doi.org/10.1158/1055-9965.EPI-12-0149 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 22556274 [pubmed] ID - 1055-9965.EPI-12-0149 [pii] ID - 10.1158/1055-9965.EPI-12-0149 [doi] ID - PMC4146524 [pmc] ID - NIHMS404694 [mid] PP - ppublish GI - No: U01 CA088248 Organization: (CA) *NCI NIH HHS* Country: United States No: U01 CA152958 Organization: (CA) *NCI NIH HHS* Country: United States No: U01CA152958 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20120503 DP - 2012 Jul DC - 20120709 EZ - 2012/05/05 06:00 DA - 2012/12/12 06:00 DT - 2012/05/05 06:00 YR - 2012 ED - 20121211 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22556274 <198. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22516371 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Maaskant-Braat AJ AU - Voogd AC AU - van de Poll-Franse LV AU - Coebergh JW AU - Nieuwenhuijzen GA FA - Maaskant-Braat, Adriana J FA - Voogd, Adri C FA - van de Poll-Franse, Lonneke V FA - Coebergh, Jan Willem W FA - Nieuwenhuijzen, Grard A IN - Maaskant-Braat, Adriana J. Department of Surgery, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, The Netherlands. sabrinamaaskant@gmail.com TI - Axillary and systemic treatment of patients with breast cancer and micrometastatic disease or isolated tumor cells in the sentinel lymph node. SO - Breast. 21(4):524-8, 2012 Aug AS - BREAST. 21(4):524-8, 2012 Aug NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Axilla MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant MH - Decision Support Techniques MH - Female MH - Humans MH - *Lymph Node Excision/sn [Statistics & Numerical Data] MH - Lymphatic Metastasis MH - Mastectomy MH - Middle Aged MH - Multivariate Analysis MH - Neoplasm Micrometastasis MH - Netherlands MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] MH - Registries MH - Sentinel Lymph Node Biopsy AB - BACKGROUND: After introduction of sentinel node biopsy (SNB) in patients with breast cancer a higher proportion of micrometastases and isolated tumor cells are being detected. Prognostic impact and clinical relevance of this minimal nodal involvement is under debate and substantial variation in the use of axillary surgery and/or systemic adjuvant treatment could be expected. AB - METHODS: Data from the population-based Eindhoven Cancer Registry were used on all (n = 9038) women who underwent SNB for invasive breast cancer from 1996 to 2008 and medical files were studied to determine the role of minimal nodal involvement in the decision to use adjuvant systemic treatment. AB - RESULTS: Forty-five percent of 172 patients with isolated tumor cells and 76% of 605 patients with micrometastases received adjuvant systemic treatment. Thirty-five of 59 patients with isolated tumor cells and 153 of 193 patients with micrometastases received systemic therapy based on primary tumor characteristics. The remainder probably received adjuvant therapy based on presence of minimal nodal involvement. Thirty-seven percent of the patients with isolated tumor cells underwent an axillary lymph node dissection compared to 75% when micrometastases were present. Multivariate analyses showed a significantly higher chance of receiving systemic treatment when isolated tumor cells (OR 1.5 (95% CI, 1.05-2.15)) or micrometastases (OR 10.7 (95% CI, 8.56-13.27)) were present, compared to a negative lymph node status. AB - CONCLUSION: The debate on necessity of performing completion ALND and administration of systemic therapy in patients with minimal nodal involvement is reflected by the treatment patterns observed in our population-based study. AB - SYNOPSIS: Describing time-trends and predictors of axillary and systemic treatment of patients with breast cancer and micrometastases or isolated tumor cells in their sentinel lymph node(s). AB - Copyright © 2012 Elsevier Ltd. All rights reserved. RN - 0 (Antineoplastic Agents) ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(12)00067-7 DO - https://dx.doi.org/10.1016/j.breast.2012.03.008 PT - Evaluation Studies PT - Journal Article ID - 22516371 [pubmed] ID - S0960-9776(12)00067-7 [pii] ID - 10.1016/j.breast.2012.03.008 [doi] PP - ppublish PH - 2011/12/20 [received] PH - 2012/03/12 [revised] PH - 2012/03/18 [accepted] LG - English EP - 20120418 DP - 2012 Aug DC - 20120716 EZ - 2012/04/21 06:00 DA - 2012/11/09 06:00 DT - 2012/04/21 06:00 YR - 2012 ED - 20121108 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22516371 <199. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22747264 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jones B FA - Jones, Bolette IN - Jones, Bolette. Cardiff and Vale University Local Health Board, UK. bolette.jones@wales.nhs.uk TI - BresDex: helping women make breast cancer surgery choices. SO - Journal of Visual Communication in Medicine. 35(2):59-64, 2012 Jun AS - J Vis Commun Med. 35(2):59-64, 2012 Jun NJ - Journal of visual communication in medicine PI - Journal available in: Print PI - Citation processed from: Internet JC - 101254059 IO - J Vis Commun Med SB - Index Medicus CP - England MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy, Radical/px [Psychology] MH - *Mastectomy, Segmental/px [Psychology] MH - Patient Satisfaction MH - *Women's Health AB - Women diagnosed with early breast cancer face a difficult decision between mastectomy and breast conservation surgery with radiotherapy. BresDex is an interactive decision-making support tool, designed to go together with the assistance and information these women currently receive, to help them in making the right choices. This paper will discuss the concepts behind this decision-making tool, the development of the project and the role of clinical photography within it. ES - 1745-3062 IL - 1745-3054 DO - https://dx.doi.org/10.3109/17453054.2012.690132 PT - Journal Article ID - 22747264 [pubmed] ID - 10.3109/17453054.2012.690132 [doi] PP - ppublish LG - English DP - 2012 Jun DC - 20120703 EZ - 2012/07/04 06:00 DA - 2012/11/08 06:00 DT - 2012/07/04 06:00 YR - 2012 ED - 20121107 RD - 20120703 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22747264 <200. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22483606 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Caretta-Weyer H AU - Sisney GA AU - Beckman C AU - Burnside ES AU - Salkowsi LR AU - Strigel RM AU - Wilke LG AU - Neuman HB FA - Caretta-Weyer, Holly FA - Sisney, Gale A FA - Beckman, Catherine FA - Burnside, Elizabeth S FA - Salkowsi, Lonie R FA - Strigel, Roberta M FA - Wilke, Lee G FA - Neuman, Heather B IN - Caretta-Weyer, Holly. Department of Surgery, Division of Surgical Oncology, University of Wisconsin, Madison, WI 53792-7375, USA. TI - Impact of axillary ultrasound and core needle biopsy on the utility of intraoperative frozen section analysis and treatment decision making in women with invasive breast cancer. SO - American Journal of Surgery. 204(3):308-14, 2012 Sep AS - Am J Surg. 204(3):308-14, 2012 Sep NJ - American journal of surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 3z4, 0370473 IO - Am. J. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Axilla/dg [Diagnostic Imaging] MH - Biomarkers, Tumor/an [Analysis] MH - *Biopsy, Needle MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma, Ductal, Breast/dg [Diagnostic Imaging] MH - *Carcinoma, Ductal, Breast/pa [Pathology] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - *Carcinoma, Ductal, Breast/th [Therapy] MH - Female MH - *Frozen Sections MH - Humans MH - Intraoperative Period MH - *Lymph Nodes/dg [Diagnostic Imaging] MH - *Lymph Nodes/pa [Pathology] MH - Lymphatic Metastasis/dg [Diagnostic Imaging] MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Grading MH - Neoplasm Staging MH - Predictive Value of Tests MH - Retrospective Studies MH - Sensitivity and Specificity MH - *Sentinel Lymph Node Biopsy MH - Ultrasonography AB - BACKGROUND: Our objective was to evaluate the impact of preoperative axillary ultrasound and core needle biopsy (CNB) on breast cancer treatment decision making. A secondary aim was to evaluate the impact on the utility of intraoperative sentinel lymph node (SLN) frozen section. AB - METHODS: A review of 84 patients with clinically negative axilla who underwent axillary ultrasound was performed. Sensitivity, specificity, and positive/negative predictive value for axillary ultrasound with CNB was calculated. AB - RESULTS: Thirty-one (37%) had suspicious nodes. Of 27 amenable to CNB, 12 (14%) were malignant, changing treatment plans. The sensitivity of ultrasound and CNB was 54% and specificity 100%; the positive and negative predictive values were 100% and 80%, respectively. In 41 patients with normal ultrasounds who underwent SLN frozen section, 10 (24%) were positive. AB - CONCLUSIONS: Preoperative axillary ultrasound impacts treatment decision making in 14%. With a sensitivity of 54%, it is a useful adjunct to, but not replacement for, SLN biopsy. Frozen section remains of utility even after a negative axillary ultrasound. AB - Copyright © 2012 Elsevier Inc. All rights reserved. RN - 0 (Biomarkers, Tumor) ES - 1879-1883 IL - 0002-9610 DI - S0002-9610(12)00126-2 DO - https://dx.doi.org/10.1016/j.amjsurg.2011.10.016 PT - Journal Article ID - 22483606 [pubmed] ID - S0002-9610(12)00126-2 [pii] ID - 10.1016/j.amjsurg.2011.10.016 [doi] PP - ppublish PH - 2011/07/28 [received] PH - 2011/10/12 [revised] PH - 2011/10/12 [accepted] LG - English EP - 20120406 DP - 2012 Sep DC - 20120827 EZ - 2012/04/10 06:00 DA - 2012/10/30 06:00 DT - 2012/04/10 06:00 YR - 2012 ED - 20121029 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22483606 <201. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22784391 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Clayman ML AU - Makoul G AU - Harper MM AU - Koby DG AU - Williams AR FA - Clayman, Marla L FA - Makoul, Gregory FA - Harper, Maya M FA - Koby, Danielle G FA - Williams, Adam R IN - Clayman, Marla L. Division of General Internal Medicine, Northwestern University, Chicago, IL, USA. m-clayman@northwestern.edu TI - Development of a shared decision making coding system for analysis of patient-healthcare provider encounters. SO - Patient Education & Counseling. 88(3):367-72, 2012 Sep AS - Patient Educ Couns. 88(3):367-72, 2012 Sep NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417351 OI - Source: NLM. NIHMS389338 SB - Nursing Journal CP - Ireland MH - Aged MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms MH - *Clinical Coding/mt [Methods] MH - Communication MH - *Decision Making MH - Decision Support Techniques MH - Evidence-Based Medicine MH - Female MH - Humans MH - Middle Aged MH - Patient Participation/px [Psychology] MH - *Patient Participation MH - Patient-Centered Care MH - *Physician-Patient Relations MH - Reproducibility of Results MH - Self Efficacy MH - Surveys and Questionnaires MH - Videotape Recording AB - OBJECTIVES: To describe the development and refinement of a scheme, detail of essential elements and participants in shared decision making (DEEP-SDM), for coding shared decision making (SDM) while reporting on the characteristics of decisions in a sample of patients with metastatic breast cancer. AB - METHODS: The evidence-based patient choice instrument was modified to reflect Makoul and Clayman's integrative model of SDM. Coding was conducted on video recordings of 20 women at the first visit with their medical oncologists after suspicion of disease progression. Noldus Observer XT v.8, a video coding software platform, was used for coding. AB - RESULTS: The sample contained 80 decisions (range: 1-11), divided into 150 decision making segments. Most decisions were physician-led, although patients and physicians initiated similar numbers of decision-making conversations. AB - CONCLUSION: DEEP-SDM facilitates content analysis of encounters between women with metastatic breast cancer and their medical oncologists. Despite the fractured nature of decision making, it is possible to identify decision points and to code each of the essential elements of shared decision making. Further work should include application of DEEP-SDM to non-cancer encounters. AB - PRACTICE IMPLICATIONS: A better understanding of how decisions unfold in the medical encounter can help inform the relationship of SDM to patient-reported outcomes. AB - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(12)00241-8 DO - https://dx.doi.org/10.1016/j.pec.2012.06.011 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 22784391 [pubmed] ID - S0738-3991(12)00241-8 [pii] ID - 10.1016/j.pec.2012.06.011 [doi] ID - PMC3417351 [pmc] ID - NIHMS389338 [mid] PP - ppublish PH - 2012/02/02 [received] PH - 2012/05/08 [revised] PH - 2012/06/12 [accepted] GI - No: K12 HD055884 Organization: (HD) *NICHD NIH HHS* Country: United States No: R03 CA124202 Organization: (CA) *NCI NIH HHS* Country: United States No: R03CA123202 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20120709 DP - 2012 Sep DC - 20120807 EZ - 2012/07/13 06:00 DA - 2012/10/27 06:00 DT - 2012/07/13 06:00 YR - 2012 ED - 20121026 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22784391 <202. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22541508 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sivell S AU - Edwards A AU - Manstead AS AU - Reed MW AU - Caldon L AU - Collins K AU - Clements A AU - Elwyn G AU - BresDex Group FA - Sivell, Stephanie FA - Edwards, Adrian FA - Manstead, Antony S R FA - Reed, Malcolm W R FA - Caldon, Lisa FA - Collins, Karen FA - Clements, Alison FA - Elwyn, Glyn FA - BresDex Group IN - Sivell, Stephanie. Marie Curie Palliative Care Research Centre, Wales Cancer Trials Unit, School of Medicine, Cardiff University, Cardiff, UK. sivells2@cardiff.ac.uk TI - Increasing readiness to decide and strengthening behavioral intentions: evaluating the impact of a web-based patient decision aid for breast cancer treatment options (BresDex: www.bresdex.com). SO - Patient Education & Counseling. 88(2):209-17, 2012 Aug AS - Patient Educ Couns. 88(2):209-17, 2012 Aug NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - Cohort Studies MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Health Behavior MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - *Intention MH - *Internet MH - Mastectomy MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation/td [Trends] MH - Patient Satisfaction MH - Surveys and Questionnaires AB - OBJECTIVES: To undertake a quantitative evaluation of a theory-based, interactive online decision aid (BresDex) to support women choosing surgery for early breast cancer (Stage I and II), based on observations of its use in practice. AB - METHODS: Observational cohort study. Website log-files collected data on the use of BresDex. Online questionnaires assessed knowledge about breast cancer and treatment options, degree to which women were deliberating about their options, and surgery intentions, pre- and post-BresDex. AB - RESULTS: Readiness to make a decision significantly increased after using BresDex (p<.001), although there was no significant improvement in knowledge. Participants that were 'less ready' to make a decision before using BresDex, spent a longer time using BresDex (p<.05). Significant associations between surgery intentions and choices were observed (p<.001), with the majority of participants going on to have BCS. Greater length of time spent on BresDex was associated with stronger intentions to have BCS (p<.05). AB - CONCLUSION: The use of BresDex appears to facilitate readiness to make a decision for surgery, helping to strengthen surgery intentions. AB - PRACTICE IMPLICATIONS: BresDex may prove a useful adjunct to the support provided by the clinical team for women facing surgery for early breast cancer. AB - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(12)00125-5 DO - https://dx.doi.org/10.1016/j.pec.2012.03.012 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 22541508 [pubmed] ID - S0738-3991(12)00125-5 [pii] ID - 10.1016/j.pec.2012.03.012 [doi] PP - ppublish PH - 2011/09/06 [received] PH - 2012/01/18 [revised] PH - 2012/03/27 [accepted] GI - No: C6475/A7053 Organization: *Cancer Research UK* Country: United Kingdom LG - English EP - 20120426 DP - 2012 Aug DC - 20120731 EZ - 2012/05/01 06:00 DA - 2012/10/27 06:00 DT - 2012/05/01 06:00 YR - 2012 ED - 20121026 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22541508 <203. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22331002 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wong J AU - D'Alimonte L AU - Angus J AU - Paszat L AU - Metcalfe K AU - Whelan T AU - Llewellyn-Thomas H AU - Warner E AU - Franssen E AU - Szumacher E FA - Wong, Jennifer FA - D'Alimonte, Laura FA - Angus, Jan FA - Paszat, Larry FA - Metcalfe, Kelly FA - Whelan, Tim FA - Llewellyn-Thomas, Hilary FA - Warner, Eiran FA - Franssen, Edmee FA - Szumacher, Ewa IN - Wong, Jennifer. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. TI - Development of patients' decision aid for older women with stage I breast cancer considering radiotherapy after lumpectomy. SO - International Journal of Radiation Oncology, Biology, Physics. 84(1):30-8, 2012 Sep 01 AS - Int J Radiat Oncol Biol Phys. 84(1):30-8, 2012 Sep 01 NJ - International journal of radiation oncology, biology, physics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - g97, 7603616 IO - Int. J. Radiat. Oncol. Biol. Phys. SB - Index Medicus CP - United States MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/ch [Chemistry] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - *Decision Support Techniques MH - Female MH - Humans MH - Mastectomy, Segmental MH - *Pamphlets MH - Patient Participation MH - Pilot Projects MH - Radiotherapy, Adjuvant/ae [Adverse Effects] MH - Radiotherapy, Adjuvant/mt [Methods] MH - Radiotherapy, Adjuvant/px [Psychology] MH - Receptors, Estrogen/an [Analysis] MH - Surveys and Questionnaires AB - PURPOSE: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. AB - METHODS AND MATERIALS: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. AB - RESULTS: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. AB - CONCLUSIONS: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be enhanced by the use of a tailored PtDA to help patients be better informed about their treatment options. AB - Copyright © 2012 Elsevier Inc. All rights reserved. RN - 0 (Receptors, Estrogen) ES - 1879-355X IL - 0360-3016 DI - S0360-3016(11)03539-5 DO - https://dx.doi.org/10.1016/j.ijrobp.2011.11.028 PT - Evaluation Studies PT - Journal Article PT - Patient Education Handout PT - Research Support, Non-U.S. Gov't ID - 22331002 [pubmed] ID - S0360-3016(11)03539-5 [pii] ID - 10.1016/j.ijrobp.2011.11.028 [doi] PP - ppublish PH - 2011/04/04 [received] PH - 2011/11/04 [revised] PH - 2011/11/07 [accepted] LG - English EP - 20120211 DP - 2012 Sep 01 DC - 20120820 EZ - 2012/02/15 06:00 DA - 2012/10/27 06:00 DT - 2012/02/15 06:00 YR - 2012 ED - 20121026 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22331002 <204. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21764374 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fallbjork U AU - Frejeus E AU - Rasmussen BH FA - Fallbjork, Ulrika FA - Frejeus, Elin FA - Rasmussen, Birgit H IN - Fallbjork, Ulrika. Department of Nursing, Umea University, SE-901 87 Umea, Sweden. ulrika.fallbjork@nurs.umu.se TI - A preliminary study into women's experiences of undergoing reconstructive surgery after breast cancer. SO - European Journal of Oncology Nursing. 16(3):220-6, 2012 Jul AS - EUR J ONCOL NURS. 16(3):220-6, 2012 Jul NJ - European journal of oncology nursing : the official journal of European Oncology Nursing Society PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100885136 IO - Eur J Oncol Nurs SB - Index Medicus SB - Nursing Journal CP - Scotland MH - Adaptation, Psychological MH - Adult MH - Body Image MH - Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Emotions MH - Female MH - Humans MH - Interviews as Topic MH - Mammaplasty/nu [Nursing] MH - *Mammaplasty/px [Psychology] MH - Mastectomy/nu [Nursing] MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Patient Education as Topic MH - Qualitative Research MH - Surveys and Questionnaires MH - Sweden AB - UNLABELLED: Breast cancer is the most common type of cancer among women. In Sweden, about 40% of women diagnosed with breast cancer undergo a mastectomy; breast reconstruction (BR) may be an option for these women. However, the experience of undergoing reconstructive surgery appears to be only very scarcely researched, despite its importance in clinical nursing. AB - AIM: The purpose of this study was to explore women's experiences of undergoing breast reconstructive surgery after mastectomy due to breast cancer. AB - METHODS: Six women participated in narrative interviews about their experiences of reconstructive surgery, and the interview data were analysed using thematic narrative analysis. AB - RESULTS: All six women were unprepared for the strenuous experience of undergoing a BR. They described the process as difficult and painful, entailing several operations and an unexpectedly long recovery period. They were also unprepared for how arduous it would be, both physically and emotionally. However, getting a BR had been important to all the women. The BR process was captured in four themes: (1) uninformed care; (2) arduous experiences; (3) body alterations; and (4) moving on. AB - CONCLUSIONS: Obtaining adequate information and being involved in the decision-making process along the pathway of a BR could help the women to prepare physically and emotionally for the strenuous experiences related to reconstructive surgery. AB - Copyright © 2011 Elsevier Ltd. All rights reserved. ES - 1532-2122 IL - 1462-3889 DI - S1462-3889(11)00089-5 DO - https://dx.doi.org/10.1016/j.ejon.2011.05.005 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21764374 [pubmed] ID - S1462-3889(11)00089-5 [pii] ID - 10.1016/j.ejon.2011.05.005 [doi] PP - ppublish PH - 2011/01/18 [received] PH - 2011/05/23 [revised] PH - 2011/05/25 [accepted] LG - English EP - 20110720 DP - 2012 Jul DC - 20120525 EZ - 2011/07/19 06:00 DA - 2012/10/25 06:00 DT - 2011/07/19 06:00 YR - 2012 ED - 20121024 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21764374 <205. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22734034 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Albert JM AU - Liu DD AU - Shen Y AU - Pan IW AU - Shih YC AU - Hoffman KE AU - Buchholz TA AU - Giordano SH AU - Smith BD FA - Albert, Jeffrey M FA - Liu, Diane D FA - Shen, Yu FA - Pan, I-Wen FA - Shih, Ya-Chen Tina FA - Hoffman, Karen E FA - Buchholz, Thomas A FA - Giordano, Sharon H FA - Smith, Benjamin D IN - Albert, Jeffrey M. The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. TI - Nomogram to predict the benefit of radiation for older patients with breast cancer treated with conservative surgery. CM - Comment in: J Clin Oncol. 2013 Feb 10;31(5):647-8; PMID: 23269999 CM - Comment in: J Clin Oncol. 2012 Aug 10;30(23):2809-11; PMID: 22734024 CM - Comment in: J Clin Oncol. 2013 Feb 10;31(5):648-9; PMID: 23520644 SO - Journal of Clinical Oncology. 30(23):2837-43, 2012 Aug 10 AS - J Clin Oncol. 30(23):2837-43, 2012 Aug 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410401 SB - Index Medicus CP - United States MH - Aged MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - Mastectomy, Segmental MH - *Nomograms MH - SEER Program AB - PURPOSE: The role of radiation therapy (RT) after conservative surgery (CS) remains controversial for older patients with breast cancer. Guidelines based on recent clinical trials have suggested that RT may be omitted in selected patients with favorable disease. However, it is not known whether this recommendation should extend to other older women. Accordingly, we developed a nomogram to predict the likelihood of long-term breast preservation with and without RT. AB - METHODS: We used Surveillance, Epidemiology, and End Results-Medicare data to identify 16,092 women age 66 to 79 years treated with CS between 1992 and 2002, using claims to identify receipt of RT and subsequent mastectomy. Time to mastectomy was estimated using the Kaplan-Meier method. Cox proportional hazards models determined the effect of covariates on mastectomy-free survival (MFS). A nomogram was developed to predict 5- and 10-year MFS, given associated risk factors, and bootstrap validation was performed. AB - RESULTS: With a median follow-up of 7.2 years, the overall 5- and 10-year MFS rates were 98.1% (95% CI, 97.8% to 98.3%) and 95.4% (95% CI, 94.9% to 95.8%), respectively. In multivariate analysis, age, race, tumor size, estrogen receptor status, and receipt of RT were predictive of time to mastectomy and were incorporated into the nomogram. Nodal status was also included given a significant interaction with RT. The resulting nomogram demonstrated good accuracy in predicting MFS, with a bootstrap-corrected concordance index of 0.66. AB - CONCLUSION: This clinically useful tool predicts 5- and 10-year MFS among older women with early breast cancer using readily available clinicopathologic factors and can aid individualized clinical decision making by estimating predicted benefit from RT. ES - 1527-7755 IL - 0732-183X DI - JCO.2011.41.0076 DO - https://dx.doi.org/10.1200/JCO.2011.41.0076 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. ID - 22734034 [pubmed] ID - JCO.2011.41.0076 [pii] ID - 10.1200/JCO.2011.41.0076 [doi] ID - PMC3410401 [pmc] PP - ppublish GI - No: T32 CA077050 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA016672 Organization: (CA) *NCI NIH HHS* Country: United States No: CA16672 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA079466 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 HS018535 Organization: (HS) *AHRQ HHS* Country: United States No: T32CA77050 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20120625 DP - 2012 Aug 10 DC - 20120809 EZ - 2012/06/27 06:00 DA - 2012/10/10 06:00 DT - 2012/06/27 06:00 YR - 2012 ED - 20121009 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22734034 <206. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22866495 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lowen JT FA - Lowen, J Trout TI - Reshaping lives. SO - Minnesota Medicine. 95(6):20-4, 2012 Jun AS - Minn Med. 95(6):20-4, 2012 Jun NJ - Minnesota medicine PI - Journal available in: Print PI - Citation processed from: Print JC - nby, 8000173 IO - Minn Med SB - Index Medicus CP - United States MH - Adipose Tissue/tr [Transplantation] MH - *Body Image MH - Breast Implants/px [Psychology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Cooperative Behavior MH - Decision Making MH - Female MH - Humans MH - Mammaplasty/mt [Methods] MH - *Mammaplasty/px [Psychology] MH - *Mastectomy/px [Psychology] MH - Minimally Invasive Surgical Procedures/px [Psychology] MH - Minnesota MH - Patient Care Team MH - Patient Education as Topic MH - *Quality of Life/px [Psychology] IS - 0026-556X IL - 0026-556X PT - Journal Article ID - 22866495 [pubmed] PP - ppublish LG - English DP - 2012 Jun DC - 20120807 EZ - 2012/08/08 06:00 DA - 2012/09/21 06:00 DT - 2012/08/08 06:00 YR - 2012 ED - 20120920 RD - 20141120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22866495 <207. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22221704 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wei S AU - Kragel CP AU - Zhang K AU - Hameed O FA - Wei, Shi FA - Kragel, Christopher P FA - Zhang, Kui FA - Hameed, Omar IN - Wei, Shi. Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35249-7331, USA. swei@uab.edu TI - Factors associated with residual disease after initial breast-conserving surgery for ductal carcinoma in situ. SO - Human Pathology. 43(7):986-93, 2012 Jul AS - Hum Pathol. 43(7):986-93, 2012 Jul NJ - Human pathology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - gec, 9421547 IO - Hum. Pathol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - Carcinoma, Intraductal, Noninfiltrating/rt [Radiotherapy] MH - *Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Female MH - Humans MH - *Mastectomy, Segmental/mt [Methods] MH - Middle Aged MH - *Neoplasm, Residual/pa [Pathology] MH - Neoplasm, Residual/su [Surgery] MH - Predictive Value of Tests MH - Prognosis MH - Risk Factors MH - Treatment Outcome AB - Breast-conserving surgery with radiation therapy has become a standard treatment option in women with localized ductal carcinoma in situ. Re-excision is common in breast-conserving surgery, partly due to lack of consensus on what might constitute an adequate margin. In this study, we aimed to identify potential predictive factors for presence/absence of residual disease after initial breast-conserving surgery. Of 232 cases with a diagnosis of ductal carcinoma in situ without invasive carcinoma at initial biopsy between 2005 and 2009, 108 patients underwent breast-conserving surgery, of which 46 had re-excisions due to close margins (<= 2 mm). The notable features significantly associated with ductal carcinoma in situ residuum (19/46; 41%) on univariate logistic regression analysis included the number of close margins, the percentage of sections with ductal carcinoma in situ, and the number of duct spaces with ductal carcinoma in situ (no. of ductal carcinoma in situ ducts) at close margins. Only the percentage of sections with ductal carcinoma in situ remained a significant factor associated with outcomes on multivariate analysis, whereas the number of ductal carcinoma in situ ducts at close margins held borderline predictive value (P = .054). Furthermore, logistic regression and classification and regression tree analysis using the 10-fold cross validation method revealed optimal predicting accuracy by using the 3 significant factors in univariate analysis. The final decision tree was constructed by using the number of ductal carcinoma in situ ducts at close margins and the percentage of sections with ductal carcinoma in situ. Thus, these 2 factors represent the most powerful predictors for residual disease on re-excision. Optimal discriminatory power for prediction of absence of residual disease was achieved with cutoffs of 18 ductal carcinoma in situ ducts at close margins and 51.3% sections with ductal carcinoma in situ. AB - Copyright © 2012 Elsevier Inc. All rights reserved. ES - 1532-8392 IL - 0046-8177 DI - S0046-8177(11)00387-X DO - https://dx.doi.org/10.1016/j.humpath.2011.09.010 PT - Journal Article ID - 22221704 [pubmed] ID - S0046-8177(11)00387-X [pii] ID - 10.1016/j.humpath.2011.09.010 [doi] PP - ppublish PH - 2011/08/04 [received] PH - 2011/09/09 [revised] PH - 2011/09/14 [accepted] LG - English EP - 20120104 DP - 2012 Jul DC - 20120618 EZ - 2012/01/07 06:00 DA - 2012/09/15 06:00 DT - 2012/01/10 06:00 YR - 2012 ED - 20120914 RD - 20120618 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22221704 <208. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21947677 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Retel VP AU - Joore MA AU - van Harten WH FA - Retel, Valesca P FA - Joore, Manuela A FA - van Harten, Wim H IN - Retel, Valesca P. Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. v.retel@nki.nl TI - Head-to-head comparison of the 70-gene signature versus the 21-gene assay: cost-effectiveness and the effect of compliance. SO - Breast Cancer Research & Treatment. 131(2):627-36, 2012 Jan AS - Breast Cancer Res Treat. 131(2):627-36, 2012 Jan NJ - Breast cancer research and treatment PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. SB - Index Medicus CP - Netherlands MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/ge [Genetics] MH - Chemotherapy, Adjuvant MH - Cost-Benefit Analysis MH - Decision Support Techniques MH - Female MH - *Gene Expression Profiling/ec [Economics] MH - Gene Expression Profiling/mt [Methods] MH - Guideline Adherence MH - Humans MH - Prognosis MH - Sensitivity and Specificity AB - Both the 70-gene signature and the 21-gene assay are novel prognostic tests used to guide adjuvant chemotherapy decisions in patients with early breast cancer. Although the results of ongoing prospective trials will only become available in some years, the tests have already been included in clinical guidelines such as St. Gallen's. In literature, the cost-effectiveness (CE) of both tests as compared to conventional prognostic tests has been described. We report on a direct comparison of CE; as different compliance rates were reported, we also taken these into account. A Markov decision model with a time horizon of 20 years was developed to assess the effects, costs and CE of three alternatives; 21-gene, 70-gene, and St. Gallen (SG) or Adjuvant Online (AO), dependent on the dataset used in patients with early, node-negative, breast cancer. Sensitivity and specificity were based on two datasets, incorporating compliances rates based on literature. For both datasets, whereas the 70-gene signature yielded more quality adjusted life years (QALYs) and was less costly; the 21-gene amounted more life years (LYs) but was more costly. The decision uncertainty surrounding the probability of CE of the Thomassen-series amounted 55% for both cost/LY and cost/QALY, for the Fan-series 80% for LY and 65% for QALYs. Taking reported compliance with discordant test results into account, in general, the effect of all strategies decreased, while the costs increased, without relatively influencing the CEA performance. This comparison indicates that the performances of the 70-gene and the 21-gene based on reported studies are close. The 21-gene has the highest probability of being cost-effective when focusing on cost/LY, while focusing on cost/QALY, the 70-gene signature was most cost-effective. The level of compliance can have serious impact on the CE. With additional data, preferably from head-to-head outcome studies and especially on compliance concerning discordant test results, calculations can be made with higher degrees of certainty. ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-011-1769-7 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21947677 [pubmed] ID - 10.1007/s10549-011-1769-7 [doi] PP - ppublish PH - 2011/08/30 [received] PH - 2011/09/02 [accepted] LG - English EP - 20110924 DP - 2012 Jan DC - 20120103 EZ - 2011/09/28 06:00 DA - 2012/09/15 06:00 DT - 2011/09/29 06:00 YR - 2012 ED - 20120914 RD - 20120103 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21947677 <209. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21587043 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Dickinson BP AU - Handel N FA - Dickinson, Brian P FA - Handel, Neal IN - Dickinson, Brian P. Brian P. Dickinson, M.D., Inc., Newport Beach, CA, USA. drbriandickinson@drbriandickinson.com TI - Approaching revisional surgery in augmentation and mastopexy/augmentation patients. SO - Annals of Plastic Surgery. 68(1):12-6, 2012 Jan AS - Ann Plast Surg. 68(1):12-6, 2012 Jan NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Adult MH - Algorithms MH - Breast Implants/ae [Adverse Effects] MH - Decision Support Techniques MH - Female MH - Humans MH - Mammaplasty/is [Instrumentation] MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - Nipples/bs [Blood Supply] MH - Nipples/su [Surgery] MH - Patient Satisfaction MH - Postoperative Complications/pc [Prevention & Control] MH - *Postoperative Complications MH - Reoperation MH - Retrospective Studies AB - BACKGROUND: Breast augmentation and mastopexy augmentation procedures are becoming more common. The young plastic and reconstructive surgeon is often challenged revisional surgery operations in these patients. These cases are challenging, require significant operative time, and can be associated with a high revision rate. It is important for the young surgeon to have an approach to deal with these common and difficult scenarios. AB - METHODS: A retrospective chart review was conducted on all patients who underwent a revision augmentation or revision mastopexy augmentation procedure between 2008 and 2010 by the authors. The most commonly encountered mitigating circumstances in the revision augmentation or revision mastopexy augmentation populations were identified and an algorithm was created on how to address these difficult problems. AB - RESULTS: Between July 1, 2008 and July 1, 2010, 264 patients underwent revision augmentation or revision mastopexy augmentation procedures. The most commonly encountered patient scenarios were recurrence of ptosis, recurrent capsular contracture, implant malposition, rippling, and desiring a reduction in implant size. We encountered many mitigating circumstances that complicated the revisions. We devised a stepwise algorithmic approach to address these problems based on the following factors: (1) blood supply to the nipple-areola complex, (2) need to change implant plane, (3) patient desire to reduce or increase in breast implant volume, (4) need for total en bloc capsulectomy or capsulorrhaphy, (5) incision approach used to perform the capsulectomy, and (6) patient-related factors that need to be medically optimized or treated before, during, and after surgery. By adhering to these steps, outcomes can be accomplished more reliably and safely. AB - CONCLUSION: Specialized preoperative planning is necessary to consistently deliver safe and aesthetic revision augmentation and revision mastopexy augmentation results. It is important for the operative surgeon to carefully consider the potential adverse effect of implants and prior mastopexy or reduction incisions and patterns on the blood supply to the nipple-areola complex. With educated planning, successful results can be achieved in most cases, and the risk of serious complications can be minimized. ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/SAP.0b013e3182110ff3 PT - Evaluation Studies PT - Journal Article ID - 21587043 [pubmed] ID - 10.1097/SAP.0b013e3182110ff3 [doi] PP - ppublish LG - English DP - 2012 Jan DC - 20111228 EZ - 2011/05/19 06:00 DA - 2012/09/15 06:00 DT - 2011/05/19 06:00 YR - 2012 ED - 20120914 RD - 20111228 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21587043 <210. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22570396 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mao JJ AU - Leed R AU - Bowman MA AU - Desai K AU - Bramble M AU - Armstrong K AU - Barg F FA - Mao, Jun J FA - Leed, Rana FA - Bowman, Marjorie A FA - Desai, Krupali FA - Bramble, Manuel FA - Armstrong, Katrina FA - Barg, Frances IN - Mao, Jun J. Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. maoj@uphs.upenn.edu TI - Acupuncture for hot flashes: decision making by breast cancer survivors. CM - Comment in: J Am Board Fam Med. 2012 May-Jun;25(3):274; PMID: 22570389 SO - Journal of the American Board of Family Medicine: JABFM. 25(3):323-32, 2012 May-Jun AS - J Am Board Fam Med. 25(3):323-32, 2012 May-Jun NJ - Journal of the American Board of Family Medicine : JABFM PI - Journal available in: Print PI - Citation processed from: Internet JC - 101256526 IO - J Am Board Fam Med PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3490193 OI - Source: NLM. NIHMS386248 SB - Index Medicus CP - United States MH - *Acupuncture Therapy/mt [Methods] MH - Adult MH - Aged MH - *Breast Neoplasms/co [Complications] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Hot Flashes/et [Etiology] MH - Hot Flashes/px [Psychology] MH - *Hot Flashes/th [Therapy] MH - Humans MH - Interview, Psychological MH - Middle Aged MH - *Survivors MH - Time Factors MH - Women's Health AB - PURPOSE: Hot flashes (HFs) are a particularly common and distressing symptom among breast cancer survivors (BCSs). Given its low rate of side effects, acupuncture shows promise as a therapeutic approach for HFs, but little is known about BCS's decision making about the use of acupuncture. This study seeks to identify attitudes and beliefs about using acupuncture for HFs by BCSs. AB - METHODS: Using the Theory of Planned Behavior (TPB) as a conceptual framework, we conducted semistructured interviews among women with stage I-III breast cancer who had finished primary treatment and were currently experiencing HFs. Interviews were taped, transcribed, and coded. We used a modified grounded theory approach to analyze the data. AB - RESULTS: Twenty-five BCSs (13 whites/12 African American) participated in the study. Respondents stated that their intended use of acupuncture for HFs would be dependent on (1) expected therapeutic effects (eg, pain relief, energy); (2) practical concerns (eg, fear of needles, practitioner experience, time commitment); and (3) source of decision support/validation (eg, family members, physicians, self). Although constructs in the TPB accounted for many decision factors, respondents identified 2 major themes outside of the TPB: (1) viewing acupuncture as a natural alternative to medications, and (2) assessing the degree of HFs as bothersome enough in the context of other medical comorbidities to trigger the need for therapy. AB - CONCLUSION: BCSs expressed varied expected therapeutic benefits, practical concerns, and decision support, emphasizing the "natural appeal" and symptom appraisal as key determinants when using acupuncture for HFs. Incorporating these factors in counseling BCSs may promote patient-centered communication, leading to improved hot flash management and quality of life. IS - 1557-2625 IL - 1557-2625 DI - 25/3/323 DO - https://dx.doi.org/10.3122/jabfm.2012.03.110165 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 22570396 [pubmed] ID - 25/3/323 [pii] ID - 10.3122/jabfm.2012.03.110165 [doi] ID - PMC3490193 [pmc] ID - NIHMS386248 [mid] PP - ppublish GI - No: K23 AT004112 Organization: (AT) *NCCIH NIH HHS* Country: United States No: 1K23 AT004112-04 Organization: (AT) *NCCIH NIH HHS* Country: United States LG - English DP - 2012 May-Jun DC - 20120509 EZ - 2012/05/10 06:00 DA - 2012/09/12 06:00 DT - 2012/05/10 06:00 YR - 2012 ED - 20120911 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22570396 <211. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22748534 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lannin DR AU - Killelea B AU - Horowitz N AU - Chagpar AB FA - Lannin, Donald R FA - Killelea, Brigid FA - Horowitz, Nina FA - Chagpar, Anees B IN - Lannin, Donald R. Department of Surgery and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut 06520, USA. donald.lannin@yale.edu TI - Validation of the Louisville breast sentinel node prediction models and a proposed modification to guide management of the node positive axilla. SO - American Surgeon. 78(7):761-5, 2012 Jul AS - Am Surg. 78(7):761-5, 2012 Jul NJ - The American surgeon PI - Journal available in: Print PI - Citation processed from: Internet JC - 43e, 0370522 IO - Am Surg SB - Index Medicus CP - United States MH - Algorithms MH - Axilla MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Lymph Node Excision MH - Lymphatic Metastasis MH - Mastectomy MH - Middle Aged MH - Models, Biological MH - Patient Selection MH - Retrospective Studies MH - Sentinel Lymph Node Biopsy/mt [Methods] MH - *Sentinel Lymph Node Biopsy AB - The ACOSOG Z11 trial is rapidly changing use of axillary dissection, but it is not known how generalizable the Z11 results are. This study compares characteristics of the Z11 patients with the larger group of sentinel node-positive patients and evaluates two previously described Louisville algorithms to determine whether they might still be useful to predict extent of axillary node involvement and guide management of the axilla. The Yale Breast Center database was queried to calculate the Louisville prediction points for patients with a positive sentinel node and to compare the predicted with actual results. Of 1215 sentinel node biopsies performed between 2004 and 2010, 282 (23%) had at least one positive node. Thirty-one per cent of these patients would have been eligible for Z11. This group had much less axillary node involvement than the 69 per cent who were ineligible. The Yale data confirmed the accuracy of the two Louisville models and showed that tumor size, number of positive sentinel nodes, and proportion of positive sentinel nodes were all significant predictors. However, these results were much more robust if at least three sentinel nodes had been removed. The Z11 patients were clearly a good risk group. The data validate the two Louisville models and suggest that the models may be useful to select patients to avoid axillary dissection, both among the currently Z11-eligible and -ineligible populations. A modified algorithm is proposed in which all patients with a positive sentinel node have at least three total nodes removed. ES - 1555-9823 IL - 0003-1348 PT - Journal Article PT - Validation Studies ID - 22748534 [pubmed] PP - ppublish LG - English DP - 2012 Jul DC - 20120703 EZ - 2012/07/04 06:00 DA - 2012/09/05 06:00 DT - 2012/07/04 06:00 YR - 2012 ED - 20120904 RD - 20120703 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22748534 <212. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22004778 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Izquierdo F AU - Gracia J AU - Guerra M AU - Blasco JA AU - Andradas E FA - Izquierdo, Fatima FA - Gracia, Javier FA - Guerra, Mercedes FA - Blasco, Juan Antonio FA - Andradas, Elena IN - Izquierdo, Fatima. Agencia Lain Entralgo, Madrid, Spain. fatima.izquierdo@uets.info TI - Health technology assessment-based development of a Spanish breast cancer patient decision aid. SO - International Journal of Technology Assessment in Health Care. 27(4):363-8, 2011 Oct AS - Int J Technol Assess Health Care. 27(4):363-8, 2011 Oct NJ - International journal of technology assessment in health care PI - Journal available in: Print PI - Citation processed from: Internet JC - gti, 8508113 IO - Int J Technol Assess Health Care SB - Index Medicus CP - England MH - Adolescent MH - Adult MH - Aged MH - *Breast Neoplasms/di [Diagnosis] MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Patient Education as Topic MH - *Patient Participation MH - Socioeconomic Factors MH - Spain MH - *Technology Assessment, Biomedical/og [Organization & Administration] MH - Young Adult AB - OBJECTIVES: The aim of this study was to develop a breast cancer Patient Decision Aid (PDA), using a Health Technology Assessment (HTA) process, to assist patients in their choice of therapeutic options, and to promote shared decision making among patients, healthcare professionals, and other interested parties. AB - METHODS: A systematic review (SR) was conducted of existing breast cancer patient Decision Aids encountered in the main scientific journal databases and on institutional Web sites that create PDAs, together with a Qualitative Research (QR) study, using semi-structured interviews and focus group with stakeholders (patients, family members, and health professionals), with the aim of developing a PDA for breast cancer. AB - RESULTS: The SR shows that PDAs in breast cancer not only increase patient knowledge of the illness, leading to more realistic expectations of treatment outcomes, but also reduce passivity in the decision-making process and facilitate the appropriate choice of treatment options in accordance with patient medical and personal preferences. The analysis of QR shows that both breast cancer patients and healthcare professionals agree that surgery, adjuvant treatments, and breast reconstruction represent the most important decisions to be made. Worry, anxiety, optimism, and trust in healthcare professionals were determined as factors that most affected patients subjective experiences of the illness. This HTA was used as the basis for developing a PDA software program. AB - CONCLUSIONS: The SR and QR used in the development of this PDA for breast cancer allowed patients to access information, gain additional knowledge of their illness, make shared treatment decisions, and gave healthcare professionals a deeper insight into patient experiences of the disease. ES - 1471-6348 IL - 0266-4623 DI - S0266462311000493 DO - https://dx.doi.org/10.1017/S0266462311000493 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 22004778 [pubmed] ID - S0266462311000493 [pii] ID - 10.1017/S0266462311000493 [doi] PP - ppublish LG - English DP - 2011 Oct DC - 20111018 EZ - 2011/10/19 06:00 DA - 2012/08/28 06:00 DT - 2011/10/19 06:00 YR - 2011 ED - 20120827 RD - 20111018 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22004778 <213. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22531408 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tong WM AU - Dixon R AU - Ekis H AU - Halvorson EG FA - Tong, Winnie Mao Yiu FA - Dixon, Robert FA - Ekis, Heidi FA - Halvorson, Eric G IN - Tong, Winnie Mao Yiu. Division of Plastic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. TI - The impact of preoperative CT angiography on breast reconstruction with abdominal perforator flaps. SO - Annals of Plastic Surgery. 68(5):525-30, 2012 May AS - Ann Plast Surg. 68(5):525-30, 2012 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Abdomen MH - Adult MH - Aged MH - Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - *Epigastric Arteries/dg [Diagnostic Imaging] MH - Female MH - *Free Tissue Flaps/bs [Blood Supply] MH - Graft Survival MH - Humans MH - Incidental Findings MH - *Mammaplasty/mt [Methods] MH - Mastectomy MH - Middle Aged MH - *Multidetector Computed Tomography MH - Predictive Value of Tests MH - *Preoperative Care/mt [Methods] MH - Retrospective Studies MH - Sensitivity and Specificity MH - Treatment Outcome AB - PURPOSE: Because of the anatomic variability of the deep inferior epigastric artery, preoperative CT angiography (pCTA) has gained popularity for planning abdominal perforator flap breast reconstruction. This study evaluates how pCTA has affected preoperative planning, operative time, and outcome. AB - METHODS: We performed a retrospective study of abdominal free flap breast reconstruction at our institution over a 4-year period, with pCTA performed routinely after the first year. Operative time and outcomes were compared between procedures with and without pCTA. Incidental findings were recorded. AB - RESULTS: Between 2006 and 2010, 102 abdominal perforator flap surgeries were performed on 69 patients; of whom, 51 patients had pCTA and 18 did not. pCTA changed preoperative planning in 50% of cases by identifying the best perforator in unilateral cases or perforators with long intramuscular course. Preoperative plan based on pCTA corresponded to operative procedures in 89% of cases. The sensitivity and positive predictive value of pCTA to localize perforators were 79% and 92%, respectively. Operative time was significantly reduced with pCTA for both unilateral (636 vs. 496 minutes, P = 0.017) and bilateral cases (746 vs. 629 minutes, P = 0.05). Rates of fat necrosis, partial flap necrosis, and complete flap loss were comparable between the 2 groups. Incidentalomas were found in 36% of patients. AB - CONCLUSIONS: pCTA appears to reduce operative time by minimizing time spent identifying perforators, assisting in side selection for unilateral reconstruction, and optimizing planning when a long intramuscular course is identified. The effect of a learning curve cannot be excluded and is the chief limitation of this study. ES - 1536-3708 IL - 0148-7043 DI - 00000637-201205000-00025 DO - https://dx.doi.org/10.1097/SAP.0b013e31823b69a4 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 22531408 [pubmed] ID - 10.1097/SAP.0b013e31823b69a4 [doi] ID - 00000637-201205000-00025 [pii] PP - ppublish LG - English DP - 2012 May DC - 20120425 EZ - 2012/04/26 06:00 DA - 2012/08/21 06:00 DT - 2012/04/26 06:00 YR - 2012 ED - 20120820 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22531408 <214. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22510128 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lu Q AU - Tan EY AU - Ho B AU - Chen JJ AU - Chan PM FA - Lu, Qinghui FA - Tan, Ern Yu FA - Ho, Bernard FA - Chen, Juliana J C FA - Chan, Patrick M Y IN - Lu, Qinghui. Department of General Surgery, Tan Tock Seng Hospital, Singapore. qinghui.lu@gmail.com TI - Surgical excision of intraductal breast papilloma diagnosed on core biopsy. SO - ANZ Journal of Surgery. 82(3):168-72, 2012 Mar AS - ANZ J Surg. 82(3):168-72, 2012 Mar NJ - ANZ journal of surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dze, 101086634 IO - ANZ J Surg SB - Index Medicus CP - Australia MH - Adult MH - Aged MH - Aged, 80 and over MH - Biopsy, Needle MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy MH - Middle Aged MH - Papilloma, Intraductal/pa [Pathology] MH - *Papilloma, Intraductal/su [Surgery] MH - Retrospective Studies AB - BACKGROUND: The need for surgical excision of benign papillary lesions diagnosed on core biopsy remains debatable. This lack of consensus arises because although there is a possibility of histological underestimation, there are as yet no reliable predictors of malignancy. We therefore aimed to evaluate the incidence of histological underestimation in our practice, and to identify factors that predict for this, in order to reduce unnecessary surgery without missing out on possible malignancy. AB - METHODS: Retrospective review of 106 patients diagnosed with a papillary lesion on percutaneous image-guided core biopsy was performed between 1 January 2005 and 31 December 2008. The presence of atypia on core biopsy and the presence of malignancy in the surgical specimen were correlated with standard clinical, radiological and pathological features. AB - RESULTS: Histological underestimation occurred in 15 of 81 patients (19%). Malignancy was more likely when atypia was present in the core biopsy (P= 0.04, OR 5.17). Otherwise, a final diagnosis of malignancy was not correlated with any clinical or radiological features (P > 0.05). The presence of atypia was also not correlated with any clinical or radiological features. AB - CONCLUSION: In our study, 19% of patients with a benign papillary lesion diagnosed on core biopsy were found to have atypical ductal hyperplasia or malignancy following surgery. In view of this, together with the absence of reliable predictive factors for malignancy, we recommend surgical excision of all papillary lesions diagnosed on core biopsy. AB - Copyright © 2012 Tan Tock Seng Hospital. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons. ES - 1445-2197 IL - 1445-1433 DO - https://dx.doi.org/10.1111/j.1445-2197.2011.05969.x PT - Evaluation Studies PT - Journal Article ID - 22510128 [pubmed] ID - 10.1111/j.1445-2197.2011.05969.x [doi] PP - ppublish LG - English EP - 20120117 DP - 2012 Mar DC - 20120418 EZ - 2012/04/19 06:00 DA - 2012/08/21 06:00 DT - 2012/04/19 06:00 YR - 2012 ED - 20120820 RD - 20120418 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22510128 <215. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22670237 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ko MG AU - Files JA AU - Pruthi S FA - Ko, Marcia G FA - Files, Julia A FA - Pruthi, Sandhya IN - Ko, Marcia G. Mayo Clinic, Scottsdale, AZ 85369, USA. ko.marcia@mayo.edu TI - Reducing the risk of breast cancer: A personalized approach. SO - Journal of Family Practice. 61(6):340-7, 2012 Jun AS - J. FAM. PRACT.. 61(6):340-7, 2012 Jun NJ - The Journal of family practice PI - Journal available in: Print PI - Citation processed from: Internet JC - 7502590 IO - J Fam Pract SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/et [Etiology] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Support Techniques MH - Family Practice MH - Female MH - Humans MH - Mammography MH - Mastectomy MH - Practice Guidelines as Topic MH - *Precision Medicine MH - Risk Assessment MH - Risk Factors MH - Risk Reduction Behavior RN - 0 (Antineoplastic Agents) ES - 1533-7294 IL - 0094-3509 DI - jfp_6106k PT - Journal Article ID - 22670237 [pubmed] ID - jfp_6106k [pii] PP - ppublish LG - English DP - 2012 Jun DC - 20120606 EZ - 2012/06/07 06:00 DA - 2012/08/17 06:00 DT - 2012/06/07 06:00 YR - 2012 ED - 20120816 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22670237 <216. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22472404 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Menes TS AU - Zissman S AU - Golan O AU - Sperber F AU - Klausner J AU - Schneebaum S FA - Menes, Tehillah S FA - Zissman, Sivan FA - Golan, Orit FA - Sperber, Fani FA - Klausner, Joseph FA - Schneebaum, Schlomo IN - Menes, Tehillah S. Department of Surgery, Sourasky Medical Center, Tel Aviv, Israel. tehillahm@tasmc.health.gov.il TI - Yield of selective magnetic resonance imaging in preoperative workup of newly diagnosed breast cancer patients planned for breast conserving surgery. SO - American Surgeon. 78(4):451-5, 2012 Apr AS - Am Surg. 78(4):451-5, 2012 Apr NJ - The American surgeon PI - Journal available in: Print PI - Citation processed from: Internet JC - 43e, 0370522 IO - Am Surg SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - Female MH - Humans MH - *Magnetic Resonance Imaging MH - *Mastectomy, Segmental MH - Middle Aged MH - *Neoplasms, Ductal, Lobular, and Medullary/di [Diagnosis] MH - Neoplasms, Ductal, Lobular, and Medullary/su [Surgery] MH - *Preoperative Care MH - Retrospective Studies MH - Treatment Outcome AB - The role of routine preoperative magnetic resonance imaging (MRI) in newly diagnosed breast cancer patients planned for breast conserving surgery is presently being debated. In our medical center we practice selective use of preoperative MRI; we sought to examine the yield of MRI in this highly selected group of patients. A retrospective study of all newly diagnosed breast cancer patients presenting between January 2007 and July 2010 to the Tel Aviv Sourasky Medical Center (Tel Aviv, Israel) was completed. Patients planned for breast conserving surgery who underwent preoperative MRI were included in this study. Patients and tumor characteristics, indication for MRI, findings on MRI, consequent workup, and impact on surgical treatment were recorded. Association between preoperative characteristics and yield of MRI was examined. During the study period, 105 patients that were candidates for breast conserving surgery underwent preoperative evaluation with MRI. Use of breast MRI increased over time. Rates of mastectomy were stable throughout the study years. Dense mammogram was the most frequent (51, 68%) indication for MRI. Additional suspicious findings were found in 41 (39%) patients, prompting further workup including 36 biopsies in 25 patients, of which 22 (61%) were with cancer. These additional findings prompted a change in the surgical plan in a third of the patients. In most patients (92; 88%) clear margins were achieved. Limiting the use of MRI in the preoperative workup of breast cancer patients to a selected group of patients can increase the yield of MRI. ES - 1555-9823 IL - 0003-1348 PT - Evaluation Studies PT - Journal Article ID - 22472404 [pubmed] PP - ppublish LG - English DP - 2012 Apr DC - 20120404 EZ - 2012/04/05 06:00 DA - 2012/07/28 06:00 DT - 2012/04/05 06:00 YR - 2012 ED - 20120727 RD - 20120404 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22472404 <217. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22458616 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Pusic AL AU - Klassen AF AU - Snell L AU - Cano SJ AU - McCarthy C AU - Scott A AU - Cemal Y AU - Rubin LR AU - Cordeiro PG FA - Pusic, Andrea L FA - Klassen, Anne F FA - Snell, Laura FA - Cano, Stefan J FA - McCarthy, Colleen FA - Scott, Amie FA - Cemal, Yeliz FA - Rubin, Lisa R FA - Cordeiro, Peter G IN - Pusic, Andrea L. Division of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. pusica@mskcc.org TI - Measuring and managing patient expectations for breast reconstruction: impact on quality of life and patient satisfaction. [Review] SO - Expert Review of Pharmacoeconomics & Outcomes Research. 12(2):149-58, 2012 Apr AS - Expert rev. pharmacoecon. outcomes res.. 12(2):149-58, 2012 Apr NJ - Expert review of pharmacoeconomics & outcomes research PI - Journal available in: Print PI - Citation processed from: Internet JC - 101132257 IO - Expert Rev Pharmacoecon Outcomes Res PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182909 OI - Source: NLM. NIHMS380935 SB - Index Medicus CP - England MH - Breast/ah [Anatomy & Histology] MH - Breast/su [Surgery] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - *Mammaplasty/px [Psychology] MH - Mastectomy MH - Patient Education as Topic MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - *Quality of Life/px [Psychology] MH - Recovery of Function MH - Treatment Outcome AB - The goal of postmastectomy breast reconstruction is to restore a woman's body image and to satisfy her personal expectations regarding the results of surgery. Studies in other surgical areas have shown that unrecognized or unfulfilled expectations may predict dissatisfaction more strongly than even the technical success of the surgery. Patient expectations play an especially critical role in elective procedures, such as cancer reconstruction, where the patient's primary motivation is improved health-related quality of life. In breast reconstruction, assessment of patient expectations is therefore vital to optimal patient care. This report summarizes the existing literature on patient expectations regarding breast reconstruction, and provides a viewpoint on how this field can evolve. Specifically, we consider how systematic measurement and management of patient expectations may improve patient education, shared medical decision-making and patient perception of outcomes. ES - 1744-8379 IL - 1473-7167 DO - https://dx.doi.org/10.1586/erp.11.105 PT - Journal Article PT - Review ID - 22458616 [pubmed] ID - 10.1586/erp.11.105 [doi] ID - PMC4182909 [pmc] ID - NIHMS380935 [mid] PP - ppublish GI - No: R03 CA128476 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2012 Apr DC - 20120330 EZ - 2012/03/31 06:00 DA - 2012/07/27 06:00 DT - 2012/03/31 06:00 YR - 2012 ED - 20120726 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22458616 <218. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22160638 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Frati A AU - Chereau E AU - Coutant C AU - Bezu C AU - Antoine M AU - Chopier J AU - Darai E AU - Uzan S AU - Gligorov J AU - Rouzier R FA - Frati, Albane FA - Chereau, Elisabeth FA - Coutant, Charles FA - Bezu, Corinne FA - Antoine, Martine FA - Chopier, Jocelyne FA - Darai, Emile FA - Uzan, Serge FA - Gligorov, Joseph FA - Rouzier, Roman IN - Frati, Albane. Department of Obstetrics and Gynecology (Pole GYNORESP), Hopital Tenon, Assistance Publique Hopitaux de Paris, 4 rue de la Chine, 75020 Paris, France. TI - Comparison of two nomograms to predict pathologic complete responses to neoadjuvant chemotherapy for breast cancer: evidence that HER2-positive tumors need specific predictors. SO - Breast Cancer Research & Treatment. 132(2):601-7, 2012 Apr AS - Breast Cancer Res Treat. 132(2):601-7, 2012 Apr NJ - Breast cancer research and treatment PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - Antibodies, Monoclonal, Humanized/ad [Administration & Dosage] MH - *Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - *Biomarkers, Tumor/an [Analysis] MH - Breast Neoplasms/ch [Chemistry] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant MH - Chi-Square Distribution MH - *Decision Support Techniques MH - Discriminant Analysis MH - Female MH - Humans MH - Logistic Models MH - Mastectomy MH - Middle Aged MH - Neoadjuvant Therapy MH - *Nomograms MH - Paris MH - Probability MH - ROC Curve MH - *Receptor, ErbB-2/an [Analysis] MH - Taxoids/ad [Administration & Dosage] MH - Trastuzumab MH - Treatment Outcome AB - The aim of this study is to compare two published nomograms, the "Institut Gustave Roussy/M.D. Anderson Cancer Center" (IGR/MDACC) and the Colleoni nomograms, in predicting pathologic complete responses (pCR) to preoperative chemotherapy in an independent cohort and to assess the impact of HER2 status. Data from 200 patients with breast carcinoma treated with preoperative chemotherapy were collected. We calculated pCR rate predictions with the two nomograms and compared the predictions with the outcomes. Sixty percent of the patients with HER2-positive tumors received trastuzumab concomitantly with taxanes. Model performances were quantified with respect to discrimination and calibration. In the whole population, the area under the ROC curve (AUC) for the IGR/MDACC nomogram and the Colleoni nomogram were 0.74 and 0.75, respectively. Both of them underestimated the pCR rate (P = 0.026 and 0.0005). When patients treated with trastuzumab were excluded, the AUC were excellent: 0.78 for both nomograms with no significant difference between the predicted and the observed pCR (P = 0.14 and 0.15). When the specific population treated with trastuzumab preoperatively was analyzed, the AUC for the IGR/MDACC nomogram and the Colleoni nomogram were poor, 0.52 and 0.53, respectively. The IGR/MDACC and the Colleoni nomograms were accurate in predicting the probability of pCR after preoperative chemotherapy in the HER2-negative population but did not correctly predict pCR in the HER2-positive patients who received trastuzumab. This suggests that responses to preoperative chemotherapy, including trastuzumab, are biologically driven and that a specific nomogram or predictor for HER2-positive patients has to be developed. RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Biomarkers, Tumor) RN - 0 (Taxoids) RN - EC 2-7-10-1 (ERBB2 protein, human) RN - EC 2-7-10-1 (Receptor, ErbB-2) RN - P188ANX8CK (Trastuzumab) ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-011-1897-0 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 22160638 [pubmed] ID - 10.1007/s10549-011-1897-0 [doi] PP - ppublish PH - 2011/09/05 [received] PH - 2011/11/22 [accepted] LG - English EP - 20111209 DP - 2012 Apr DC - 20120314 EZ - 2011/12/14 06:00 DA - 2012/06/23 06:00 DT - 2011/12/14 06:00 YR - 2012 ED - 20120622 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22160638 <219. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22415294 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Peate M AU - Meiser B AU - Cheah BC AU - Saunders C AU - Butow P AU - Thewes B AU - Hart R AU - Phillips KA AU - Hickey M AU - Friedlander M FA - Peate, M FA - Meiser, B FA - Cheah, B C FA - Saunders, C FA - Butow, P FA - Thewes, B FA - Hart, R FA - Phillips, K-A FA - Hickey, M FA - Friedlander, M IN - Peate, M. Prince of Wales Clinical School, University of NSW, Randwick, New South Wales, Australia. michelle.peate@sydney.edu.au TI - Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. SO - British Journal of Cancer. 106(6):1053-61, 2012 Mar 13 AS - Br J Cancer. 106(6):1053-61, 2012 Mar 13 NJ - British journal of cancer PI - Journal available in: Print PI - Citation processed from: Internet JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3304428 SB - Index Medicus CP - England MH - Adult MH - Anxiety MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - Conflict (Psychology) MH - Decision Making MH - *Decision Support Techniques MH - Depression MH - Emotions MH - Female MH - *Fertility Preservation MH - Humans MH - Neoplasm Staging MH - Patient Education as Topic MH - Patient Satisfaction MH - Prospective Studies MH - Referral and Consultation MH - Surveys and Questionnaires AB - BACKGROUND: Fertility is a priority for many young women with breast cancer. Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions. This study aimed to prospectively evaluate the efficacy of a fertility-related decision aid (DA). AB - METHODS: A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics, aged 18-40 years and desired future fertility, were assessed on decisional conflict, knowledge, decision regret, and satisfaction about fertility-related treatment decisions. These were measured at baseline, 1 and 12 months, and were examined using linear mixed effects models. AB - RESULTS: Compared with usual care, women who received the DA had reduced decisional conflict (beta=-1.51; 95%CI: -2.54 to 0.48; P=0.004) and improved knowledge (beta=0.09; 95%CI: 0.01-0.16; P=0.02), after adjusting for education, desire for children and baseline uncertainty. The DA was associated with reduced decisional regret at 1 year (beta=-3.73; 95%CI: -7.12 to -0.35; P=0.031), after adjusting for education. Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility (P<0.001), fertility options (P=0.005), and rated it more helpful (P=0.002), than those who received standard care. AB - CONCLUSION: These findings support widespread use of this DA shortly after diagnosis (before chemotherapy) among younger breast cancer patients who have not completed their families. ES - 1532-1827 IL - 0007-0920 DI - bjc201261 DO - https://dx.doi.org/10.1038/bjc.2012.61 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 22415294 [pubmed] ID - bjc201261 [pii] ID - 10.1038/bjc.2012.61 [doi] ID - PMC3304428 [pmc] PP - ppublish LG - English DP - 2012 Mar 13 DC - 20120314 EZ - 2012/03/15 06:00 DA - 2012/05/17 06:00 DT - 2012/03/15 06:00 YR - 2012 ED - 20120516 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22415294 <220. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21543184 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Obeidat R AU - Finnell DS AU - Lally RM FA - Obeidat, Rana FA - Finnell, Deborah S FA - Lally, Robin M IN - Obeidat, Rana. University at Buffalo, The State University of New York, Buffalo, NY, USA. robeidat@buffalo.edu TI - Decision aids for surgical treatment of early stage breast cancer: a narrative review of the literature. [Review] SO - Patient Education & Counseling. 85(3):e311-21, 2011 Dec AS - Patient Educ Couns. 85(3):e311-21, 2011 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Narration MH - *Patient Education as Topic MH - Patient Participation MH - Quality of Life MH - Treatment Outcome AB - OBJECTIVE: To review and critique the published empirical research on decision aids for women actually facing surgical treatment of early stage breast cancer, synthesize findings across studies related to outcomes of decision aids use with specific attention to the influence of system and client characteristics, and identify opportunities for further research. AB - METHODS: A systematic and reproducible search was carried out to identify studies evaluating decision aids for women making breast cancer surgical treatment decisions. All included studies were appraised. AB - RESULTS: Most studies evaluated the outcomes of decision aids use in terms of final treatment decisions, patients' knowledge of treatment options, anxiety, decisional conflict, satisfaction and quality of life. Included studies varied in design, measures used to assess effectiveness, format of the aids, patient populations and clinical settings. Studies yielded mixed results related to the effect of the decision aids on the outcomes measured. AB - CONCLUSION: Despite the mixed findings of the studies, some support exists for the use of decision aids with women diagnosed with early stage breast cancer. AB - PRACTICE IMPLICATIONS: To ensure successful implementation of decision aids in clinical practice, healthcare providers should be educated on their use. Greater allocation of time, space and access to decision aids is also needed. AB - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(11)00185-6 DO - https://dx.doi.org/10.1016/j.pec.2011.03.019 PT - Journal Article PT - Review ID - 21543184 [pubmed] ID - S0738-3991(11)00185-6 [pii] ID - 10.1016/j.pec.2011.03.019 [doi] PP - ppublish PH - 2010/07/17 [received] PH - 2011/01/31 [revised] PH - 2011/03/26 [accepted] LG - English EP - 20110504 DP - 2011 Dec DC - 20111115 EZ - 2011/05/06 06:00 DA - 2012/05/10 06:00 DT - 2011/05/06 06:00 YR - 2011 ED - 20120509 RD - 20111115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21543184 <221. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20175937 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee MK AU - Noh DY AU - Nam SJ AU - Ahn SH AU - Park BW AU - Lee ES AU - Yun YH FA - Lee, Myung Kyung FA - Noh, Dong Young FA - Nam, Seok Jin FA - Ahn, Se Hyun FA - Park, Byeong Woo FA - Lee, Eun Sook FA - Yun, Young Ho IN - Lee, Myung Kyung. Division of Cancer Control, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea. TI - Association of shared decision-making with type of breast cancer surgery: a cross-sectional study. SO - BMC Health Services Research. 10:48, 2010 Feb 23 AS - BMC Health Serv Res. 10:48, 2010 Feb 23 NJ - BMC health services research PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088677 IO - BMC Health Serv Res PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837652 SB - Index Medicus CP - England MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - Communication MH - Cross-Sectional Studies MH - *Decision Making MH - Female MH - Humans MH - Informed Consent/px [Psychology] MH - Mastectomy/mt [Methods] MH - Mastectomy, Segmental/mt [Methods] MH - Middle Aged MH - *Patient Education as Topic MH - *Patient Participation MH - Republic of Korea MH - Surveys and Questionnaires AB - BACKGROUND: Although some studies examined the association between shared decision-making (SDM) and type of breast cancer surgery received, it is little known how treatment decisions might be shaped by the information provided by physicians. The purpose of this study was to identify the associations between shared decision making (SDM) and surgical treatment received. AB - METHODS: Questionnaires on SDM were administered to 1,893 women undergoing primary curative surgery for newly diagnosed stage 0-II localized breast cancer at five hospitals in Korea. Questions included being informed on treatment options and the patient's own opinion in decision-making. AB - RESULTS: Patients more likely to undergo mastectomy were those whose opinions were respected in treatment decisions (adjusted odds ratio, aOR), 1.40; 95% confidence interval (CI), 1.14-1.72) and who were informed on chemotherapy (aOR, 2.57; CI, 2.20-3.01) or hormone therapy (aOR, 2.03; CI, 1.77-2.32). In contrast, patients less likely to undergo mastectomy were those who were more informed on breast surgery options (aOR, 0.34; CI, 0.27-0.42). In patients diagnosed with stage 0-IIa cancer, clinical factors and the provision of information on treatment by the doctor were associated with treatment decisions. In patients diagnosed with stage IIb cancer, the patient's opinion was more respected in treatment decisions. AB - CONCLUSION: Our population-based study suggested that women's treatment decisions might be shaped by the information provided by physicians, and that women might request different information from their physicians based on their preferred treatment options. These results might need to be confirmed in other studies of treatment decisions. ES - 1472-6963 IL - 1472-6963 DI - 1472-6963-10-48 DO - https://dx.doi.org/10.1186/1472-6963-10-48 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20175937 [pubmed] ID - 1472-6963-10-48 [pii] ID - 10.1186/1472-6963-10-48 [doi] ID - PMC2837652 [pmc] PP - epublish PH - 2009/02/13 [received] PH - 2010/02/23 [accepted] LG - English EP - 20100223 DP - 2010 Feb 23 DC - 20100315 EZ - 2010/02/24 06:00 DA - 2012/05/01 06:00 DT - 2010/02/24 06:00 YR - 2010 ED - 20120430 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20175937 <222. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21665420 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Belkora JK AU - Volz S AU - Teng AE AU - Moore DH AU - Loth MK AU - Sepucha KR FA - Belkora, Jeffrey K FA - Volz, Shelley FA - Teng, Alexandra E FA - Moore, Dan H FA - Loth, Meredith K FA - Sepucha, Karen R IN - Belkora, Jeffrey K. Institute for Health Policy Studies, University of California, San Francisco, USA. jeff.belkora@ucsf.edu TI - Impact of decision aids in a sustained implementation at a breast care center. SO - Patient Education & Counseling. 86(2):195-204, 2012 Feb AS - Patient Educ Couns. 86(2):195-204, 2012 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Program Development MH - Program Evaluation MH - San Francisco MH - Socioeconomic Factors AB - OBJECTIVE: We examined the reach and impact of five decision aids (DAs) routinely distributed to breast cancer patients as part of a shared decision making demonstration project. AB - METHODS: From 2005 to 2008, we surveyed patients' change in knowledge and decisional conflict (DC) before and after their review of DAs. Using bivariate tests, we identified significant predictors of change in knowledge or decisional conflict and entered significant predictors into a multivariate regression model. AB - RESULTS: We distributed 1553 DAs to 1098 patients and received 549 completed surveys. The DAs were associated with increased knowledge and decreased DC. For knowledge, significant predictors of above-average change included: lower baseline knowledge and viewing the surgery decision aid. For decisional conflict, significant predictors of above-average change included: higher decisional conflict; viewing any of the early-stage cancer DAs; and Hispanic ethnicity. AB - CONCLUSIONS: DAs used in routine care were associated with significant knowledge gains and reductions in decisional conflict. Some subsets of patients (those reporting low baseline knowledge, high DC, or Hispanic ethnicity) may benefit more than others. AB - PRACTICE IMPLICATIONS: Breast cancer patients benefit overall from routine distribution of DAs. Our exploratory findings may be useful in generating hypotheses to identify target populations who would most benefit from reviewing DAs. AB - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(11)00237-0 DO - https://dx.doi.org/10.1016/j.pec.2011.05.011 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21665420 [pubmed] ID - S0738-3991(11)00237-0 [pii] ID - 10.1016/j.pec.2011.05.011 [doi] PP - ppublish PH - 2010/11/18 [received] PH - 2011/04/30 [revised] PH - 2011/05/05 [accepted] LG - English EP - 20110612 DP - 2012 Feb DC - 20120130 EZ - 2011/06/14 06:00 DA - 2012/04/24 06:00 DT - 2011/06/15 06:00 YR - 2012 ED - 20120423 RD - 20120130 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21665420 <223. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21571485 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sivell S AU - Marsh W AU - Edwards A AU - Manstead AS AU - Clements A AU - Elwyn G AU - BresDex group FA - Sivell, Stephanie FA - Marsh, William FA - Edwards, Adrian FA - Manstead, Antony S R FA - Clements, Alison FA - Elwyn, Glyn FA - BresDex group IN - Sivell, Stephanie. Marie Curie Palliative Care Research Group, Wales Cancer Trials Unit, School of Medicine, Cardiff University, Cardiff, UK. sivells2@cardiff.ac.uk IR - Caldon L IR - Collins K IR - Day TJ IR - Evans R IR - Patnick J IR - Reed MW IR - Rogers V TI - Theory-based design and field-testing of an intervention to support women choosing surgery for breast cancer: BresDex. SO - Patient Education & Counseling. 86(2):179-88, 2012 Feb AS - Patient Educ Couns. 86(2):179-88, 2012 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Intention MH - Interviews as Topic MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Neoplasm Staging MH - Patient Participation MH - Psychological Theory MH - Qualitative Research MH - Reproducibility of Results AB - OBJECTIVE: Design and undertake usability and field-testing evaluation of a theory-guided decision aid (BresDex) in supporting women choosing surgery for early breast cancer. AB - METHODS: An extended Theory of Planned Behavior (TPB) and the Common Sense Model of Illness Representations (CSM) guided the design of BresDex. BresDex was evaluated and refined across 3 cycles by interviewing 6 women without personal history of breast cancer, 8 women with personal history of breast cancer who had completed treatment and 11 women newly diagnosed with breast cancer. Participants were interviewed for views on content, presentation (usability) and perceived usefulness towards deciding on treatment (utility). Framework analysis was used, guided by the extended TPB and the CSM. AB - RESULTS: BresDex was positively received in content and presentation (usability). It appeared an effective support to decision-making and useful source for further information, particularly in clarifying attitudes, social norms and perceived behavioral control, and presenting consequences of decisions (utility). AB - CONCLUSION: This study illustrates the potential benefit of the extended TPB and CSM in designing a decision aid to support women choosing breast cancer surgery. AB - PRACTICE IMPLICATIONS: BresDex could provide decision-making support and serve as an additional source of information, to complement the care received from the clinical team. AB - Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(11)00202-3 DO - https://dx.doi.org/10.1016/j.pec.2011.04.014 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21571485 [pubmed] ID - S0738-3991(11)00202-3 [pii] ID - 10.1016/j.pec.2011.04.014 [doi] PP - ppublish PH - 2010/09/01 [received] PH - 2011/03/07 [revised] PH - 2011/04/08 [accepted] GI - No: C6475/A7053 Organization: *Cancer Research UK* Country: United Kingdom LG - English EP - 20110514 DP - 2012 Feb DC - 20120130 EZ - 2011/05/17 06:00 DA - 2012/04/24 06:00 DT - 2011/05/17 06:00 YR - 2012 ED - 20120423 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21571485 <224. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21554985 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mazurowski MA AU - Lo JY AU - Harrawood BP AU - Tourassi GD FA - Mazurowski, Maciej A FA - Lo, Joseph Y FA - Harrawood, Brian P FA - Tourassi, Georgia D IN - Mazurowski, Maciej A. Department of Radiology, Duke University Medical Center, 2424 Erwin Rd., Suite 302, Durham, NC 27705, USA. maciej.mazurowski@duke.edu TI - Mutual information-based template matching scheme for detection of breast masses: from mammography to digital breast tomosynthesis. SO - Journal of Biomedical Informatics. 44(5):815-23, 2011 Oct AS - J Biomed Inform. 44(5):815-23, 2011 Oct NJ - Journal of biomedical informatics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100970413, d2m IO - J Biomed Inform PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176954 OI - Source: NLM. NIHMS293721 SB - Index Medicus CP - United States MH - Algorithms MH - *Breast/pa [Pathology] MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Diagnosis, Computer-Assisted/mt [Methods] MH - Female MH - Humans MH - *Mammography/mt [Methods] MH - Pattern Recognition, Automated MH - *Radiographic Image Interpretation, Computer-Assisted/mt [Methods] AB - Development of a computational decision aid for a new medical imaging modality typically is a long and complicated process. It consists of collecting data in the form of images and annotations, development of image processing and pattern recognition algorithms for analysis of the new images and finally testing of the resulting system. Since new imaging modalities are developed more rapidly than ever before, any effort for decreasing the time and cost of this development process could result in maximizing the benefit of the new imaging modality to patients by making the computer aids quickly available to radiologists that interpret the images. In this paper, we make a step in this direction and investigate the possibility of translating the knowledge about the detection problem from one imaging modality to another. Specifically, we present a computer-aided detection (CAD) system for mammographic masses that uses a mutual information-based template matching scheme with intelligently selected templates. We presented principles of template matching with mutual information for mammography before. In this paper, we present an implementation of those principles in a complete computer-aided detection system. The proposed system, through an automatic optimization process, chooses the most useful templates (mammographic regions of interest) using a large database of previously collected and annotated mammograms. Through this process, the knowledge about the task of detecting masses in mammograms is incorporated in the system. Then, we evaluate whether our system developed for screen-film mammograms can be successfully applied not only to other mammograms but also to digital breast tomosynthesis (DBT) reconstructed slices without adding any DBT cases for training. Our rationale is that since mutual information is known to be a robust inter-modality image similarity measure, it has high potential of transferring knowledge between modalities in the context of the mass detection task. Experimental evaluation of the system on mammograms showed competitive performance compared to other mammography CAD systems recently published in the literature. When the system was applied "as-is" to DBT, its performance was notably worse than that for mammograms. However, with a simple additional preprocessing step, the performance of the system reached levels similar to that obtained for mammograms. In conclusion, the presented CAD system not only performed competitively on screen-film mammograms but it also performed robustly on DBT showing that direct transfer of knowledge across breast imaging modalities for mass detection is in fact possible. AB - Copyright © 2011 Elsevier Inc. All rights reserved. ES - 1532-0480 IL - 1532-0464 DI - S1532-0464(11)00072-4 DO - https://dx.doi.org/10.1016/j.jbi.2011.04.008 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 21554985 [pubmed] ID - S1532-0464(11)00072-4 [pii] ID - 10.1016/j.jbi.2011.04.008 [doi] ID - PMC3176954 [pmc] ID - NIHMS293721 [mid] PP - ppublish PH - 2010/12/28 [received] PH - 2011/04/21 [revised] PH - 2011/04/22 [accepted] GI - No: R56 CA101911 Organization: (CA) *NCI NIH HHS* Country: United States No: R56-CA101911 Organization: (CA) *NCI NIH HHS* Country: United States No: R56 CA101911-05 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA112437 Organization: (CA) *NCI NIH HHS* Country: United States No: R01-CA112437 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA112437-04 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20110501 DP - 2011 Oct DC - 20110919 EZ - 2011/05/11 06:00 DA - 2012/04/20 06:00 DT - 2011/05/11 06:00 YR - 2011 ED - 20120419 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21554985 <225. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21223468 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Au AH AU - Lam WW AU - Chan MC AU - Or AY AU - Kwong A AU - Suen D AU - Wong AL AU - Juraskova I AU - Wong TW AU - Fielding R FA - Au, Angel H Y FA - Lam, Wendy W T FA - Chan, Miranda C M FA - Or, Amy Y M FA - Kwong, Ava FA - Suen, Dacita FA - Wong, Annie L FA - Juraskova, Ilona FA - Wong, Teresa W T FA - Fielding, Richard IN - Au, Angel H Y. Centre for Psycho-Oncological Research & Training, School of Public Health, The University of Hong Kong, Hong Kong, China. TI - Development and pilot-testing of a Decision Aid for use among Chinese women facing breast cancer surgery. SO - Health Expectations. 14(4):405-16, 2011 Dec AS - Health Expect. 14(4):405-16, 2011 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Asian Continental Ancestry Group/px [Psychology] MH - Breast Neoplasms/eh [Ethnology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Hong Kong MH - Humans MH - Interviews as Topic MH - *Pamphlets MH - *Patient Participation MH - Pilot Projects MH - Stress, Psychological MH - Surveys and Questionnaires AB - BACKGROUND: Women choosing breast cancer surgery encounter treatment decision-making (TDM) difficulties, which can cause psychological distress. Decision Aids (DAs) may facilitate TDM, but there are no DAs designed for Chinese populations. We developed a DA for Chinese women newly diagnosed with breast cancer, for use during the initial surgical consultation. AB - AIMS: Conduct a pilot study to assess the DA acceptability and utility among Chinese women diagnosed with breast cancer. AB - METHODS: Women preferred the DA in booklet format. A booklet was developed and revised and evaluated in two consecutive pilot studies (P1 and P2). On concluding their initial diagnostic consultation, 95 and 38 Chinese women newly diagnosed with breast cancer received the draft and revised draft DA booklet, respectively. Four-day post-consultation, women had questionnaires read out to them and to which they responded assessing attitudes towards the DA and their understanding of treatment options. AB - RESULTS: The original DA was read/partially read by 66/22% (n = 84) of women, whilst the revised version was read/partially read by 74/16% (n = 35), including subliterate women (chi(2) = 0.76, P = 0.679). Knowledge scores varied with the extent the booklet was read (P1: F = 12.68, d.f. 2, P < 0.001; P2: F = 3.744, d.f. 2, P = 0.034). The revised, shorter version was graphically rich and resulted in improved perceived utility, [except for the 'treatment options' (chi(2) = 5.50, P = 0.019) and 'TDM guidance' (chi(2) = 8.19, P = 0.004) sections] without increasing anxiety (F = 0.689, P = 0.408; F = 3.45, P = 0.073). AB - CONCLUSION: The DA was perceived as acceptable and useful for most women. The DA effectiveness is currently being evaluated using a randomized controlled trial. AB - Copyright © 2011 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00655.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21223468 [pubmed] ID - 10.1111/j.1369-7625.2010.00655.x [doi] ID - PMC5060593 [pmc] PP - ppublish LG - English EP - 20110111 DP - 2011 Dec DC - 20111117 EZ - 2011/01/13 06:00 DA - 2012/04/05 06:00 DT - 2011/01/13 06:00 YR - 2011 ED - 20120404 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=21223468 <226. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21223468 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Au AH AU - Lam WW AU - Chan MC AU - Or AY AU - Kwong A AU - Suen D AU - Wong AL AU - Juraskova I AU - Wong TW AU - Fielding R FA - Au, Angel H Y FA - Lam, Wendy W T FA - Chan, Miranda C M FA - Or, Amy Y M FA - Kwong, Ava FA - Suen, Dacita FA - Wong, Annie L FA - Juraskova, Ilona FA - Wong, Teresa W T FA - Fielding, Richard IN - Au, Angel H Y. Centre for Psycho-Oncological Research & Training, School of Public Health, The University of Hong Kong, Hong Kong, China. TI - Development and pilot-testing of a Decision Aid for use among Chinese women facing breast cancer surgery. SO - Health Expectations. 14(4):405-16, 2011 Dec AS - Health Expect. 14(4):405-16, 2011 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Asian Continental Ancestry Group/px [Psychology] MH - Breast Neoplasms/eh [Ethnology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Hong Kong MH - Humans MH - Interviews as Topic MH - *Pamphlets MH - *Patient Participation MH - Pilot Projects MH - Stress, Psychological MH - Surveys and Questionnaires AB - BACKGROUND: Women choosing breast cancer surgery encounter treatment decision-making (TDM) difficulties, which can cause psychological distress. Decision Aids (DAs) may facilitate TDM, but there are no DAs designed for Chinese populations. We developed a DA for Chinese women newly diagnosed with breast cancer, for use during the initial surgical consultation. AB - AIMS: Conduct a pilot study to assess the DA acceptability and utility among Chinese women diagnosed with breast cancer. AB - METHODS: Women preferred the DA in booklet format. A booklet was developed and revised and evaluated in two consecutive pilot studies (P1 and P2). On concluding their initial diagnostic consultation, 95 and 38 Chinese women newly diagnosed with breast cancer received the draft and revised draft DA booklet, respectively. Four-day post-consultation, women had questionnaires read out to them and to which they responded assessing attitudes towards the DA and their understanding of treatment options. AB - RESULTS: The original DA was read/partially read by 66/22% (n = 84) of women, whilst the revised version was read/partially read by 74/16% (n = 35), including subliterate women (chi(2) = 0.76, P = 0.679). Knowledge scores varied with the extent the booklet was read (P1: F = 12.68, d.f. 2, P < 0.001; P2: F = 3.744, d.f. 2, P = 0.034). The revised, shorter version was graphically rich and resulted in improved perceived utility, [except for the 'treatment options' (chi(2) = 5.50, P = 0.019) and 'TDM guidance' (chi(2) = 8.19, P = 0.004) sections] without increasing anxiety (F = 0.689, P = 0.408; F = 3.45, P = 0.073). AB - CONCLUSION: The DA was perceived as acceptable and useful for most women. The DA effectiveness is currently being evaluated using a randomized controlled trial. AB - Copyright © 2011 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00655.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21223468 [pubmed] ID - 10.1111/j.1369-7625.2010.00655.x [doi] PP - ppublish LG - English EP - 20110111 DP - 2011 Dec DC - 20111117 EZ - 2011/01/13 06:00 DA - 2012/04/05 06:00 DT - 2011/01/13 06:00 YR - 2011 ED - 20120404 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21223468 <227. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22231042 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kurian AW AU - Munoz DF AU - Rust P AU - Schackmann EA AU - Smith M AU - Clarke L AU - Mills MA AU - Plevritis SK FA - Kurian, Allison W FA - Munoz, Diego F FA - Rust, Peter FA - Schackmann, Elizabeth A FA - Smith, Michael FA - Clarke, Lauren FA - Mills, Meredith A FA - Plevritis, Sylvia K IN - Kurian, Allison W. Stanford University School of Medicine, Stanford, CA, USA. TI - Online tool to guide decisions for BRCA1/2 mutation carriers. CM - Comment in: J Clin Oncol. 2012 Feb 10;30(5):471-3; PMID: 22231044 SO - Journal of Clinical Oncology. 30(5):497-506, 2012 Feb 10 AS - J Clin Oncol. 30(5):497-506, 2012 Feb 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295552 SB - Index Medicus CP - United States MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Computer Simulation MH - *Decision Support Techniques MH - *Early Detection of Cancer/mt [Methods] MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Predisposition to Disease MH - Heterozygote MH - Humans MH - Incidence MH - Magnetic Resonance Imaging MH - Mammography MH - Mastectomy MH - Monte Carlo Method MH - *Mutation MH - Ovarian Neoplasms/ep [Epidemiology] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy MH - Quality of Life MH - Survival Analysis AB - PURPOSE: Women with BRCA1 or BRCA2 (BRCA1/2) mutations must choose between prophylactic surgeries and screening to manage their high risks of breast and ovarian cancer, comparing options in terms of cancer incidence, survival, and quality of life. A clinical decision tool could guide these complex choices. AB - METHODS: We built a Monte Carlo model for BRCA1/2 mutation carriers, simulating breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years and prophylactic mastectomy (PM) and/or prophylactic oophorectomy (PO) at various ages. Modeled outcomes were cancer incidence, tumor features that shape treatment recommendations, overall survival, and cause-specific mortality. We adapted the model into an online tool to support shared decision making. AB - RESULTS: We compared strategies on cancer incidence and survival to age 70 years; for example, PO plus PM at age 25 years optimizes both outcomes (incidence, 4% to 11%; survival, 80% to 83%), whereas PO at age 40 years plus MRI screening offers less effective prevention, yet similar survival (incidence, 36% to 57%; survival, 74% to 80%). To characterize patients' treatment and survivorship experiences, we reported the tumor features and treatments associated with risk-reducing interventions; for example, in most BRCA2 mutation carriers (81%), MRI screening diagnoses stage I, hormone receptor-positive breast cancers, which may not require chemotherapy. AB - CONCLUSION: Cancer risk-reducing options for BRCA1/2 mutation carriers vary in their impact on cancer incidence, recommended treatments, quality of life, and survival. To guide decisions informed by multiple health outcomes, we provide an online tool for joint use by patients with their physicians (http://brcatool.stanford.edu). ES - 1527-7755 IL - 0732-183X DI - JCO.2011.38.6060 DO - https://dx.doi.org/10.1200/JCO.2011.38.6060 PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 22231042 [pubmed] ID - JCO.2011.38.6060 [pii] ID - 10.1200/JCO.2011.38.6060 [doi] ID - PMC3295552 [pmc] PP - ppublish GI - No: R01 CA066785 Organization: (CA) *NCI NIH HHS* Country: United States No: U01 CA088248 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA66785 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA829040 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20120109 DP - 2012 Feb 10 DC - 20120213 EZ - 2012/01/11 06:00 DA - 2012/03/31 06:00 DT - 2012/01/11 06:00 YR - 2012 ED - 20120330 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22231042 <228. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21720992 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Punglia RS AU - Burstein HJ AU - Weeks JC FA - Punglia, Rinaa S FA - Burstein, Harold J FA - Weeks, Jane C IN - Punglia, Rinaa S. Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. rpunglia@lroc.harvard.edu TI - Radiation therapy for ductal carcinoma in situ: a decision analysis. SO - Cancer. 118(3):603-11, 2012 Feb 01 AS - Cancer. 118(3):603-11, 2012 Feb 01 NJ - Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 0374236, clz IO - Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189439 OI - Source: NLM. NIHMS297834 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/mo [Mortality] MH - *Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/mo [Mortality] MH - *Carcinoma, Intraductal, Noninfiltrating/rt [Radiotherapy] MH - Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Combined Modality Therapy MH - *Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Follow-Up Studies MH - Humans MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - Neoplasm Recurrence, Local/mo [Mortality] MH - *Neoplasm Recurrence, Local/rt [Radiotherapy] MH - Neoplasm Recurrence, Local/su [Surgery] MH - Radiotherapy, Adjuvant MH - Survival Rate MH - Treatment Outcome AB - BACKGROUND: The benefit of adding radiation therapy after excision of ductal carcinoma in situ (DCIS) is widely debated. Randomized clinical trials are underpowered to delineate long-term outcomes after radiation. AB - METHODS: The authors of this report constructed a Markov decision model to simulate the clinical course of DCIS in a woman aged 60 years who received treatment with either of 2 breast-conserving strategies: excision alone or excision plus radiation therapy. Sensitivity analyses were used to study the influence of risk of local recurrence, likelihood of invasive disease at recurrence, surgical choice at recurrence, and patient age at diagnosis on treatment outcomes. AB - RESULTS: The addition of radiation therapy was associated with slight improvements in invasive disease-free and overall survival. However, radiation therapy decreased the chance of having both breasts intact over a patient's lifetime. Radiation therapy improved survival by 2.1 months for women who were diagnosed with DCIS at age 60 years but decreased the chance of having both breasts by 8.6% relative to excision alone. The differences in outcomes between the treatment strategies became smaller with increasing age at diagnosis. Sensitivity analyses revealed a greater benefit for radiation with an increased likelihood of invasive recurrence. The decrement in breast preservation with radiation therapy was mitigated by an increased likelihood of mastectomy at the time of recurrence or new breast cancer diagnosis. AB - CONCLUSIONS: The current analysis quantified the benefits of radiation after excision of DCIS but also revealed that radiation therapy may increase the likelihood of eventual mastectomy. Therefore, the authors concluded that patient age and preferences should be considered when making the decision to add or forgo radiation for DCIS. AB - Copyright © 2011 American Cancer Society. ES - 1097-0142 IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.26293 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 21720992 [pubmed] ID - 10.1002/cncr.26293 [doi] ID - PMC3189439 [pmc] ID - NIHMS297834 [mid] PP - ppublish PH - 2011/02/04 [received] PH - 2011/04/05 [revised] PH - 2011/04/25 [accepted] GI - No: K05 CA166208 Organization: (CA) *NCI NIH HHS* Country: United States No: K07 CA118269 Organization: (CA) *NCI NIH HHS* Country: United States No: K07 CA118269-05 Organization: (CA) *NCI NIH HHS* Country: United States No: 1K07 CA118269 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20110630 DP - 2012 Feb 01 DC - 20120123 EZ - 2011/07/02 06:00 DA - 2012/03/28 06:00 DT - 2011/07/02 06:00 YR - 2012 ED - 20120327 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21720992 <229. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22056355 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee CN AU - Chang Y AU - Adimorah N AU - Belkora JK AU - Moy B AU - Partridge AH AU - Ollila DW AU - Sepucha KR FA - Lee, Clara N FA - Chang, Yuchiao FA - Adimorah, Nesochi FA - Belkora, Jeff K FA - Moy, Beverly FA - Partridge, Ann H FA - Ollila, David W FA - Sepucha, Karen R IN - Lee, Clara N. Division of Plastic and Reconstructive Surgery at the University of North Carolina, Chapel Hill, NC 27599-7195, USA. cnlee@med.unc.edu TI - Decision making about surgery for early-stage breast cancer. SO - Journal of the American College of Surgeons. 214(1):1-10, 2012 Jan AS - J Am Coll Surg. 214(1):1-10, 2012 Jan NJ - Journal of the American College of Surgeons PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - bzb, 9431305 IO - J. Am. Coll. Surg. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256735 OI - Source: NLM. NIHMS337004 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - Middle Aged MH - Neoplasm Staging MH - Patient Education as Topic MH - Patient Participation MH - Retrospective Studies MH - Surveys and Questionnaires AB - BACKGROUND: Practice variation in breast cancer surgery has raised concerns about the quality of treatment decisions. We sought to evaluate the quality of decisions about surgery for early-stage breast cancer by measuring patient knowledge, concordance between goals and treatments, and involvement in decisions. AB - STUDY DESIGN: A mailed survey of stage I/II breast cancer survivors was conducted at 4 sites. The Decision Quality Instrument measured knowledge, goals, and involvement in decisions. A multivariable logistic regression model of treatment was developed. The model-predicted probability of mastectomy was compared with treatment received for each patient. Concordance was defined as having mastectomy and predicted probability >0.5 or partial mastectomy and predicted probability <0.5. Frequency of discussion about partial mastectomy was compared with discussion about mastectomy using chi-square tests. AB - RESULTS: Four hundred and forty patients participated (59% response rate). Mean overall knowledge was 52.7%; 45.9% knew that local recurrence risk is higher after breast conservation and 55.7% knew that survival is equivalent for the 2 options. Most participants (89.0%) had treatment concordant with their goals. Participants preferring mastectomy had lower concordance (80.5%) than those preferring partial mastectomy (92.6%; p = 0.001). Participants reported more frequent discussion of partial mastectomy and its advantages than of mastectomy, and 48.6% reported being asked their preference. AB - CONCLUSIONS: Breast cancer survivors had major knowledge deficits, and those preferring mastectomy were less likely to have treatment concordant with goals. Patients perceived that discussions focused on partial mastectomy, and many were not asked their preference. Improvements in the quality of decisions about breast cancer surgery are needed. AB - Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved. ES - 1879-1190 IL - 1072-7515 DI - S1072-7515(11)01115-X DO - https://dx.doi.org/10.1016/j.jamcollsurg.2011.09.017 PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 22056355 [pubmed] ID - S1072-7515(11)01115-X [pii] ID - 10.1016/j.jamcollsurg.2011.09.017 [doi] ID - PMC3256735 [pmc] ID - NIHMS337004 [mid] PP - ppublish PH - 2011/07/22 [received] PH - 2011/09/15 [revised] PH - 2011/09/21 [accepted] GI - No: K07 CA154850 Organization: (CA) *NCI NIH HHS* Country: United States No: KL2 RR025746 Organization: (RR) *NCRR NIH HHS* Country: United States No: KL2 RR025746-02 Organization: (RR) *NCRR NIH HHS* Country: United States No: 1KL2RR025746 Organization: (RR) *NCRR NIH HHS* Country: United States LG - English EP - 20111106 DP - 2012 Jan DC - 20111223 EZ - 2011/11/08 06:00 DA - 2012/02/14 06:00 DT - 2011/11/08 06:00 YR - 2012 ED - 20120213 RD - 20161118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=22056355 <230. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21988888 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Edgerton ME AU - Chuang YL AU - Macklin P AU - Yang W AU - Bearer EL AU - Cristini V FA - Edgerton, Mary E FA - Chuang, Yao-Li FA - Macklin, Paul FA - Yang, Wei FA - Bearer, Elaine L FA - Cristini, Vittorio IN - Edgerton, Mary E. Department of Pathology, UT MD Anderson Cancer Center, and School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA. TI - A novel, patient-specific mathematical pathology approach for assessment of surgical volume: application to ductal carcinoma in situ of the breast. SO - Analytical Cellular Pathology. 34(5):247-63, 2011 AS - Anal Cell Pathol (Amst). 34(5):247-63, 2011 NJ - Analytical cellular pathology (Amsterdam) PI - Journal available in: Print PI - Citation processed from: Internet JC - 101541993 IO - Anal Cell Pathol (Amst) PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3613121 OI - Source: NLM. NIHMS452618 SB - Index Medicus CP - United States MH - Apoptosis MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/dg [Diagnostic Imaging] MH - Carcinoma, Intraductal, Noninfiltrating/me [Metabolism] MH - Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - *Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Caspase 3/an [Analysis] MH - Cell Proliferation MH - Computer Simulation MH - *Decision Support Techniques MH - Diffusion MH - Energy Metabolism MH - Female MH - Humans MH - Immunohistochemistry MH - Ki-67 Antigen/an [Analysis] MH - Mammography MH - *Mastectomy MH - Mitotic Index MH - *Models, Biological MH - Patient Selection MH - Retrospective Studies MH - Time Factors MH - Tumor Burden AB - We introduce a novel "mathematical pathology" approach, founded on a biophysical model, to identify robust patient-specific predictors of tumor growth useful in clinical practice to improve the accuracy of diagnosis/prognosis and intervention. In accordance with biological observations, our model simulates the diffusion-limited in situ tumors with a relatively short phase of fast initial growth, followed by a prolonged slow-growth phase where tumor size is constrained primarily by the relative weight of cell mitosis and death. The former phase may only last for a few months, so that at the time of diagnosis, we may assume that most tumors will have entered the phase where their size is changing slowly. Based on this prediction, we hypothesize that the volume of breast with ducts affected by in situ tumors at the time of diagnosis will be closely approximated by a model-derived mathematical function based on the ratio of tumor cell proliferation-to-apoptosis indices and on the extent of diffusion of cell nutrients (diffusion penetration length), which can be measured from immunohistochemical and morphometric analysis of patient histopathology specimens without the need for multiple-time measurements. We tested this idea in a retrospective study of 17 patients by staining breast tumor specimens containing ductal carcinoma in situ for mitosis with Ki-67 and for apoptosis with cleaved caspase-3 and counting cells positive for each marker. We also determined diffusion penetration by measuring the thickness of viable rims of tumor cells within ducts. Using the ensuing ratios, we applied the model to determine a predicted surgical volume or tumor size. We then corroborated our hypothesis by comparing the predicted size of each tumor based on our model with the actual size of the pathological specimen after tumor excision (R2 = 0.74-0.88). In addition, for the 17 cases studied, both histological grade and mammography were not found to correlate with tumor size (R2 = 0.08-0.47). We conclude that our mathematical pathology approach yields a high degree of accuracy in predicting the size of tumors based on the mitotic/apoptotic index and on diffusion penetration. By obtaining these ratios at the time of initial biopsy, pathologists can employ our model to predict the size of the tumor and thereby inform surgeons how much tissue to remove (surgical volume). We discuss how results from the model have implications concerning the current debate on recommendations for screening mammography, while the model itself may contribute to better planning of breast conservation surgery. RN - 0 (Ki-67 Antigen) RN - EC 3-4-22 (CASP3 protein, human) RN - EC 3-4-22 (Caspase 3) ES - 2210-7185 IL - 2210-7177 DI - 9848673505W4121J DO - https://dx.doi.org/10.3233/ACP-2011-0019 PT - Journal Article ID - 21988888 [pubmed] ID - 9848673505W4121J [pii] ID - 10.3233/ACP-2011-0019 [doi] ID - PMC3613121 [pmc] ID - NIHMS452618 [mid] PP - ppublish GI - No: U54 CA143907 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 NS046810 Organization: (NS) *NINDS NIH HHS* Country: United States No: U54 CA143837 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 NS062184 Organization: (NS) *NINDS NIH HHS* Country: United States No: U54 CA149196 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2011 DC - 20111012 EZ - 2011/10/13 06:00 DA - 2012/01/27 06:00 DT - 2011/10/13 06:00 YR - 2011 ED - 20120126 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21988888 <231. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21723312 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hersch J AU - Jansen J AU - Irwig L AU - Barratt A AU - Thornton H AU - Howard K AU - McCaffery K FA - Hersch, Jolyn FA - Jansen, Jesse FA - Irwig, Les FA - Barratt, Alexandra FA - Thornton, Hazel FA - Howard, Kirsten FA - McCaffery, Kirsten IN - Hersch, Jolyn. Screening and Test Evaluation Program, Sydney School of Public Health, Edward Ford Bldg (A27), University of Sydney, NSW 2006, Australia. jolyn.hersch@sydney.edu.au TI - How do we achieve informed choice for women considering breast screening?. CM - Comment in: Prev Med. 2011 Dec;53(6):437; author reply 438; PMID: 21803070 SO - Preventive Medicine. 53(3):144-6, 2011 Sep AS - Prev Med. 53(3):144-6, 2011 Sep NJ - Preventive medicine PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pm4, 0322116 IO - Prev Med SB - Index Medicus CP - United States MH - *Breast Neoplasms/di [Diagnosis] MH - *Choice Behavior/es [Ethics] MH - Decision Making MH - *Early Detection of Cancer/px [Psychology] MH - Female MH - Health Education MH - Health Knowledge, Attitudes, Practice MH - Humans MH - *Informed Consent/px [Psychology] MH - Patient Education as Topic/es [Ethics] MH - *Patient Education as Topic/mt [Methods] MH - Qualitative Research MH - *Women's Health/es [Ethics] AB - OBJECTIVE: In current medical literature, mammography and other cancer screening programs are subject to controversy because of debate about the magnitude and nature of the benefits and harms. This paper discusses the issues around informed choice for women considering breast screening. AB - METHOD: We discuss qualitative and quantitative studies of women's attitudes to breast screening and informed choice. AB - RESULTS: Women view breast screening as a way of avoiding potential regret, and reassurance from normal results is highly valued. Screening participants acknowledge anxiety about false positives but awareness regarding potential overdetection of indolent breast cancer is minimal, and research is needed to assess how better understanding of screening downsides may affect women's views. In any case, weighing up screening advantages and disadvantages is sensitive to personal preferences. AB - CONCLUSIONS: Communicators have an ethical obligation to make balanced information available to women, which is flexible enough to respond to the level of detail and involvement desired by each individual. Many women want to know more and to participate more actively in screening decisions. Techniques have been developed to present balanced information and support individual decision making in ways that are accessible and empowering for the wider community. Evaluations of breast cancer screening must integrate clinical data with evidence on the perspectives of women themselves. AB - Copyright © 2011 Elsevier Inc. All rights reserved. ES - 1096-0260 IL - 0091-7435 DI - S0091-7435(11)00239-8 DO - https://dx.doi.org/10.1016/j.ypmed.2011.06.013 PT - Journal Article ID - 21723312 [pubmed] ID - S0091-7435(11)00239-8 [pii] ID - 10.1016/j.ypmed.2011.06.013 [doi] PP - ppublish PH - 2011/04/07 [received] PH - 2011/06/16 [revised] PH - 2011/06/17 [accepted] LG - English EP - 20110624 DP - 2011 Sep DC - 20110913 EZ - 2011/07/05 06:00 DA - 2012/01/27 06:00 DT - 2011/07/05 06:00 YR - 2011 ED - 20120126 RD - 20120508 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21723312 <232. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21618242 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Barchie MF AU - Clive KS AU - Tyler JA AU - Sutcliffe JB AU - Kirkpatrick AD AU - Bell LM AU - Banks KP AU - Belenkiy S AU - Saenger JS AU - Peoples GE FA - Barchie, Matthew F FA - Clive, Kevin S FA - Tyler, Joshua A FA - Sutcliffe, Joseph B FA - Kirkpatrick, Aaron D FA - Bell, Lisa M FA - Banks, Kevin P FA - Belenkiy, Slava FA - Saenger, Jeff S FA - Peoples, George E IN - Barchie, Matthew F. Department of Radiology, San Antonio Uniformed Services Health Education Consortium, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA. mbarchie@satx.rr.com TI - Standardized pretreatment breast MRI--accuracy and influence on mastectomy decisions. SO - Journal of Surgical Oncology. 104(7):741-5, 2011 Dec AS - J Surg Oncol. 104(7):741-5, 2011 Dec NJ - Journal of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - k79, 0222643 IO - J Surg Oncol SB - Index Medicus CP - United States MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - *Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - *Carcinoma, Lobular/pa [Pathology] MH - *Carcinoma, Lobular/su [Surgery] MH - Clinical Protocols MH - Female MH - Humans MH - *Magnetic Resonance Imaging/st [Standards] MH - Mammography MH - Mastectomy/ut [Utilization] MH - *Mastectomy MH - Middle Aged MH - *Patient Selection MH - *Preoperative Care/st [Standards] MH - Reference Standards MH - Reproducibility of Results MH - Retrospective Studies MH - Sensitivity and Specificity AB - BACKGROUND AND OBJECTIVES: Routine pretreatment breast magnetic resonance imaging in newly diagnosed cancer patients remains controversial. We assess MRI accuracy and influence on mastectomy decisions after institution of standardized pretreatment MRI. AB - METHODS: A prospectively collected database of 74 consecutive new invasive breast cancer patients with pretreatment breast MRI was reviewed for treatment choice, radiologic, and pathologic results. Thirty-eight of 72 patients with available surgical records underwent mastectomy. Mastectomy preoperative and operative electronic records were reviewed for treatment decision analysis. AB - RESULTS: Seventeen of 72 (23.6%) invasive breast cancer patients were likely influenced to undergo mastectomy by new information from MRI. MRI reported that the multifocal/multicentric (MF/MC) rate was 20 of 72 (27.8%) versus 19 of 72 (26.4%) by surgical pathology. MRI sensitivity for MF/MC disease was 89.5% versus 11.8% for mammography. MRI specificity was 84.2%. All three false positives declined recommended preoperative biopsies. MRI MF/MC diagnosis highly correlated with pathology results, P < 0.001. AB - CONCLUSIONS: Increased mastectomy rate from 29 to 52.8% after standardization of pre-treatment breast MRI for invasive cancer is largely due to MRI findings of increased extent of disease. These MRI findings correlate well with pathologic findings and appear to justify the performance of mastectomies in these patients. AB - Copyright © 2011 Wiley Periodicals, Inc. ES - 1096-9098 IL - 0022-4790 DO - https://dx.doi.org/10.1002/jso.21960 PT - Comparative Study PT - Journal Article ID - 21618242 [pubmed] ID - 10.1002/jso.21960 [doi] PP - ppublish PH - 2010/11/30 [received] PH - 2011/04/04 [accepted] LG - English EP - 20110525 DP - 2011 Dec DC - 20111101 EZ - 2011/05/28 06:00 DA - 2011/12/14 06:00 DT - 2011/05/28 06:00 YR - 2011 ED - 20111212 RD - 20111101 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21618242 <233. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20593202 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Brown RF AU - Shuk E AU - Leighl N AU - Butow P AU - Ostroff J AU - Edgerson S AU - Tattersall M FA - Brown, Richard F FA - Shuk, Elyse FA - Leighl, Natasha FA - Butow, Phyllis FA - Ostroff, Jamie FA - Edgerson, Shawna FA - Tattersall, Martin IN - Brown, Richard F. Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine, 1112 East Clay St, Richmond, VA, 23298-0149, USA. rbrown39@vcu.edu TI - Enhancing decision making about participation in cancer clinical trials: development of a question prompt list. SO - Supportive Care in Cancer. 19(8):1227-38, 2011 Aug AS - Support Care Cancer. 19(8):1227-38, 2011 Aug NJ - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9302957, b1l IO - Support Care Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834985 OI - Source: NLM. NIHMS776662 SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - *Clinical Trials as Topic MH - Communication MH - *Decision Making MH - Female MH - Focus Groups MH - Humans MH - Informed Consent MH - Male MH - Medical Oncology/mt [Methods] MH - Middle Aged MH - *Neoplasms MH - *Patient Education as Topic MH - *Patient Participation MH - Physician-Patient Relations MH - Qualitative Research MH - Severity of Illness Index MH - Tape Recording MH - Trust AB - PURPOSE: Slow accrual to cancer clinical trials impedes the progress of effective new cancer treatments. Poor physician-patient communication has been identified as a key contributor to low trial accrual. Question prompt lists (QPLs) have demonstrated a significant promise in facilitating communication in general, surgical, and palliative oncology settings. These simple patient interventions have not been tested in the oncology clinical trial setting. We aimed to develop a targeted QPL for clinical trials (QPL-CT). AB - METHOD: Lung, breast, and prostate cancer patients who either had (trial experienced) or had not (trial naive) participated in a clinical trial were invited to join focus groups to help develop and explore the acceptability of a QPL-CT. Focus groups were audio-recorded and transcribed. A research team, including a qualitative data expert, analyzed these data to explore patients' decision-making processes and views about the utility of the QPL-CT prompt to aid in trial decision making. AB - RESULTS: Decision making was influenced by the outcome of patients' comparative assessment of perceived risks versus benefits of a trial, and the level of trust patients had in their doctors' recommendation about the trial. Severity of a patient's disease influenced trial decision making only for trial-naive patients. AB - CONCLUSION: Although patients were likely to prefer a paternalistic decision-making style, they expressed valuation of the QPL as an aid to decision making. QPL-CT utility extended beyond the actual consultation to include roles both before and after the clinical trial discussion. ES - 1433-7339 IL - 0941-4355 DO - https://dx.doi.org/10.1007/s00520-010-0942-6 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 20593202 [pubmed] ID - 10.1007/s00520-010-0942-6 [doi] ID - PMC4834985 [pmc] ID - NIHMS776662 [mid] PP - ppublish PH - 2009/12/08 [received] PH - 2010/06/14 [accepted] GI - No: R03 CA130598 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20100701 DP - 2011 Aug DC - 20110701 EZ - 2010/07/02 06:00 DA - 2011/12/13 00:00 DT - 2010/07/02 06:00 YR - 2011 ED - 20111207 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20593202 <234. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21442198 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fagerlin A AU - Dillard AJ AU - Smith DM AU - Zikmund-Fisher BJ AU - Pitsch R AU - McClure JB AU - Greene S AU - Alford SH AU - Nair V AU - Hayes DF AU - Wiese C AU - Ubel PA FA - Fagerlin, Angela FA - Dillard, Amanda J FA - Smith, Dylan M FA - Zikmund-Fisher, Brian J FA - Pitsch, Rosemarie FA - McClure, Jennifer B FA - Greene, Sarah FA - Alford, Sharon Hensley FA - Nair, Vijayan FA - Hayes, Daniel F FA - Wiese, Cheryl FA - Ubel, Peter A IN - Fagerlin, Angela. Ann Arbor VA HSR&D Center for Practice Management and Outcomes Research, Ann Arbor, MI, USA. fagerlin@umich.edu TI - Women's interest in taking tamoxifen and raloxifene for breast cancer prevention: response to a tailored decision aid. SO - Breast Cancer Research & Treatment. 127(3):681-8, 2011 Jun AS - Breast Cancer Res Treat. 127(3):681-8, 2011 Jun NJ - Breast cancer research and treatment PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742062 OI - Source: NLM. NIHMS304862 SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - *Anticarcinogenic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Making MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Patient Education as Topic MH - *Raloxifene Hydrochloride/tu [Therapeutic Use] MH - Selective Estrogen Receptor Modulators/tu [Therapeutic Use] MH - *Tamoxifen/tu [Therapeutic Use] AB - Although tamoxifen can prevent primary breast cancer, few women use it as a preventive measure. A second option, raloxifene, has recently been approved. The objective of the study was to determine women's interest in tamoxifen and raloxifene after reading a decision aid (DA) describing the risks and benefits of each medication. Women with 5-year risk of breast cancer >= 1.66 from two large health maintenance organizations were randomized to receive a DA versus usual care. After reading an on-line DA that discussed the risks and benefits of tamoxifen and raloxifene, women completed measures of risk perception, decisional conflict, behavioral intentions, and actual behavior related to tamoxifen and raloxifene. 3 months following the intervention, 8.1% of participants had looked for additional information about breast cancer prevention drugs, and 1.8% had talked to their doctor about tamoxifen and/or raloxifene. The majority, 54.7%, had decided to not take either drug, 0.5% had started raloxifene, and none had started tamoxifen. Participants were not particularly worried about taking tamoxifen or raloxifene and did not perceive significant benefits from taking these drugs. Over 50% did not perceive a change in their risk of getting breast cancer if they took tamoxifen or raloxifene. After reading a DA about tamoxifen and raloxifene, few women were interested in taking either breast cancer prevention drug. RN - 0 (Anticarcinogenic Agents) RN - 0 (Selective Estrogen Receptor Modulators) RN - 094ZI81Y45 (Tamoxifen) RN - 4F86W47BR6 (Raloxifene Hydrochloride) ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-011-1450-1 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 21442198 [pubmed] ID - 10.1007/s10549-011-1450-1 [doi] ID - PMC3742062 [pmc] ID - NIHMS304862 [mid] PP - ppublish PH - 2011/03/08 [received] PH - 2011/03/10 [accepted] GI - No: P50 CA101451 Organization: (CA) *NCI NIH HHS* Country: United States No: P50 CA101451-08 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20110326 DP - 2011 Jun DC - 20110520 EZ - 2011/03/29 06:00 DA - 2011/12/13 00:00 DT - 2011/03/29 06:00 YR - 2011 ED - 20111122 RD - 20161118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21442198 <235. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21715722 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Belkora JK AU - Hutton DW AU - Moore DH AU - Siminoff LA FA - Belkora, Jeffrey K FA - Hutton, David W FA - Moore, Dan H FA - Siminoff, Laura A IN - Belkora, Jeffrey K. University of California San Francisco, USA. TI - Does use of the adjuvant! model influence use of adjuvant therapy through better risk communication?. SO - Journal of the National Comprehensive Cancer Network. 9(7):707-12, 2011 Jul 01 AS - J. Natl. Compr. Cancer Netw.. 9(7):707-12, 2011 Jul 01 NJ - Journal of the National Comprehensive Cancer Network : JNCCN PI - Journal available in: Print PI - Citation processed from: Internet JC - 101162515 IO - J Natl Compr Canc Netw PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528013 OI - Source: NLM. NIHMS427419 SB - Index Medicus CP - United States MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - Chemotherapy, Adjuvant MH - Female MH - *Health Communication MH - Humans MH - *Patient Acceptance of Health Care MH - *Physician-Patient Relations MH - Prognosis MH - Risk Factors AB - Adjuvant! is a model that provides recurrence and mortality risk predictions for patients with breast cancer considering adjuvant therapies. Although low-risk patients who saw Adjuvant! chose adjuvant therapy less frequently, whether this was because of educational or other aspects of the decision aid is unknown. The authors explored whether Adjuvant! affects choice of therapy through increased patient knowledge. A subset of data were analyzed from a cluster randomized trial in which oncology practices in 2 major United States cities were randomly assigned to use either Adjuvant! or an informational pamphlet to educate patients. Of 405 patients, 48 were low-risk, with 28 assigned to the decision aid and 20 to the pamphlet. Among the low-risk patients, using frequency tables and Fisher exact tests, the authors explored whether Adjuvant! was associated with more accurate patient estimates of survival; whether accuracy was associated with treatment choice; and whether, after controlling for accuracy, any remaining association was seen between Adjuvant! and treatment choice. Adjuvant! was associated with more accurate estimates of baseline prognosis compared with the pamphlet (57% vs. 25%; P = .04). Patients who had more accurate estimates of baseline prognosis were less likely to choose adjuvant therapy (62% vs. 89%; P = .04). After controlling for accuracy, no statistically significant association was found between the use of Adjuvant! and adjuvant therapy (P = .59 and P = .11 for inaccurate and accurate patients, respectively). Adjuvant! seems to influence patient choice through educational rather than other means of persuasion. However, many patients held inaccurate risk perceptions after viewing Adjuvant!. RN - 0 (Antineoplastic Agents) ES - 1540-1413 IL - 1540-1405 DI - 9/7/707 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 21715722 [pubmed] ID - 9/7/707 [pii] ID - PMC3528013 [pmc] ID - NIHMS427419 [mid] PP - ppublish GI - No: K12 HD052163 Organization: (HD) *NICHD NIH HHS* Country: United States No: R01 CA074136 Organization: (CA) *NCI NIH HHS* Country: United States No: 9K12HD052163-06 Organization: (HD) *NICHD NIH HHS* Country: United States No: R01-CA71104 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2011 Jul 01 DC - 20110630 EZ - 2011/07/01 06:00 DA - 2011/10/20 06:00 DT - 2011/07/01 06:00 YR - 2011 ED - 20111019 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21715722 <236. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20688457 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Begum S AU - Grunfeld EA AU - Ho-Asjoe M AU - Farhadi J FA - Begum, Shelima FA - Grunfeld, Elizabeth A FA - Ho-Asjoe, Mark FA - Farhadi, Jian IN - Begum, Shelima. King's College London, Department of Psychology, Institute of Psychiatry, Guy's Hospital, London, UK. TI - An exploration of patient decision-making for autologous breast reconstructive surgery following a mastectomy. SO - Patient Education & Counseling. 84(1):105-10, 2011 Jul AS - Patient Educ Couns. 84(1):105-10, 2011 Jul NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Humans MH - *Mammaplasty/px [Psychology] MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Patient Satisfaction MH - Physician-Patient Relations MH - Time Factors AB - OBJECTIVE: The aim of this study was to examine patients' experiences of the decision to undergo breast reconstructive surgery following mastectomy. AB - METHOD: 21 Women, who had undergone reconstruction, took part in a semi-structured qualitative interview, which examined the participants' experience of the decision-making process. The recorded interviews were transcribed verbatim and analyzed using "framework analysis". AB - RESULTS: Women who underwent immediate reconstruction spoke of the convenience of undergoing only one operation with regards to juggling work and childcare arrangements. For women who underwent delayed reconstructive surgery the reasons centre on dissatisfaction with wearing prosthesis. Others spoke of no choice, as immediate reconstruction was not offered as an option. However both groups did report similar influential factors and received and used similar informational content and informational sources in order to make their decision. AB - CONCLUSION: The study outlines the different motivations for undergoing immediate or delayed breast reconstruction and highlights that there is not always a choice offered to patients. AB - PRACTICE IMPLICATIONS: Future patients who are considering breast reconstruction should be provided with the relevant information to make a well informed decision and may benefit from different methods of information delivery that could include decision aids such as informational booklets, photographs, and videos. AB - Copyright © 2010 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(10)00405-2 DO - https://dx.doi.org/10.1016/j.pec.2010.07.004 PT - Journal Article ID - 20688457 [pubmed] ID - S0738-3991(10)00405-2 [pii] ID - 10.1016/j.pec.2010.07.004 [doi] PP - ppublish PH - 2009/12/10 [received] PH - 2010/06/22 [revised] PH - 2010/07/03 [accepted] LG - English EP - 20100804 DP - 2011 Jul DC - 20110613 EZ - 2010/08/07 06:00 DA - 2011/10/14 06:00 DT - 2010/08/07 06:00 YR - 2011 ED - 20111013 RD - 20110613 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20688457 <237. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20609546 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jibaja-Weiss ML AU - Volk RJ AU - Granchi TS AU - Neff NE AU - Robinson EK AU - Spann SJ AU - Aoki N AU - Friedman LC AU - Beck JR FA - Jibaja-Weiss, Maria L FA - Volk, Robert J FA - Granchi, Thomas S FA - Neff, Nancy E FA - Robinson, Emily K FA - Spann, Stephen J FA - Aoki, Noriaki FA - Friedman, Lois C FA - Beck, J Robert IN - Jibaja-Weiss, Maria L. Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA. mariaj@bcm.edu TI - Entertainment education for breast cancer surgery decisions: a randomized trial among patients with low health literacy. SO - Patient Education & Counseling. 84(1):41-8, 2011 Jul AS - Patient Educ Couns. 84(1):41-8, 2011 Jul NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Computer-Assisted Instruction/mt [Methods] MH - *Decision Support Techniques MH - Educational Status MH - Female MH - Follow-Up Studies MH - Health Knowledge, Attitudes, Practice MH - *Health Literacy MH - Hospitals, Public MH - Humans MH - Mastectomy MH - Middle Aged MH - Multimedia MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - *Patient Participation AB - OBJECTIVE: To evaluate an entertainment-based patient decision aid for early stage breast cancer surgery in low health literacy patients. AB - METHODS: Newly diagnosed female patients with early stage breast cancer from two public hospitals were randomized to receive an entertainment-based decision aid for breast cancer treatment along with usual care (intervention arm) or to receive usual care only (control arm). Pre-decision (baseline), pre-surgery, and 1-year follow-up assessments were conducted. AB - RESULTS: Patients assigned to the intervention arm of the study were more likely than the controls to choose mastectomy rather than breast-conserving surgery; however, they appeared better informed and clearer about their surgical options than women assigned to the control group. No differences in satisfaction with the surgical decision or the decision-making process were observed between the patients who viewed the intervention and those assigned to the control group. AB - CONCLUSIONS: Entertainment education may be a desirable strategy for informing lower health literate women about breast cancer surgery options. AB - PRACTICE IMPLICATIONS: Incorporating patient decision aids, particularly computer-based decision aids, into standard clinical practice remains a challenge; however, patients may be directed to view programs at home or at public locations (e.g., libraries, community centers). AB - Copyright © 2010 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(10)00368-X DO - https://dx.doi.org/10.1016/j.pec.2010.06.009 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 20609546 [pubmed] ID - S0738-3991(10)00368-X [pii] ID - 10.1016/j.pec.2010.06.009 [doi] PP - ppublish PH - 2009/09/25 [received] PH - 2010/05/04 [revised] PH - 2010/06/04 [accepted] LG - English EP - 20100707 DP - 2011 Jul DC - 20110613 EZ - 2010/07/09 06:00 DA - 2011/10/14 06:00 DT - 2010/07/09 06:00 YR - 2011 ED - 20111013 RD - 20110613 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20609546 <238. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21624867 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lacovara JE AU - Arzouman J AU - Kim CJ AU - Degan JA AU - Horner M FA - Lacovara, Jane E FA - Arzouman, Jill FA - Kim, Christina J FA - Degan, Janice A FA - Horner, Margaret IN - Lacovara, Jane E. University Medical Center, Tucson, AZ, USA. jlacovara@umcaz.edu TI - Are patients with breast cancer satisfied with their decision making?: a comparison over time. SO - Clinical Journal of Oncology Nursing. 15(3):320-3, 2011 Jun AS - Clin J Oncol Nurs. 15(3):320-3, 2011 Jun NJ - Clinical journal of oncology nursing PI - Journal available in: Print PI - Citation processed from: Internet JC - czm, 9705336 IO - Clin J Oncol Nurs SB - Nursing Journal CP - United States MH - *Adaptation, Psychological MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - Confidence Intervals MH - *Decision Making MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Health Surveys MH - Humans MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - *Patient Satisfaction MH - *Stress, Psychological AB - Choosing between lumpectomy with radiation versus mastectomy is difficult for women with early-stage breast cancer, and doubt can decrease women's confidence and satisfaction. As a result, the current study surveyed satisfaction before and after surgery in a convenience sample of women with early-stage breast cancer from a single practice. All women received either total mastectomy or lumpectomy plus radiation based on their informed choice of surgical options. The surgeon and the principal investigator educated patients about both surgeries at the time of consent. Participants answered a survey about satisfaction with their decision making before their chosen surgical procedure and again by telephone six months later. Participants felt that they had made an informed choice at the time of decision (87%) and at follow-up (93%). In addition, most women were satisfied with their choice of surgical procedure at time of decision (87%) as well as six months after surgery (96%). This study allowed women to significantly participate in their care through surgical decision making, which improved satisfaction. Nurses are uniquely positioned to support women with early-stage breast cancer in their decision-making process. ES - 1538-067X IL - 1092-1095 DI - 74V1472383588618 DO - https://dx.doi.org/10.1188/11.CJON.320-323 PT - Comparative Study PT - Journal Article ID - 21624867 [pubmed] ID - 74V1472383588618 [pii] ID - 10.1188/11.CJON.320-323 [doi] PP - ppublish LG - English DP - 2011 Jun DC - 20110531 EZ - 2011/06/01 06:00 DA - 2011/10/05 06:00 DT - 2011/06/01 06:00 YR - 2011 ED - 20111004 RD - 20120118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21624867 <239. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21181326 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Preminger BA AU - Lemaine V AU - Sulimanoff I AU - Pusic AL AU - McCarthy CM FA - Preminger, Beth Aviva FA - Lemaine, Valerie FA - Sulimanoff, Isabel FA - Pusic, Andrea L FA - McCarthy, Colleen M IN - Preminger, Beth Aviva. Plastic and Reconstructive Surgery, Department of Surgery, Columbia University, The Affiliation at Harlem Hospital, 506 Lenox Ave, New York, NY 10037, USA. TI - Preoperative patient education for breast reconstruction: a systematic review of the literature. [Review] SO - Journal of Cancer Education. 26(2):270-6, 2011 Jun AS - J Cancer Educ. 26(2):270-6, 2011 Jun NJ - Journal of cancer education : the official journal of the American Association for Cancer Education PI - Journal available in: Print PI - Citation processed from: Internet JC - avy, 8610343 IO - J Cancer Educ SB - Index Medicus CP - England MH - Decision Making MH - Female MH - Humans MH - *Mammaplasty MH - *Patient Education as Topic MH - Preoperative Care MH - Research Design AB - This study aims to assess the current state of patient educational tools available for the purposes of educating women about postmastectomy breast reconstruction. A systematic review of the English language literature was conducted between the years 1966 and 2009 of all studies pertaining to the use of educational materials for breast reconstruction. MEDLINE, CINAHAL, PsycINFO, EMBASE, SCOPUS, and the Science Citation Index were searched. Only studies that both employed and evaluated a patient educational tool in the setting of postmastectomy reconstruction were selected for review. Qualifying studies were then evaluated with respect to their study design, sample size, and outcome measure evaluated. Each educational tool identified was similarly evaluated with respect to its development process, content, and educational medium. A total of 497 articles were retrieved. Of these, only seven met our inclusion criteria. These publications evaluated a total of seven educational tools. Among them were employed various mediums including written, visual, and audio materials. Detailed review revealed that the development of only one educational program included an educational needs assessment. Only two of the seven studies identified evaluated the efficacy of their educational tool using a randomized controlled trial study design. Outcome measures evaluated varied among the studies identified and included: knowledge gains (n = 4), the 'yes' or 'no' decision to undergo reconstruction (n = 3), satisfaction with decision regarding reconstruction (n = 1), decisional conflict (n = 3), and type of reconstruction (n = 3). This review highlights the need for well-designed, methodologically sound research into patient education regarding breast reconstruction. Such information is invaluable in developing patient education programs and decision aids that aim at patient empowerment. ES - 1543-0154 IL - 0885-8195 DO - https://dx.doi.org/10.1007/s13187-010-0182-y PT - Journal Article PT - Review ID - 21181326 [pubmed] ID - 10.1007/s13187-010-0182-y [doi] PP - ppublish LG - English DP - 2011 Jun DC - 20110520 EZ - 2010/12/25 06:00 DA - 2011/09/29 06:00 DT - 2010/12/25 06:00 YR - 2011 ED - 20110927 RD - 20110520 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21181326 <240. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20876346 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hooker GW AU - Leventhal KG AU - DeMarco T AU - Peshkin BN AU - Finch C AU - Wahl E AU - Joines JR AU - Brown K AU - Valdimarsdottir H AU - Schwartz MD FA - Hooker, Gillian W FA - Leventhal, Kara-Grace FA - DeMarco, Tiffani FA - Peshkin, Beth N FA - Finch, Clinton FA - Wahl, Erica FA - Joines, Jessica Rispoli FA - Brown, Karen FA - Valdimarsdottir, Heiddis FA - Schwartz, Marc D IN - Hooker, Gillian W. Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. TI - Longitudinal changes in patient distress following interactive decision aid use among BRCA1/2 carriers: a randomized trial. SO - Medical Decision Making. 31(3):412-21, 2011 May-Jun AS - Med Decis Making. 31(3):412-21, 2011 May-Jun NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ma8, 8109073 IO - Med Decis Making PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935602 OI - Source: NLM. NIHMS556265 SB - Index Medicus CP - United States MH - Adaptation, Psychological MH - Adult MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - *Genetic Counseling/px [Psychology] MH - Humans MH - Longitudinal Studies MH - Mammography MH - Mastectomy MH - Middle Aged MH - Multivariate Analysis MH - New York/ep [Epidemiology] MH - Patient Education as Topic MH - Psychometrics MH - Risk Assessment MH - *Stress, Psychological MH - Surveys and Questionnaires MH - Time Factors MH - Young Adult AB - BACKGROUND: Increasingly, women with a strong family history of breast cancer are seeking genetic testing as a starting point to making significant decisions regarding management of their cancer risks. Individuals who are found to be carriers of a BRCA1 or BRCA2 mutation have a substantially elevated risk for breast cancer and are frequently faced with the decision of whether to undergo risk-reducing mastectomy. AB - OBJECTIVE: In order to provide BRCA1/2 carriers with ongoing decision support for breast cancer risk management, a computer-based interactive decision aid was developed and tested against usual care in a randomized controlled trial. AB - DESIGN: . Following genetic counseling, 214 female (aged 21-75 years) BRCA1/2 mutation carriers were randomized to usual care (UC; n = 114) or usual care plus decision aid (DA; n = 100) arms. UC participants received no further intervention; DA participants were sent the CD-ROM-based decision aid to view at home. AB - MAIN OUTCOME MEASURES: The authors measured general distress, cancer-specific distress, and genetic testing-specific distress at 1-, 6-, and 12-month follow-up time points postrandomization. AB - RESULTS: Longitudinal analyses revealed a significant longitudinal impact of the DA on cancer-specific distress (B = 5.67, z = 2.81, P = 0.005), which varied over time (DA group by time; B = -2.19, z = -2.47, P = 0.01), and on genetic testing-specific distress (B = 5.55, z = 2.46, P = 0.01), which also varied over time (DA group by time; B = -2.46, z = -2.51, P = 0.01). Individuals randomized to UC reported significantly decreased distress in the month following randomization, whereas individuals randomized to the DA maintained their postdisclosure distress over the short term. By 12 months, the overall decrease in distress between the 2 groups was similar. AB - CONCLUSION: This report provides new insight into the long-term longitudinal effects of DAs. ES - 1552-681X IL - 0272-989X DI - 0272989X10381283 DO - https://dx.doi.org/10.1177/0272989X10381283 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 20876346 [pubmed] ID - 0272989X10381283 [pii] ID - 10.1177/0272989X10381283 [doi] ID - PMC3935602 [pmc] ID - NIHMS556265 [mid] PP - ppublish GI - No: R01 CA082346 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA1846 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20100927 DP - 2011 May-Jun DC - 20110525 EZ - 2010/09/30 06:00 DA - 2011/09/29 06:00 DT - 2010/09/30 06:00 YR - 2011 ED - 20110927 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20876346 <241. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21620153 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Zenn MR FA - Zenn, Michael R IN - Zenn, Michael R. Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Trent Drive, Durham, NC 27710-3358, USA. Michael.Zenn@duke.edu TI - Fluorescent angiography. SO - Clinics in Plastic Surgery. 38(2):293-300, 2011 Apr AS - Clin Plast Surg. 38(2):293-300, 2011 Apr NJ - Clinics in plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - dhx, 0424767 IO - Clin Plast Surg SB - Index Medicus CP - United States MH - Coloring Agents MH - Female MH - *Fluorescein Angiography MH - Humans MH - Indocyanine Green MH - *Mammaplasty MH - *Surgical Flaps/bs [Blood Supply] AB - Fluorescent angiography is a simple and effective real-time tool for measurement of tissue perfusion both in and out of the operating room. It has multiple uses including: (1) identifying perforating vessels during flap planning; (2) locating primary and secondary angiosomes within a prepared flap; (3) as an aid in decision making for tissue debridement and flap creation; (4) intraoperative evaluation of microanastomoses; (5) postoperative flap monitoring, and (6) documentation of perfusion. The technology is easy to use in the hands of the operating surgeon and is safe for the patient, as it requires no radiation exposure. AB - Copyright © 2011 Elsevier Inc. All rights reserved. RN - 0 (Coloring Agents) RN - IX6J1063HV (Indocyanine Green) ES - 1558-0504 IL - 0094-1298 DI - S0094-1298(11)00018-6 DO - https://dx.doi.org/10.1016/j.cps.2011.03.009 PT - Journal Article ID - 21620153 [pubmed] ID - S0094-1298(11)00018-6 [pii] ID - 10.1016/j.cps.2011.03.009 [doi] PP - ppublish LG - English DP - 2011 Apr DC - 20110530 EZ - 2011/05/31 06:00 DA - 2011/09/16 06:00 DT - 2011/05/31 06:00 YR - 2011 ED - 20110915 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21620153 <242. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21585690 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Harwood R AU - Douglas C AU - Clark D FA - Harwood, Rachael FA - Douglas, Charles FA - Clark, David IN - Harwood, Rachael. Faculty of Medicine, The University of Newcastle, New South Wales, Australia. rachael.c.harwood@studentmail.newcastle.edu.au TI - Decision aids for breast and nodal surgery in patients with early breast cancer: development and a pilot study. SO - Asia-Pacific Journal of Clinical Oncology. 7(2):114-22, 2011 Jun AS - Asia Pac J Clin Oncol. 7(2):114-22, 2011 Jun NJ - Asia-Pacific journal of clinical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101241430 IO - Asia Pac J Clin Oncol SB - Index Medicus CP - Australia MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Lymph Nodes/su [Surgery] MH - Lymphatic Metastasis MH - *Mastectomy MH - *Mastectomy, Segmental MH - *Patient Participation/mt [Methods] MH - Patient Satisfaction MH - Pilot Projects MH - *Sentinel Lymph Node Biopsy AB - AIM: As survival rates for aggressive and conservative breast and lymph node surgery are similar, surgical treatment decisions for patients with early-stage breast cancer should take patient preference into account. Decision aids have been demonstrated to increase patient knowledge and satisfaction with decision making, while decreasing decisional conflict. Hundreds of decision aids exist; however, few address lymph node surgery in any detail, and none acknowledge that there is a choice comparable to that between mastectomy and breast-conserving therapy. AB - METHODS: A systematic process was employed to develop decision aids for mastectomy versus breast-conserving therapy, axillary dissection versus sentinel node biopsy, and options following a positive sentinel node biopsy. The first two of these decision aids were evaluated in a small pilot study. Choice of operation, knowledge and decisional conflict and satisfaction were compared with outcomes in an historical control group. AB - RESULTS: Women reported favorably on the decision aids. The numbers in the pilot group were too small to allow definitive conclusions to be drawn, but suggested a possible reduction in decisional conflict, and possibly increase in decisional satisfaction, knowledge and choice of axillary clearance (rather than sentinel node biopsy) in the intervention group. AB - CONCLUSION: These decision aids could improve decision making for the surgical treatment of early breast cancer. A prospective randomized, control trial is needed to further evaluate the impact of these decision aids, particularly in the case of nodal surgery. AB - Copyright © 2011 Blackwell Publishing Asia Pty Ltd. ES - 1743-7563 IL - 1743-7555 DO - https://dx.doi.org/10.1111/j.1743-7563.2010.01375.x PT - Clinical Trial PT - Journal Article ID - 21585690 [pubmed] ID - 10.1111/j.1743-7563.2010.01375.x [doi] PP - ppublish LG - English EP - 20110124 DP - 2011 Jun DC - 20110518 EZ - 2011/05/19 06:00 DA - 2011/09/10 06:00 DT - 2011/05/19 06:00 YR - 2011 ED - 20110909 RD - 20110518 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21585690 <243. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21029281 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Caldon LJ AU - Collins KA AU - Reed MW AU - Sivell S AU - Austoker J AU - Clements AM AU - Patnick J AU - Elwyn G AU - BresDex Group FA - Caldon, Lisa J M FA - Collins, Karen A FA - Reed, Malcolm W FA - Sivell, Stephanie FA - Austoker, Joan FA - Clements, Alison M FA - Patnick, Julietta FA - Elwyn, Glyn FA - BresDex Group IN - Caldon, Lisa J M. Department of Oncology, University of Sheffield, Sheffield, UK. l.caldon@sheffield.ac.uk IR - Edwards A IR - Evans R IR - Rogers V IR - Day TJ IR - Donald A TI - Clinicians' concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision-making. SO - Health Expectations. 14(2):133-46, 2011 Jun AS - Health Expect. 14(2):133-46, 2011 Jun NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Attitude of Health Personnel MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Systems, Clinical MH - Female MH - Humans MH - Internet MH - Interviews as Topic MH - Male MH - Mastectomy/mt [Methods] MH - *Mastectomy/px [Psychology] MH - *Patient Education as Topic/mt [Methods] MH - Physician-Patient Relations MH - *Physicians/px [Psychology] MH - United Kingdom AB - BACKGROUND: There is interest in interventions that provide support for patients facing challenging decisions, such as the choice between mastectomy and breast conservation surgery for breast cancer. However, it is difficult to implement these interventions. One potential source of resistance is the attitudes of clinicians. AB - OBJECTIVE: To examine specialist breast clinicians' opinions about the provision of decision support interventions (DesIs) for patients. AB - METHODS: As part of the development of a web-based DesI (BresDex), semi-structured interviews were conducted with specialist clinicians [breast surgeons, breast care nurses (BCNs) and oncologists] from four breast units in a UK region, and speciality national opinion leaders. Interviews were recorded, transcribed and analysed using the Framework approach. AB - RESULTS: A majority of the 24 clinicians interviewed did not have a working knowledge of DesIs and were ambivalent or sceptical. Many expressed conflicting opinions: they noted the potential benefits, but at the same time expressed reservations about information overlap, overload and about content that they considered inappropriate. Many wanted access to DesIs to be always under clinical supervision. In particular, they were uncertain as regards how DeSIs could be tailored to individual patients' needs and also accommodate clinical practice variation. BCNs were particularly concerned that DesIs might induce patient anxiety and replace their role. AB - CONCLUSIONS: The concept of providing interventions to support patients in decision-making tasks generated concern, defensiveness and scepticism. These attitudes will be a significant barrier. Implementation efforts will need to recognize and address these issues if these interventions are to become embedded in clinical practice. AB - Copyright © 2010 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00633.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21029281 [pubmed] ID - 10.1111/j.1369-7625.2010.00633.x [doi] ID - PMC5060572 [pmc] PP - ppublish GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English EP - 20101028 DP - 2011 Jun DC - 20110519 EZ - 2010/10/30 06:00 DA - 2011/09/08 06:00 DT - 2010/10/30 06:00 YR - 2011 ED - 20110907 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=21029281 <244. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21029281 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Caldon LJ AU - Collins KA AU - Reed MW AU - Sivell S AU - Austoker J AU - Clements AM AU - Patnick J AU - Elwyn G AU - BresDex Group FA - Caldon, Lisa J M FA - Collins, Karen A FA - Reed, Malcolm W FA - Sivell, Stephanie FA - Austoker, Joan FA - Clements, Alison M FA - Patnick, Julietta FA - Elwyn, Glyn FA - BresDex Group IN - Caldon, Lisa J M. Department of Oncology, University of Sheffield, Sheffield, UK. l.caldon@sheffield.ac.uk IR - Edwards A IR - Evans R IR - Rogers V IR - Day TJ IR - Donald A TI - Clinicians' concerns about decision support interventions for patients facing breast cancer surgery options: understanding the challenge of implementing shared decision-making. SO - Health Expectations. 14(2):133-46, 2011 Jun AS - Health Expect. 14(2):133-46, 2011 Jun NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Attitude of Health Personnel MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Systems, Clinical MH - Female MH - Humans MH - Internet MH - Interviews as Topic MH - Male MH - Mastectomy/mt [Methods] MH - *Mastectomy/px [Psychology] MH - *Patient Education as Topic/mt [Methods] MH - Physician-Patient Relations MH - *Physicians/px [Psychology] MH - United Kingdom AB - BACKGROUND: There is interest in interventions that provide support for patients facing challenging decisions, such as the choice between mastectomy and breast conservation surgery for breast cancer. However, it is difficult to implement these interventions. One potential source of resistance is the attitudes of clinicians. AB - OBJECTIVE: To examine specialist breast clinicians' opinions about the provision of decision support interventions (DesIs) for patients. AB - METHODS: As part of the development of a web-based DesI (BresDex), semi-structured interviews were conducted with specialist clinicians [breast surgeons, breast care nurses (BCNs) and oncologists] from four breast units in a UK region, and speciality national opinion leaders. Interviews were recorded, transcribed and analysed using the Framework approach. AB - RESULTS: A majority of the 24 clinicians interviewed did not have a working knowledge of DesIs and were ambivalent or sceptical. Many expressed conflicting opinions: they noted the potential benefits, but at the same time expressed reservations about information overlap, overload and about content that they considered inappropriate. Many wanted access to DesIs to be always under clinical supervision. In particular, they were uncertain as regards how DeSIs could be tailored to individual patients' needs and also accommodate clinical practice variation. BCNs were particularly concerned that DesIs might induce patient anxiety and replace their role. AB - CONCLUSIONS: The concept of providing interventions to support patients in decision-making tasks generated concern, defensiveness and scepticism. These attitudes will be a significant barrier. Implementation efforts will need to recognize and address these issues if these interventions are to become embedded in clinical practice. AB - Copyright © 2010 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00633.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21029281 [pubmed] ID - 10.1111/j.1369-7625.2010.00633.x [doi] PP - ppublish GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English EP - 20101028 DP - 2011 Jun DC - 20110519 EZ - 2010/10/30 06:00 DA - 2011/09/08 06:00 DT - 2010/10/30 06:00 YR - 2011 ED - 20110907 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21029281 <245. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21369831 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Culver JO AU - MacDonald DJ AU - Thornton AA AU - Sand SR AU - Grant M AU - Bowen DJ AU - Burke H AU - Garcia N AU - Metcalfe KA AU - Weitzel JN FA - Culver, Julie O FA - MacDonald, Deborah J FA - Thornton, Andrea A FA - Sand, Sharon R FA - Grant, Marcia FA - Bowen, Deborah J FA - Burke, Harry FA - Garcia, Nellie FA - Metcalfe, Kelly A FA - Weitzel, Jeffrey N IN - Culver, Julie O. Division of Clinical Cancer Genetics, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA 91010-3000, USA. jculver@coh.org TI - Development and evaluation of a decision aid for BRCA carriers with breast cancer.[Erratum appears in J Genet Couns. 2013 Jun;22(3):406] SO - Journal of Genetic Counseling. 20(3):294-307, 2011 Jun AS - J Genet Couns. 20(3):294-307, 2011 Jun NJ - Journal of genetic counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9206865 IO - J Genet Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531556 OI - Source: NLM. NIHMS366519 SB - Index Medicus CP - United States MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Focus Groups MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Counseling MH - *Heterozygote Detection MH - Humans MH - Mastectomy MH - Ovariectomy MH - Risk Reduction Behavior AB - BRCA+ breast cancer patients face high risk for a second breast cancer and ovarian cancer. Helping these women decide among risk-reducing options requires effectively conveying complex, emotionally-laden, information. To support their decision-making needs, we developed a web-based decision aid (DA) as an adjunct to genetic counseling. Phase 1 used focus groups to determine decision-making needs. These findings and the Ottawa Decision Support Framework guided the DA development. Phase 2 involved nine focus groups of four stakeholder types (BRCA+ breast cancer patients, breast cancer advocates, and genetics and oncology professionals) to evaluate the DA's decision-making utility, information content, visual display, and implementation. Overall, feedback was very favorable about the DA, especially a values and preferences ranking-exercise and an output page displaying personalized responses. Stakeholders were divided as to whether the DA should be offered at-home versus only in a clinical setting. This well-received DA will be further tested to determine accessibility and effectiveness. ES - 1573-3599 IL - 1059-7700 DO - https://dx.doi.org/10.1007/s10897-011-9350-4 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 21369831 [pubmed] ID - 10.1007/s10897-011-9350-4 [doi] ID - PMC3531556 [pmc] ID - NIHMS366519 [mid] PP - ppublish PH - 2010/09/09 [received] PH - 2011/01/06 [accepted] GI - No: P30CA033572 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA033572-26 Organization: (CA) *NCI NIH HHS* Country: United States No: M01 RR00043 Organization: (RR) *NCRR NIH HHS* Country: United States No: M01 RR000043 Organization: (RR) *NCRR NIH HHS* Country: United States No: P30 CA033572 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20110303 DP - 2011 Jun DC - 20110510 EZ - 2011/03/04 06:00 DA - 2011/08/24 06:00 DT - 2011/03/04 06:00 YR - 2011 ED - 20110823 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21369831 <246. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21559024 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Caldon LJ AU - Collins KA AU - Wilde DJ AU - Ahmedzai SH AU - Noble TW AU - Stotter A AU - Sibbering DM AU - Holt S AU - Reed MW FA - Caldon, L J M FA - Collins, K A FA - Wilde, D J FA - Ahmedzai, S H FA - Noble, T W FA - Stotter, A FA - Sibbering, D M FA - Holt, S FA - Reed, M W R IN - Caldon, L J M. Department of Oncology, University of Sheffield, School of Medicine and Biomedical Sciences, Beech Hill Road, Sheffield S10 2RX, UK. l.caldon@sheffield.ac.uk TI - Why do hospital mastectomy rates vary? Differences in the decision-making experiences of women with breast cancer. SO - British Journal of Cancer. 104(10):1551-7, 2011 May 10 AS - Br J Cancer. 104(10):1551-7, 2011 May 10 NJ - British journal of cancer PI - Journal available in: Print PI - Citation processed from: Internet JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101915 SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Hospitals MH - Humans MH - *Mastectomy/ut [Utilization] MH - Middle Aged MH - Patient Participation MH - Patient Satisfaction MH - Referral and Consultation AB - BACKGROUND: Hospital mastectomy rates vary. This study explores the relationship between mastectomy rates and breast cancer patients' consultation and decision-making experiences with specialist clinicians. AB - METHODS: Qualitative semi-structured interviews were conducted with 65 patients from three purposively selected breast units from a single UK region. Patients provided with a choice of breast cancer surgery (breast conservation therapy (BCT) or mastectomy) were purposively recruited from high, medium and low case-mix-adjusted mastectomy rate units. AB - RESULTS: Low mastectomy rate unit patients' consultation and decision-making experiences were markedly different to those of the medium and high mastectomy rate breast units. Treatment variation was associated with patients' perception of the most reassuring and least disruptive treatment; the content and style of information provision (equipoise or directed); level of patient participation in decision making; the time and process of decision making and patient autonomy in decision making. The provision of more comprehensive less directive information and greater autonomy, time and support of independent decision making were associated with a lower uptake of BCT. AB - CONCLUSION: Variation in hospital mastectomy rates was associated with differences in the consultation and decision-making experiences of breast cancer patients. Higher mastectomy rates were associated with the facilitation of more informed autonomous patient decision making. ES - 1532-1827 IL - 0007-0920 DI - bjc2011141 DO - https://dx.doi.org/10.1038/bjc.2011.141 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 21559024 [pubmed] ID - bjc2011141 [pii] ID - 10.1038/bjc.2011.141 [doi] ID - PMC3101915 [pmc] PP - ppublish GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English DP - 2011 May 10 DC - 20110511 EZ - 2011/05/12 06:00 DA - 2011/08/02 06:00 DT - 2011/05/12 06:00 YR - 2011 ED - 20110801 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21559024 <247. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20980697 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Howard AF AU - Balneaves LG AU - Bottorff JL AU - Rodney P FA - Howard, A Fuchsia FA - Balneaves, Lynda G FA - Bottorff, Joan L FA - Rodney, Patricia IN - Howard, A Fuchsia. School of Population and Public Health, University of British Columbia, Vancouver, Canada. fuchsiahoward@mac.com TI - Preserving the self: the process of decision making about hereditary breast cancer and ovarian cancer risk reduction. SO - Qualitative Health Research. 21(4):502-19, 2011 Apr AS - Qual Health Res. 21(4):502-19, 2011 Apr NJ - Qualitative health research PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9202144, bqc IO - Qual Health Res PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880460 OI - Source: NLM. CAMS2745 SB - Health Technology Assessment Journals CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/ep [Epidemiology] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Early Detection of Cancer MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Testing MH - Humans MH - Interview, Psychological MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Mutation MH - *Neoplastic Syndromes, Hereditary/ep [Epidemiology] MH - Ovarian Neoplasms/ep [Epidemiology] MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/su [Surgery] MH - Ovariectomy MH - Qualitative Research MH - Risk Reduction Behavior MH - Women's Health AB - Women who carry BRCA1 or BRCA2 (BRCA1/2) gene mutations have up to an 88% lifetime risk of breast cancer and up to a 65% lifetime risk of ovarian cancer. Strategies to address these risks include cancer screening and risk-reducing surgery (i.e., mastectomy and salpingo-oophorectomy). We conducted a grounded theory study with 22 BRCA1/2 mutation-carrier women to understand how women make decisions about these risk-reducing strategies. Preserving the self was the overarching decision-making process evident in the participants' descriptions. This process was shaped by contextual conditions including the characteristics of health services, the nature of hereditary breast and ovarian cancer risk-reduction decisions, gendered roles, and the women's perceived proximity to cancer. The women engaged in five decision-making styles, and these were characterized by the use of specific decision-making approaches. These findings provide theoretical insights that could inform the provision of decisional support to BRCA1/2 carriers. IS - 1049-7323 IL - 1049-7323 DI - 1049732310387798 DO - https://dx.doi.org/10.1177/1049732310387798 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20980697 [pubmed] ID - 1049732310387798 [pii] ID - 10.1177/1049732310387798 [doi] ID - PMC4880460 [pmc] ID - CAMS2745 [mid] PP - ppublish GI - No: 80474-1 Organization: *Canadian Institutes of Health Research* Country: Canada Organization: *Canadian Institutes of Health Research* Country: Canada LG - English EP - 20101027 DP - 2011 Apr DC - 20110323 EZ - 2010/10/29 06:00 DA - 2011/07/29 06:00 DT - 2010/10/29 06:00 YR - 2011 ED - 20110728 RD - 20161216 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=20980697 <248. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20980697 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Howard AF AU - Balneaves LG AU - Bottorff JL AU - Rodney P FA - Howard, A Fuchsia FA - Balneaves, Lynda G FA - Bottorff, Joan L FA - Rodney, Patricia IN - Howard, A Fuchsia. School of Population and Public Health, University of British Columbia, Vancouver, Canada. fuchsiahoward@mac.com TI - Preserving the self: the process of decision making about hereditary breast cancer and ovarian cancer risk reduction. SO - Qualitative Health Research. 21(4):502-19, 2011 Apr AS - Qual Health Res. 21(4):502-19, 2011 Apr NJ - Qualitative health research PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9202144, bqc IO - Qual Health Res PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4880460 OI - Source: NLM. CAMS2745 SB - Health Technology Assessment Journals CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/ep [Epidemiology] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Early Detection of Cancer MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Testing MH - Humans MH - Interview, Psychological MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Mutation MH - *Neoplastic Syndromes, Hereditary/ep [Epidemiology] MH - Ovarian Neoplasms/ep [Epidemiology] MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/su [Surgery] MH - Ovariectomy MH - Qualitative Research MH - Risk Reduction Behavior MH - Women's Health AB - Women who carry BRCA1 or BRCA2 (BRCA1/2) gene mutations have up to an 88% lifetime risk of breast cancer and up to a 65% lifetime risk of ovarian cancer. Strategies to address these risks include cancer screening and risk-reducing surgery (i.e., mastectomy and salpingo-oophorectomy). We conducted a grounded theory study with 22 BRCA1/2 mutation-carrier women to understand how women make decisions about these risk-reducing strategies. Preserving the self was the overarching decision-making process evident in the participants' descriptions. This process was shaped by contextual conditions including the characteristics of health services, the nature of hereditary breast and ovarian cancer risk-reduction decisions, gendered roles, and the women's perceived proximity to cancer. The women engaged in five decision-making styles, and these were characterized by the use of specific decision-making approaches. These findings provide theoretical insights that could inform the provision of decisional support to BRCA1/2 carriers. IS - 1049-7323 IL - 1049-7323 DI - 1049732310387798 DO - https://dx.doi.org/10.1177/1049732310387798 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20980697 [pubmed] ID - 1049732310387798 [pii] ID - 10.1177/1049732310387798 [doi] ID - PMC4880460 [pmc] ID - CAMS2745 [mid] PP - ppublish GI - Organization: *Canadian Institutes of Health Research* Country: Canada LG - English EP - 20101027 DP - 2011 Apr DC - 20110323 EZ - 2010/10/29 06:00 DA - 2011/07/29 06:00 DT - 2010/10/29 06:00 YR - 2011 ED - 20110728 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20980697 <249. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21675615 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Subhas G AU - Shah AJ AU - Gupta A AU - Cook J AU - Dubay L AU - Silapaswan S AU - Kolachalam R AU - Kestenberg W AU - Ferguson L AU - Jacobs MJ AU - Goriel Y AU - Mittal VK FA - Subhas, Gokulakkrishna FA - Shah, Asha J FA - Gupta, Aditya FA - Cook, Jonathan FA - Dubay, Linda FA - Silapaswan, Sumet FA - Kolachalam, Ramachandra FA - Kestenberg, William FA - Ferguson, Lorenzo FA - Jacobs, Michael J FA - Goriel, Yousif FA - Mittal, Vijay K IN - Subhas, Gokulakkrishna. Department of Surgery, Providence Hospital and Medical Centers, Southfield, Michigan 48075, USA. TI - Review of third and fourth re-excision for narrow or positive margins of invasive and intraductal carcinoma. SO - International Surgery. 96(1):18-20, 2011 Jan-Mar AS - Int Surg. 96(1):18-20, 2011 Jan-Mar NJ - International surgery PI - Journal available in: Print PI - Citation processed from: Print JC - gup, 0043524 IO - Int Surg SB - Index Medicus CP - Italy MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma in Situ/pa [Pathology] MH - *Carcinoma in Situ/su [Surgery] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - Neoplasm Invasiveness MH - Neoplasm, Residual/pa [Pathology] MH - *Neoplasm, Residual/su [Surgery] MH - *Reoperation/sn [Statistics & Numerical Data] MH - Retrospective Studies AB - The trend in breast surgery has shifted toward breast conservation. We reviewed our third and fourth breast re-excision cases, with an analysis of various factors used in making this decision. A retrospective analysis identified 585 patients who underwent re-excision surgery for positive or close margins of invasive carcinoma or ductal carcinoma in situ (DCIS). Of these patients 75 (13%) and 17 (3%) underwent third and fourth re-excisions, respectively. The indication for a third re-excision was the presence of positive and/or close (< or = 1 mm) margins for invasive carcinoma or DCIS in 72/75 patients. A third re-excision was done 31 days (range 8-123 days) after the second re-excision. Re-excision of margins was done in 45 (60%) patients, whereas 30 (40%) patients underwent mastectomy. Residual tumor mandated a fourth re-excision in 17 patients, which was done 45 days (range 14-87 days) after the third surgery. Re-excision of margins was done in 6 patients, whereas 11 patients underwent mastectomy. Involved or close margins with DCIS were the most common indication for re-excision, accounting for 61/75 (82%) of third and 16/17 (94%) of fourth re-excisions. Histopathology revealed that 28/75 (37%) of third and 7/17 (41%) of fourth re-excision patients had no residual tumor. In conclusion, the majority of re-excisions was done for margins < 1 mm. Lower rates of re-excision were noted in well-differentiated invasive carcinomas. A close or involved DCIS margin was more likely to lead to a third and even a fourth re-excision. The absence of residual tumors in 40% of patients undergoing third and fourth re-excisions calls for a review of margin guidelines for breast re-excision. IS - 0020-8868 IL - 0020-8868 PT - Journal Article ID - 21675615 [pubmed] PP - ppublish LG - English DP - 2011 Jan-Mar DC - 20110616 EZ - 2011/06/17 06:00 DA - 2011/07/27 06:00 DT - 2011/06/17 06:00 YR - 2011 ED - 20110726 RD - 20110616 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21675615 <250. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21320319 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Oostendorp LJ AU - Ottevanger PB AU - van der Graaf WT AU - Stalmeier PF FA - Oostendorp, Linda J M FA - Ottevanger, Petronella B FA - van der Graaf, Winette T A FA - Stalmeier, Peep F M IN - Oostendorp, Linda J M. Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands. l.oostendorp@ebh.umcn.nl TI - Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol. SO - BMC Medical Informatics & Decision Making. 11:9, 2011 Feb 14 AS - BMC Med Inf Decis Mak. 11:9, 2011 Feb 14 NJ - BMC medical informatics and decision making PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088682 IO - BMC Med Inform Decis Mak PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045872 SB - Index Medicus CP - England MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Decision Making MH - *Decision Support Techniques MH - Humans MH - *Neoplasms/dt [Drug Therapy] MH - Patient Education as Topic MH - Patient Participation MH - Socioeconomic Factors MH - Surveys and Questionnaires AB - BACKGROUND: There is a continuing debate on the desirability of informing patients with cancer and thereby involving them in treatment decisions. On the one hand, information uptake may be hampered, and additional stress could be inflicted by involving these patients. On the other hand, even patients with advanced cancer desire information on risks and prognosis. To settle the debate, a decision aid will be developed and presented to patients with advanced disease at the point of decision making. The aid is used to assess the amount of information desired. Factors related to information desire are explored, as well as the ability of the medical oncologist to judge the patient's information desire. The effects of the information on patient well-being are assessed by comparing the decision aid group with a usual care group. AB - METHODS/DESIGN: This study is a randomized controlled trial of patients with advanced colorectal, breast, or ovarian cancer who have started treatment with first-line palliative chemotherapy. The trial will consist of 100 patients in the decision aid group and 70 patients in the usual care group. To collect complete data of 170 patients, 246 patients will be approached for the study. Patients will complete a baseline questionnaire on sociodemographic data, well-being measures, and psychological measures, believed to predict information desire. The medical oncologist will judge the patient's information desire. After disease progression is diagnosed, the medical oncologist offers the choice between second-line palliative chemotherapy plus best supportive care (BSC) and BSC alone. Randomization will take place to determine whether patients will receive usual care (n = 70) or usual care and the decision aid (n = 100). The aid offers information about the potential risks and benefits of both treatment options, in terms of adverse events, tumour response, and survival. Patients decide for each item whether they desire the information or not. Two follow-up questionnaires will evaluate the effect of the decision aid. AB - DISCUSSION: This study attempts to settle the debate on the desirability of informing patients with cancer. In contrast to several earlier studies, we will actually deliver information on treatment options to patients at the point of decision making. RN - 0 (Antineoplastic Agents) ES - 1472-6947 IL - 1472-6947 DI - 1472-6947-11-9 DO - https://dx.doi.org/10.1186/1472-6947-11-9 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 21320319 [pubmed] ID - 1472-6947-11-9 [pii] ID - 10.1186/1472-6947-11-9 [doi] ID - PMC3045872 [pmc] PP - epublish PH - 2010/12/21 [received] PH - 2011/02/14 [accepted] LG - English EP - 20110214 DP - 2011 Feb 14 DC - 20110301 EZ - 2011/02/16 06:00 DA - 2011/07/21 06:00 DT - 2011/02/16 06:00 YR - 2011 ED - 20110720 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21320319 <251. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20574492 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Heller L AU - Miller MJ FA - Heller, Lior FA - Miller, Michael J IN - Heller, Lior. Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX. TI - Patient education and decision making in breast reconstruction. SO - Seminars in Plastic Surgery. 18(2):139-47, 2004 May AS - Semin. plast. surg.. 18(2):139-47, 2004 May NJ - Seminars in plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 101131275 IO - Semin Plast Surg PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884726 CP - United States KW - Breast reconstruction; patient decision-making aid; patient education AB - A well-informed patient who actively participates in decision making is an essential ingredient of successful outcome in breast reconstruction. The plastic surgeon must be prepared to answer all the patient's questions in a clear and concise manner. All women considering breast reconstruction need to understand the rationale for reconstruction and have realistic expectations for what can be accomplished. They need to consider the optimal timing and the advantages and disadvantages of each technical option. The patient education process can be enhanced by the thoughtful inclusion of growing set of educational tools and decision aids. This article reviews each of these issues and suggests a way to organize and present the essential material in a way that has proven effective with women in our practice. ES - 1536-0067 IL - 1535-2188 DO - https://dx.doi.org/10.1055/s-2004-829048 PT - Journal Article ID - 20574492 [pubmed] ID - 10.1055/s-2004-829048 [doi] ID - PMC2884726 [pmc] PP - ppublish LG - English DP - 2004 May DC - 20100624 EZ - 2010/06/25 06:00 DA - 2004/05/01 00:01 DT - 2004/05/01 00:00 YR - 2004 ED - 20110714 RD - 20130529 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=20574492 <252. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21444865 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Peate M AU - Meiser B AU - Friedlander M AU - Zorbas H AU - Rovelli S AU - Sansom-Daly U AU - Sangster J AU - Hadzi-Pavlovic D AU - Hickey M FA - Peate, Michelle FA - Meiser, Bettina FA - Friedlander, Michael FA - Zorbas, Helen FA - Rovelli, Susan FA - Sansom-Daly, Ursula FA - Sangster, Jennifer FA - Hadzi-Pavlovic, Dusan FA - Hickey, Martha IN - Peate, Michelle. Prince of Wales Clinical School, University of New South Wales, Randwick, NSW, Australia. m.peate@unswalumni.com TI - It's now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer--an Australian fertility decision aid collaborative group study. SO - Journal of Clinical Oncology. 29(13):1670-7, 2011 May 01 AS - J Clin Oncol. 29(13):1670-7, 2011 May 01 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Australia MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/px [Psychology] MH - Conflict (Psychology) MH - *Decision Making MH - Female MH - *Fertility MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Patient Participation AB - PURPOSE: For many young women with early breast cancer, fertility is a priority. Interventions to retain fertility options generally need to be accessed before chemotherapy, but many women do not receive information regarding these options in a timely fashion. Knowledge about fertility and decisional conflict has not previously been measured in young patients with breast cancer considering future pregnancies. AB - METHODS: One hundred eleven young women with early breast cancer who had not yet completed their families were recruited around the time of diagnosis. Knowledge regarding fertility-related information, decisional conflict, and preferences regarding fertility information and decision making was measured. AB - RESULTS: From a potential fertility-related knowledge score of 10, the mean was 5.2 (standard deviation = 2.3; range, 0 to 10). Decreased knowledge was associated with increased decisional conflict about pursuing fertility preserving interventions (odds ratio [OR] = 0.57; 95% CI, 0.44 to 0.73; P < .001). Thirty-one percent of women reported that they would consider undertaking in vitro fertilization (IVF) as a method to conserve their fertility, whereas 38% were uncertain. Consideration of IVF was not related to whether subjects were in a committed relationship (OR = 1.20; P = .716) or a definite desire for more children (OR = 1.54; P = .513). AB - CONCLUSION: Around diagnosis, many young patients with breast cancer have low levels of knowledge about fertility issues. Further, low knowledge is associated with increased decisional conflict, which is likely to undermine the quality of decision making. These findings suggest that targeted and timely fertility information may reduce decisional conflict and increase informed choice. Neither relationship status nor firm plans regarding future children reliably predict desire to pursue fertility preservation. ES - 1527-7755 IL - 0732-183X DI - JCO.2010.31.2462 DO - https://dx.doi.org/10.1200/JCO.2010.31.2462 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21444865 [pubmed] ID - JCO.2010.31.2462 [pii] ID - 10.1200/JCO.2010.31.2462 [doi] PP - ppublish LG - English EP - 20110328 DP - 2011 May 01 DC - 20110502 EZ - 2011/03/30 06:00 DA - 2011/06/29 06:00 DT - 2011/03/30 06:00 YR - 2011 ED - 20110628 RD - 20110502 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21444865 <253. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21299290 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Vodermaier A AU - Caspari C AU - Wang L AU - Koehm J AU - Ditsch N AU - Untch M FA - Vodermaier, Andrea FA - Caspari, Cornelia FA - Wang, Lisa FA - Koehm, Janna FA - Ditsch, Nina FA - Untch, Michael IN - Vodermaier, Andrea. Department of Obstetrics and Gynaecology-Campus Grosshadern, University of Munich. avoderma@psych.ubc.ca TI - How and for whom are decision aids effective? Long-term psychological outcome of a randomized controlled trial in women with newly diagnosed breast cancer. SO - Health Psychology. 30(1):12-9, 2011 Jan AS - Health Psychol. 30(1):12-9, 2011 Jan NJ - Health psychology : official journal of the Division of Health Psychology, American Psychological Association PI - Journal available in: Print PI - Citation processed from: Internet JC - ejl, 8211523 IO - Health Psychol SB - Index Medicus CP - United States MH - *Adaptation, Psychological MH - Aged MH - *Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Conflict (Psychology) MH - *Decision Making MH - Female MH - Humans MH - Internal-External Control MH - Linear Models MH - Middle Aged MH - *Patient Education as Topic MH - Surveys and Questionnaires AB - OBJECTIVE: The current study evaluates the long-term psychological impact of a decision aid intervention for surgical and systemic treatment in women with newly diagnosed breast cancer from a previous reported randomized, controlled trial (Vodermaier et al., 2009). AB - METHODS: Patients (n = 111) were randomized into usual care, or a 20-min decision aid intervention plus an information brochure prior to consultation planning with the senior physician. The retention rate at 1 year was 88%. AB - RESULTS: Linear mixed model analyses demonstrated that the intervention group experienced less decisional conflict (p = .047; d = .19), which was driven by perceptions of a more effective choice (p = .029; d = .20) over time. Subgroup analyses revealed that patients in the intervention group who participated in chemotherapy decision making showed better long-term body image outcomes (p = .009; d = .44), which were mediated by reduced depressive coping (p = .049). No effects emerged for anxiety and depressive symptoms, or for quality of life. Internal health locus of control moderated group effects on 'uncertainty with the decision' (p = .003). AB - CONCLUSIONS: The study results provide novel evidence on the role of individual differences and the mechanisms behind decision aid effectiveness, and demonstrate the long-term impact of decision aid interventions on some indices of well-being. AB - Copyright (PsycINFO Database Record (c) 2010 APA, all rights reserved). ES - 1930-7810 IL - 0278-6133 DI - 2011-02060-002 DO - https://dx.doi.org/10.1037/a0021648 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 21299290 [pubmed] ID - 2011-02060-002 [pii] ID - 10.1037/a0021648 [doi] PP - ppublish LG - English DP - 2011 Jan DC - 20110208 EZ - 2011/02/09 06:00 DA - 2011/06/22 06:00 DT - 2011/02/09 06:00 YR - 2011 ED - 20110621 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21299290 <254. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20629766 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Brown RF AU - Butow PN AU - Juraskova I AU - Ribi K AU - Gerber D AU - Bernhard J AU - Tattersall MH FA - Brown, Richard F FA - Butow, Phyllis N FA - Juraskova, Ilona FA - Ribi, Karin FA - Gerber, Daniela FA - Bernhard, Jurg FA - Tattersall, Martin H N IN - Brown, Richard F. Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. TI - Sharing decisions in breast cancer care: Development of the Decision Analysis System for Oncology (DAS-O) to identify shared decision making during treatment consultations. SO - Health Expectations. 14(1):29-37, 2011 Mar AS - Health Expect. 14(1):29-37, 2011 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/th [Therapy] MH - Communication MH - *Decision Making MH - Female MH - Humans MH - Observer Variation MH - *Patient Participation/mt [Methods] MH - Physician-Patient Relations MH - Reproducibility of Results AB - BACKGROUND: Shared Decision Making (SDM) is widely accepted as the preferred method for reaching treatment decisions in the oncology setting including those about clinical trial participation: however, there is some disagreement between researchers over the components of SDM. Specific standardized coding systems are needed to help overcome this difficulty. AB - OBJECTIVE: The first objective was to describe the development of an oncology specific SDM coding system, the DAS-O. The second objective was to provide reliability and validity data supporting the DAS-O. AB - SETTING AND PARTICIPANTS: Consultation data were available from tertiary cancer center out patient oncology clinics in: Australia, New Zealand (ANZ), Switzerland, Germany and Austria (SGA). Patients were women with a confirmed diagnosis of early stage breast cancer. Reliability data were from 18 randomly selected coded transcripts drawn from ANZ and SGA. Concurrent validity data are from 55 (ANZ) consultations. AB - MEASUREMENT: Inter and Intra rater reliability data was evaluated using Kappa correlation statistics and correlation coefficients. Correlation coefficients were used to assess concurrent validity between the DAS-O and two other SDM coding systems, OPTION and DSAT. AB - RESULTS: Inter and Intra rater reliability for the system were high with average Kappas of 0.58 and 0.65 respectively. Correlation coefficients between DAS-O and OPTION was 0.73 and >0.5 for DSAT. AB - CONCLUSIONS: We have developed a reliable and valid coding system for identifying and rating the quality of SDM in breast cancer consultations. AB - Copyright © 2010 The Authors. Health Expectations © 2010 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DI - HEX613 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00613.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20629766 [pubmed] ID - HEX613 [pii] ID - 10.1111/j.1369-7625.2010.00613.x [doi] ID - PMC5060562 [pmc] PP - ppublish LG - English DP - 2011 Mar DC - 20110221 EZ - 2010/07/16 06:00 DA - 2011/06/10 06:00 DT - 2010/07/16 06:00 YR - 2011 ED - 20110609 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=20629766 <255. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20629766 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Brown RF AU - Butow PN AU - Juraskova I AU - Ribi K AU - Gerber D AU - Bernhard J AU - Tattersall MH FA - Brown, Richard F FA - Butow, Phyllis N FA - Juraskova, Ilona FA - Ribi, Karin FA - Gerber, Daniela FA - Bernhard, Jurg FA - Tattersall, Martin H N IN - Brown, Richard F. Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. TI - Sharing decisions in breast cancer care: Development of the Decision Analysis System for Oncology (DAS-O) to identify shared decision making during treatment consultations. SO - Health Expectations. 14(1):29-37, 2011 Mar AS - Health Expect. 14(1):29-37, 2011 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/th [Therapy] MH - Communication MH - *Decision Making MH - Female MH - Humans MH - Observer Variation MH - *Patient Participation/mt [Methods] MH - Physician-Patient Relations MH - Reproducibility of Results AB - BACKGROUND: Shared Decision Making (SDM) is widely accepted as the preferred method for reaching treatment decisions in the oncology setting including those about clinical trial participation: however, there is some disagreement between researchers over the components of SDM. Specific standardized coding systems are needed to help overcome this difficulty. AB - OBJECTIVE: The first objective was to describe the development of an oncology specific SDM coding system, the DAS-O. The second objective was to provide reliability and validity data supporting the DAS-O. AB - SETTING AND PARTICIPANTS: Consultation data were available from tertiary cancer center out patient oncology clinics in: Australia, New Zealand (ANZ), Switzerland, Germany and Austria (SGA). Patients were women with a confirmed diagnosis of early stage breast cancer. Reliability data were from 18 randomly selected coded transcripts drawn from ANZ and SGA. Concurrent validity data are from 55 (ANZ) consultations. AB - MEASUREMENT: Inter and Intra rater reliability data was evaluated using Kappa correlation statistics and correlation coefficients. Correlation coefficients were used to assess concurrent validity between the DAS-O and two other SDM coding systems, OPTION and DSAT. AB - RESULTS: Inter and Intra rater reliability for the system were high with average Kappas of 0.58 and 0.65 respectively. Correlation coefficients between DAS-O and OPTION was 0.73 and >0.5 for DSAT. AB - CONCLUSIONS: We have developed a reliable and valid coding system for identifying and rating the quality of SDM in breast cancer consultations. AB - Copyright © 2010 The Authors. Health Expectations © 2010 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DI - HEX613 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00613.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20629766 [pubmed] ID - HEX613 [pii] ID - 10.1111/j.1369-7625.2010.00613.x [doi] PP - ppublish LG - English DP - 2011 Mar DC - 20110221 EZ - 2010/07/16 06:00 DA - 2011/06/10 06:00 DT - 2010/07/16 06:00 YR - 2011 ED - 20110609 RD - 20110221 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20629766 <256. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20637714 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Harcourt D AU - Russell C AU - Hughes J AU - White P AU - Nduka C AU - Smith R FA - Harcourt, D FA - Russell, C FA - Hughes, J FA - White, P FA - Nduka, C FA - Smith, R IN - Harcourt, D. Dept of Breast Surgery, Queen Victoria Hospital NHS Foundation Trust, Holtye Road, E Grinstead, W Sussex RH19 3DZ, UK. Diana2.Harcourt@uwe.ac.uk TI - Patient satisfaction in relation to nipple reconstruction: the importance of information provision. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 64(4):494-9, 2011 Apr AS - J Plast Reconstr Aesthet Surg. 64(4):494-9, 2011 Apr NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Anxiety/di [Diagnosis] MH - Body Image MH - Breast Neoplasms/su [Surgery] MH - Decision Making MH - Depression/di [Diagnosis] MH - Esthetics MH - Female MH - Humans MH - *Mammaplasty MH - Middle Aged MH - *Nipples/su [Surgery] MH - Patient Education as Topic MH - *Patient Satisfaction MH - Regression Analysis MH - Surveys and Questionnaires AB - 127 women who had previously undergone surgical nipple reconstruction completed self-report questionnaires to assess body image, anxiety, depression, information preference, and satisfaction with surgical outcome, information provision, and the decision to undergo the procedure. Whilst most women were satisfied with the outcome of surgery and of their decision to have nipple reconstruction, this study highlights the importance of information provision that meets patients' needs at the time of decision-making, in particular information about likely nipple sensation after surgery. AB - Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(10)00348-7 DO - https://dx.doi.org/10.1016/j.bjps.2010.06.008 PT - Journal Article ID - 20637714 [pubmed] ID - S1748-6815(10)00348-7 [pii] ID - 10.1016/j.bjps.2010.06.008 [doi] PP - ppublish PH - 2010/02/16 [received] PH - 2010/05/28 [revised] PH - 2010/06/09 [accepted] LG - English EP - 20100716 DP - 2011 Apr DC - 20110314 EZ - 2010/07/20 06:00 DA - 2011/06/01 06:00 DT - 2010/07/20 06:00 YR - 2011 ED - 20110531 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20637714 <257. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21323821 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Feibelmann S AU - Yang TS AU - Uzogara EE AU - Sepucha K FA - Feibelmann, Sandra FA - Yang, Theresa S FA - Uzogara, Ekeoma E FA - Sepucha, Karen IN - Feibelmann, Sandra. Health Decision Research Unit, Massachusetts General Hospital (MGH), Boston, MA 02114, USA. TI - What does it take to have sustained use of decision aids? A programme evaluation for the Breast Cancer Initiative. SO - Health Expectations. 14 Suppl 1:85-95, 2011 Mar AS - Health Expect. 14 Suppl 1:85-95, 2011 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/th [Therapy] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Information Dissemination MH - *Patient Education as Topic/mt [Methods] AB - BACKGROUND: The Breast Cancer Initiative (BCI) was started in 2002 to disseminate breast cancer decision aids (PtDAs) to providers. AB - METHODS: We analysed BCI programme data for 195 sites and determined the proportion of sites involved in each of five stages of dissemination and implementation of PtDAs. We conducted cross-sectional mail and telephone surveys of 79 sites with the most interest in implementation. We examined barriers associated with sustained use of the PtDAs. AB - RESULTS: Since 2002 we attempted contact with 195 sites to join the BCI. The majority indicated interest in using PtDAs 172 of 195 (88%), 93 of 195 signed up for the BCI (48%), 57 of 195 reported distributing PtDAs to at least one patient (57%), and 46 of 195 reported sustained use (24%). We analysed data from interviews with 59 of 79 active sites (75% response rate). The majority of providers 49 of 59 (83%) had watched the PtDAs, and 46 of 59 (78%) distributed them to patients. The most common barriers were lack of a reliable way to identify patients before decisions are made (37%), a lack of time to distribute the PtDAs (22%) and having too many educational materials (15%). Sites that indicated a lack of clinician support as a barrier were significantly less likely to have sustained use compared to sites that didn't (33% vs. 74%, P = 0.02). AB - CONCLUSIONS: Community breast cancer providers, both physicians and non-physicians, express a high interest in using PtDAs with their patients. About a quarter of sites report sustained use of the PtDAs in routine care. AB - Copyright © 2011 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00640.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21323821 [pubmed] ID - 10.1111/j.1369-7625.2010.00640.x [doi] ID - PMC5057173 [pmc] PP - ppublish LG - English DP - 2011 Mar DC - 20110217 EZ - 2011/02/18 06:00 DA - 2011/05/21 06:00 DT - 2011/02/26 06:00 YR - 2011 ED - 20110520 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=21323821 <258. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20579123 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sivell S AU - Edwards A AU - Elwyn G AU - Manstead AS FA - Sivell, Stephanie FA - Edwards, Adrian FA - Elwyn, Glyn FA - Manstead, Antony S R IN - Sivell, Stephanie. Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, Wales, UK. sivells2@cardiff.ac.uk TI - Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the Common Sense Model contribute to decision support interventions?. SO - Health Expectations. 14 Suppl 1:6-19, 2011 Mar AS - Health Expect. 14 Suppl 1:6-19, 2011 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Body Image MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Patient Preference MH - Risk Assessment MH - Treatment Outcome AB - OBJECTIVE: To describe the evidence about factors influencing breast cancer patients' surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). AB - BACKGROUND: A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservation surgery with radiotherapy. However, research does not always reflect the complexities of decision making and is often atheoretical. A theoretical approach, as provided by the CSM and the TPB, could help to identify and tailor support by focusing on patients' representations of their breast cancer and predicting surgery choices. AB - DESIGN: Literature search and narrative synthesis of data. AB - SYNTHESIS: Twenty-six studies reported women's surgery choices to be influenced by perceived clinical outcomes of surgery, appearance and body image, treatment concerns, involvement in decision making and preferences of clinicians. These factors can be mapped onto the key constructs of both the TPB and CSM and used to inform the design and development of decision support interventions to ensure accurate information is provided in areas most important to patients. AB - CONCLUSIONS: The TPB and CSM have the potential to inform the design of decision support for breast cancer patients, with accurate and clear information that avoids leading patients to make decisions they may come to regret. Further research is needed examining how the components of the extended TPB and CSM account for patients' surgery choices. AB - Copyright © 2010 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DI - HEX558 DO - https://dx.doi.org/10.1111/j.1369-7625.2009.00558.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20579123 [pubmed] ID - HEX558 [pii] ID - 10.1111/j.1369-7625.2009.00558.x [doi] ID - PMC5057170 [pmc] PP - ppublish GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English DP - 2011 Mar DC - 20110217 EZ - 2010/06/29 06:00 DA - 2011/05/21 06:00 DT - 2010/06/29 06:00 YR - 2011 ED - 20110520 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=20579123 <259. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21323821 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Feibelmann S AU - Yang TS AU - Uzogara EE AU - Sepucha K FA - Feibelmann, Sandra FA - Yang, Theresa S FA - Uzogara, Ekeoma E FA - Sepucha, Karen IN - Feibelmann, Sandra. Health Decision Research Unit, Massachusetts General Hospital (MGH), Boston, MA 02114, USA. TI - What does it take to have sustained use of decision aids? A programme evaluation for the Breast Cancer Initiative. SO - Health Expectations. 14 Suppl 1:85-95, 2011 Mar AS - Health Expect. 14 Suppl 1:85-95, 2011 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/th [Therapy] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Information Dissemination MH - *Patient Education as Topic/mt [Methods] AB - BACKGROUND: The Breast Cancer Initiative (BCI) was started in 2002 to disseminate breast cancer decision aids (PtDAs) to providers. AB - METHODS: We analysed BCI programme data for 195 sites and determined the proportion of sites involved in each of five stages of dissemination and implementation of PtDAs. We conducted cross-sectional mail and telephone surveys of 79 sites with the most interest in implementation. We examined barriers associated with sustained use of the PtDAs. AB - RESULTS: Since 2002 we attempted contact with 195 sites to join the BCI. The majority indicated interest in using PtDAs 172 of 195 (88%), 93 of 195 signed up for the BCI (48%), 57 of 195 reported distributing PtDAs to at least one patient (57%), and 46 of 195 reported sustained use (24%). We analysed data from interviews with 59 of 79 active sites (75% response rate). The majority of providers 49 of 59 (83%) had watched the PtDAs, and 46 of 59 (78%) distributed them to patients. The most common barriers were lack of a reliable way to identify patients before decisions are made (37%), a lack of time to distribute the PtDAs (22%) and having too many educational materials (15%). Sites that indicated a lack of clinician support as a barrier were significantly less likely to have sustained use compared to sites that didn't (33% vs. 74%, P = 0.02). AB - CONCLUSIONS: Community breast cancer providers, both physicians and non-physicians, express a high interest in using PtDAs with their patients. About a quarter of sites report sustained use of the PtDAs in routine care. AB - Copyright © 2011 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DO - https://dx.doi.org/10.1111/j.1369-7625.2010.00640.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 21323821 [pubmed] ID - 10.1111/j.1369-7625.2010.00640.x [doi] PP - ppublish LG - English DP - 2011 Mar DC - 20110217 EZ - 2011/02/18 06:00 DA - 2011/05/21 06:00 DT - 2011/02/26 06:00 YR - 2011 ED - 20110520 RD - 20110217 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21323821 <260. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20579123 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sivell S AU - Edwards A AU - Elwyn G AU - Manstead AS FA - Sivell, Stephanie FA - Edwards, Adrian FA - Elwyn, Glyn FA - Manstead, Antony S R IN - Sivell, Stephanie. Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, Wales, UK. sivells2@cardiff.ac.uk TI - Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the Common Sense Model contribute to decision support interventions?. SO - Health Expectations. 14 Suppl 1:6-19, 2011 Mar AS - Health Expect. 14 Suppl 1:6-19, 2011 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Body Image MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Patient Preference MH - Risk Assessment MH - Treatment Outcome AB - OBJECTIVE: To describe the evidence about factors influencing breast cancer patients' surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). AB - BACKGROUND: A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservation surgery with radiotherapy. However, research does not always reflect the complexities of decision making and is often atheoretical. A theoretical approach, as provided by the CSM and the TPB, could help to identify and tailor support by focusing on patients' representations of their breast cancer and predicting surgery choices. AB - DESIGN: Literature search and narrative synthesis of data. AB - SYNTHESIS: Twenty-six studies reported women's surgery choices to be influenced by perceived clinical outcomes of surgery, appearance and body image, treatment concerns, involvement in decision making and preferences of clinicians. These factors can be mapped onto the key constructs of both the TPB and CSM and used to inform the design and development of decision support interventions to ensure accurate information is provided in areas most important to patients. AB - CONCLUSIONS: The TPB and CSM have the potential to inform the design of decision support for breast cancer patients, with accurate and clear information that avoids leading patients to make decisions they may come to regret. Further research is needed examining how the components of the extended TPB and CSM account for patients' surgery choices. AB - Copyright © 2010 Blackwell Publishing Ltd. ES - 1369-7625 IL - 1369-6513 DI - HEX558 DO - https://dx.doi.org/10.1111/j.1369-7625.2009.00558.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20579123 [pubmed] ID - HEX558 [pii] ID - 10.1111/j.1369-7625.2009.00558.x [doi] PP - ppublish GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English DP - 2011 Mar DC - 20110217 EZ - 2010/06/29 06:00 DA - 2011/05/21 06:00 DT - 2010/06/29 06:00 YR - 2011 ED - 20110520 RD - 20110217 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20579123 <261. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21169619 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Atkinson NL AU - Massett HA AU - Mylks C AU - McCormack LA AU - Kish-Doto J AU - Hesse BW AU - Wang MQ FA - Atkinson, Nancy L FA - Massett, Holly A FA - Mylks, Christy FA - McCormack, Lauren A FA - Kish-Doto, Julia FA - Hesse, Bradford W FA - Wang, Min Qi IN - Atkinson, Nancy L. Department of Public and Community Health, University of Maryland, College Park, Maryland 20742, USA. atkinson@umd.edu TI - Assessing the impact of user-centered research on a clinical trial eHealth tool via counterbalanced research design. SO - Journal of the American Medical Informatics Association. 18(1):24-31, 2011 Jan-Feb AS - J Am Med Inform Assoc. 18(1):24-31, 2011 Jan-Feb NJ - Journal of the American Medical Informatics Association : JAMIA PI - Journal available in: Print PI - Citation processed from: Internet JC - b92, 9430800 IO - J Am Med Inform Assoc PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005871 SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/th [Therapy] MH - *Clinical Trials as Topic MH - *Consumer Health Information MH - Female MH - Health Services Research/mt [Methods] MH - Humans MH - *Internet MH - Middle Aged MH - *Patient Preference MH - Patient Satisfaction MH - *Patient Selection MH - Program Development MH - Single-Blind Method MH - United States MH - User-Computer Interface AB - OBJECTIVE: Informatics applications have the potential to improve participation in clinical trials, but their design must be based on user-centered research. This research used a fully counterbalanced experimental design to investigate the effect of changes made to the original version of a website, http://BreastCancerTrials.org/, and confirm that the revised version addressed and reinforced patients' needs and expectations. AB - DESIGN: Participants included women who had received a breast cancer diagnosis within the last 5 years (N=77). They were randomized into two groups: one group used and reviewed the original version first followed by the redesigned version, and the other group used and reviewed them in reverse order. AB - MEASUREMENTS: The study used both quantitative and qualitative measures. During use, participants' click paths and general reactions were observed. After use, participants were asked to answer survey items and open-ended questions to indicate their reactions and which version they preferred and met their needs and expectations better. AB - RESULTS: Overall, the revised version of the site was preferred and perceived to be clearer, easier to navigate, more trustworthy and credible, and more private and safe overall. However, users who viewed the original version last had similar attitudes toward both versions. AB - CONCLUSION: By applying research findings to the redesign of a website for clinical trial searching, it was possible to re-engineer the interface to better support patients' decisions to participate in clinical trials. The mechanisms of action in this case appeared to revolve around creating an environment that supported a sense of personal control and decisional autonomy. ES - 1527-974X IL - 1067-5027 DI - 18/1/24 DO - https://dx.doi.org/10.1136/jamia.2010.006122 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural ID - 21169619 [pubmed] ID - 18/1/24 [pii] ID - 10.1136/jamia.2010.006122 [doi] ID - PMC3005871 [pmc] PP - ppublish LG - English DP - 2011 Jan-Feb DC - 20101220 EZ - 2010/12/21 06:00 DA - 2011/04/27 06:00 DT - 2010/12/21 06:00 YR - 2011 ED - 20110426 RD - 20150205 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21169619 <262. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21134649 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sabel MS FA - Sabel, Michael S IN - Sabel, Michael S. University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA. msabel@umich.edu TI - Surgical considerations in early-stage breast cancer: lessons learned and future directions. [Review] SO - Seminars in Radiation Oncology. 21(1):10-9, 2011 Jan AS - Semin Radiat Oncol. 21(1):10-9, 2011 Jan NJ - Seminars in radiation oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - c1y, 9202882 IO - Semin Radiat Oncol SB - Index Medicus CP - United States MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - Female MH - Humans MH - Magnetic Resonance Imaging MH - *Mastectomy/mt [Methods] MH - Neoadjuvant Therapy MH - Patient Satisfaction MH - Patient Selection MH - Physician-Patient Relations MH - Reoperation MH - Specimen Handling AB - Emerging evidence regarding the relationship between local failure and outcome in breast cancer has placed increased emphasis on the surgeon's role in reducing local recurrence after breast-conserving surgery. This includes both improving patient selection and optimizing the procedure. Proper patient selection, selective use of magnetic resonance imaging, and better patient-physician communication including the use of decision aids can optimize both local control and patient satisfaction without unnecessarily increasing the mastectomy rate. Neoadjuvant systemic therapy can increase both the number of patients eligible for breast-conservation surgery as well as the likelihood of success. Adequate surgical margins are crucial and can be achieved without excessive re-excision rates with detailed preoperative planning, consideration of oncoplastic resections. and intraoperative margin analysis. This article reviews several areas in which the surgeon can help ensure the success of breast-conservation therapy. AB - Copyright © 2011 Elsevier Inc. All rights reserved. ES - 1532-9461 IL - 1053-4296 DI - S1053-4296(10)00061-5 DO - https://dx.doi.org/10.1016/j.semradonc.2010.08.002 PT - Journal Article PT - Review ID - 21134649 [pubmed] ID - S1053-4296(10)00061-5 [pii] ID - 10.1016/j.semradonc.2010.08.002 [doi] PP - ppublish LG - English DP - 2011 Jan DC - 20101207 EZ - 2010/12/08 06:00 DA - 2011/04/20 06:00 DT - 2010/12/08 06:00 YR - 2011 ED - 20110419 RD - 20101207 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21134649 <263. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20200857 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Richman AR AU - Tzeng JP AU - Carey LA AU - Retel VP AU - Brewer NT FA - Richman, Alice R FA - Tzeng, Janice P FA - Carey, Lisa A FA - Retel, Valesca P FA - Brewer, Noel T IN - Richman, Alice R. Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA. TI - Knowledge of genomic testing among early-stage breast cancer patients. SO - Psycho-Oncology. 20(1):28-35, 2011 Jan AS - Psychooncology. 20(1):28-35, 2011 Jan NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/ge [Genetics] MH - Chemotherapy, Adjuvant MH - Cross-Sectional Studies MH - *Decision Making MH - Female MH - Genetic Predisposition to Disease MH - *Genetic Testing MH - Genomics MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Neoplasm Recurrence, Local/dt [Drug Therapy] MH - *Neoplasm Recurrence, Local/ge [Genetics] MH - Neoplasm Staging MH - Recurrence MH - Risk AB - BACKGROUND: Genomic recurrence risk test results now inform clinical decisions about adjuvant treatment for women with early-stage breast cancer. We sought to understand patients' knowledge of these tests and correlates of their knowledge. AB - METHODS: Participants in this cross-sectional study were 78 women, treated for early-stage, estrogen receptor-positive breast cancer with 0-3 positive lymph nodes, whose medical records indicated they received Oncotype DX testing earlier. We mailed a questionnaire that assessed knowledge of genomic recurrence risk testing (13 item scale, alpha=0.83) and reviewed medical charts of consenting patients. AB - RESULTS: Knowledge about genomic recurrence risk testing was low (mean knowledge score=67%, SD=0.23). Low knowledge scores were more commonly due to responses of 'don't know' than incorrect answers. Most women (91%) clearly understood that test results can aid decisions about chemotherapy, and few (22%) understood that the test's estimate of the chance of metastasis assumes the patient is receiving hormone therapy. Higher knowledge about genomic recurrence risk testing was associated with higher education, reading ability, and numeracy. Knowledge was higher among women who recalled receiving both verbal and printed information about the test and among women who had active roles in deciding about their treatments. Higher knowledge was also associated with having fewer concerns about genomic testing. AB - DISCUSSION: Among early-stage breast cancer patients who received Oncotype DX, we found low knowledge about many aspects of genomic recurrence risk testing. Research is needed to understand testing information provided to patients and best practices for patient education. AB - Copyright © 2010 John Wiley & Sons, Ltd. RN - 0 (Antineoplastic Agents) ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1699 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20200857 [pubmed] ID - 10.1002/pon.1699 [doi] PP - ppublish LG - English DP - 2011 Jan DC - 20101224 EZ - 2010/03/05 06:00 DA - 2011/03/12 06:00 DT - 2010/03/05 06:00 YR - 2011 ED - 20110311 RD - 20101224 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=20200857 <264. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20881153 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fagerlin A AU - Sepucha KR AU - Couper MP AU - Levin CA AU - Singer E AU - Zikmund-Fisher BJ FA - Fagerlin, Angela FA - Sepucha, Karen R FA - Couper, Mick P FA - Levin, Carrie A FA - Singer, Eleanor FA - Zikmund-Fisher, Brian J IN - Fagerlin, Angela. VA Health Services Research & Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. fagerlin@med.umich.edu TI - Patients' knowledge about 9 common health conditions: the DECISIONS survey. SO - Medical Decision Making. 30(5 Suppl):35S-52S, 2010 Sep-Oct AS - Med Decis Making. 30(5 Suppl):35S-52S, 2010 Sep-Oct NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Internet JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Confidence Intervals MH - Cross-Sectional Studies MH - Decision Making MH - Early Detection of Cancer MH - Educational Measurement MH - Educational Status MH - Female MH - General Surgery MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Logistic Models MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Neoplasms/di [Diagnosis] MH - Neoplasms/dt [Drug Therapy] MH - Neoplasms/su [Surgery] MH - Odds Ratio MH - *Patient Education as Topic MH - *Patient Participation MH - Prescription Drugs MH - Risk AB - BACKGROUND: To make informed decisions, patients must have adequate knowledge of key decision-relevant facts. AB - OBJECTIVE: To determine adults' knowledge about information relevant to common types of medication, screening, or surgery decisions they recently made. AB - SETTING: National sample of US adults identified by random-digit dialing. AB - DESIGN: Cross-sectional survey conducted between November 2006 and May 2007. AB - PARTICIPANTS: A total of 2575 English-speaking adults aged 40 y or older who reported having discussed the following medical decisions with a health care provider within the previous 2 y: prescription medications for hypertension, hypercholesterolemia, or depression; screening tests for colorectal, breast, or prostate cancer; or surgeries for knee/hip replacement, cataracts, or lower back pain. AB - MEASUREMENTS: Participants answered knowledge questions and rated the importance of their health care provider, family/friends, and the media as sources of information. AB - RESULTS: Accuracy rates varied widely across questions and decision contexts. For example, patients considering cataract surgery were more likely to correctly estimate recovery time than those patients considering lower back pain or knee/hip replacement (78% v. 29% and 39%, P < 0.001). Similarly, participants were more knowledgeable of facts about colorectal cancer screening than those who were asked about breast or prostate cancer. Finally, respondents were consistently more knowledgeable on comparable questions about blood pressure medication than cholesterol medication or antidepressants. The impact of demographic characteristics and sources of information also varied substantially. For example, blacks had lower knowledge than whites about cancer screening decisions (odds ratio [OR] = 0.57; 95% confidence interval [CI] = 0.43, 0.75; P = 0.001) and medication (OR = 0.77; 95% CI = 0.60, 0.97; P = 0.03) even after we controlled for other demographic factors. The same was not true for surgical decisions. AB - LIMITATIONS: The questions did not measure all knowledge relevant to informed decision making, were subject to recall biases, and may have assessed numeracy more than knowledge. AB - CONCLUSIONS: Patient knowledge of key facts relevant to recently made medical decisions is often poor and varies systematically by decision type and patient characteristics. Improving patient knowledge about risks, benefits, and characteristics of medical procedures is essential to support informed decision making. RN - 0 (Prescription Drugs) ES - 1552-681X IL - 0272-989X DI - 30/5_suppl/35S DO - https://dx.doi.org/10.1177/0272989X10378700 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20881153 [pubmed] ID - 30/5_suppl/35S [pii] ID - 10.1177/0272989X10378700 [doi] PP - ppublish LG - English DP - 2010 Sep-Oct DC - 20100930 EZ - 2010/10/01 06:00 DA - 2011/03/08 06:00 DT - 2010/10/15 06:00 YR - 2010 ED - 20110307 RD - 20100930 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20881153 <265. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20829330 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Miller SM AU - Roussi P AU - Daly MB AU - Scarpato J FA - Miller, Suzanne M FA - Roussi, Pagona FA - Daly, Mary B FA - Scarpato, John IN - Miller, Suzanne M. Psychosocial and Biobehavioral Medicine Program, Fox Chase Cancer Center, Cheltenham, Pennsylvania 19012, USA. suzanne.miller@fccc.edu TI - New strategies in ovarian cancer: uptake and experience of women at high risk of ovarian cancer who are considering risk-reducing salpingo-oophorectomy. [Review] SO - Clinical Cancer Research. 16(21):5094-106, 2010 Nov 01 AS - Clin Cancer Res. 16(21):5094-106, 2010 Nov 01 NJ - Clinical cancer research : an official journal of the American Association for Cancer Research PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - c2h, 9502500 IO - Clin. Cancer Res. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107031 OI - Source: NLM. NIHMS226892 SB - Index Medicus CP - United States MH - Carcinoma/et [Etiology] MH - Carcinoma/pc [Prevention & Control] MH - *Carcinoma/th [Therapy] MH - Choice Behavior MH - Decision Making/ph [Physiology] MH - Female MH - Hormone Replacement Therapy/ae [Adverse Effects] MH - Hormone Replacement Therapy/sn [Statistics & Numerical Data] MH - Hormone Replacement Therapy/ut [Utilization] MH - Humans MH - Medical Oncology/ed [Education] MH - Medical Oncology/mt [Methods] MH - *Medical Oncology/td [Trends] MH - Ovarian Neoplasms/et [Etiology] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovarian Neoplasms/th [Therapy] MH - Ovariectomy/ed [Education] MH - Ovariectomy/mt [Methods] MH - *Ovariectomy/ut [Utilization] MH - Patient Education as Topic MH - Risk Factors MH - *Risk Reduction Behavior MH - Salpingostomy/ed [Education] MH - Salpingostomy/mt [Methods] MH - *Salpingostomy/ut [Utilization] AB - Here, we review factors associated with uptake of risk-reducing salpingo-oophorectomy by women at increased hereditary risk for ovarian cancer, as well as quality of life issues following surgery. Forty-one research studies identified through PubMed and PsychInfo met inclusion criteria. Older age, having had children, a family history of ovarian cancer, a personal history of breast cancer, prophylactic mastectomy, and BRCA1/2 mutation carrier status increase the likelihood of undergoing surgery. Psychosocial variables predictive of surgery uptake include greater perceived risk of ovarian cancer and cancer-related anxiety. Most women report satisfaction with their decision to undergo surgery and both lower perceived ovarian cancer risk and less cancer-related anxiety as benefits. Hormonal deprivation is the main disadvantage reported, particularly by premenopausal women who are not on hormonal replacement therapy (HRT). The evidence is mixed about satisfaction with the level of information provided prior to surgery, although generally, women report receiving insufficient information about the pros and cons of HRT. These findings indicate that when designing decision aids, demographic, medical history, and psychosocial variables need to be addressed in order to facilitate quality decision making. AB - Copyright ©2010 AACR. IS - 1078-0432 IL - 1078-0432 DI - 1078-0432.CCR-09-2953 DO - https://dx.doi.org/10.1158/1078-0432.CCR-09-2953 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Review ID - 20829330 [pubmed] ID - 1078-0432.CCR-09-2953 [pii] ID - 10.1158/1078-0432.CCR-09-2953 [doi] ID - PMC3107031 [pmc] ID - NIHMS226892 [mid] PP - ppublish GI - No: RC1 CA 145063-01 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA104979 Organization: (CA) *NCI NIH HHS* Country: United States No: P01 CA057586 Organization: (CA) *NCI NIH HHS* Country: United States No: RC1 CA145063 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 HG011766 Organization: (HG) *NHGRI NIH HHS* Country: United States No: P30 CA006927 Organization: (CA) *NCI NIH HHS* Country: United States No: P01CA57586 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20100909 DP - 2010 Nov 01 DC - 20101102 EZ - 2010/09/11 06:00 DA - 2011/02/25 06:00 DT - 2010/09/11 06:00 YR - 2010 ED - 20110224 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20829330 <266. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20937486 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hogarth M AU - Hajopoulos K AU - Young M AU - Cowles N AU - Churin J AU - Hornthal B AU - Esserman L FA - Hogarth, Michael FA - Hajopoulos, Kathy FA - Young, Meg FA - Cowles, Neil FA - Churin, John FA - Hornthal, Bethany FA - Esserman, Laura IN - Hogarth, Michael. Department of Pathology and Laboratory Medicine, University of California, Davis, USA. TI - The Communication and Care Plan: a novel approach to patient-centered clinical information systems. SO - Journal of Biomedical Informatics. 43(5 Suppl):S6-8, 2010 Oct AS - J Biomed Inform. 43(5 Suppl):S6-8, 2010 Oct NJ - Journal of biomedical informatics PI - Journal available in: Print PI - Citation processed from: Internet JC - 100970413, d2m IO - J Biomed Inform SB - Index Medicus CP - United States MH - Appointments and Schedules MH - Breast Neoplasms/th [Therapy] MH - Decision Support Systems, Clinical MH - *Electronic Health Records MH - Female MH - Humans MH - Internet MH - Patient Care Management MH - *Patient-Centered Care/mt [Methods] MH - *Telemedicine/mt [Methods] MH - User-Computer Interface AB - The US health care system and its information access models are organized around institutions and providers. Patient-centered functionality is rarely present in prevailing information systems and, if present, it typically does not ideally support shared decision making about important treatment events. We sought to better understand the functional needs of providers and patients around the process of care plan decision making, and used this information to develop a prototype decision support tool, using women with newly diagnosed breast cancer as our clinical scenario. This paper describes the user-centered design process we undertook and the resulting prototype system, the Communication and Care Plan (CCP). AB - Copyright © 2010 Elsevier Inc. All rights reserved. ES - 1532-0480 IL - 1532-0464 DI - S1532-0464(10)00103-6 DO - https://dx.doi.org/10.1016/j.jbi.2010.07.004 PT - Journal Article ID - 20937486 [pubmed] ID - S1532-0464(10)00103-6 [pii] ID - 10.1016/j.jbi.2010.07.004 [doi] PP - ppublish PH - 2010/06/01 [received] PH - 2010/07/01 [revised] PH - 2010/07/03 [accepted] LG - English DP - 2010 Oct DC - 20101012 EZ - 2010/10/13 06:00 DA - 2011/02/24 06:00 DT - 2010/10/22 06:00 YR - 2010 ED - 20110223 RD - 20101012 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20937486 <267. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20956831 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Elmore JG AU - Ganschow PS AU - Geller BM FA - Elmore, Joann G FA - Ganschow, Pamela S FA - Geller, Berta M IN - Elmore, Joann G. Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98104-2499, USA. jelmore@uw.edu TI - Communication between patients and providers and informed decision making. [Review] SO - Journal of the National Cancer Institute. Monographs. 2010(41):204-9, 2010 AS - J Natl Cancer Inst Monogr. 2010(41):204-9, 2010 NJ - Journal of the National Cancer Institute. Monographs PI - Journal available in: Print PI - Citation processed from: Internet JC - atr, 9011255 IO - J. Natl. Cancer Inst. Monographs PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140849 OI - Source: NLM. NIHMS311344 SB - Index Medicus CP - United States MH - Attitude to Health MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Carcinoma, Intraductal, Noninfiltrating/di [Diagnosis] MH - *Carcinoma, Intraductal, Noninfiltrating/px [Psychology] MH - Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - *Communication MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - *Informed Consent MH - Mass Media MH - Mastectomy/px [Psychology] MH - Mastectomy/ut [Utilization] MH - Patient Participation MH - Patient Preference MH - *Patients/px [Psychology] MH - *Professional-Patient Relations MH - Prognosis MH - Risk Assessment MH - Truth Disclosure MH - Uncertainty MH - Video Recording AB - Women with ductal carcinoma in situ (DCIS) need to comprehend the meaning of the diagnosis and the potential benefits and harms of treatment options. Full and understandable information is a requirement, not an option. However, with DCIS, as with many areas of medicine, a high level of uncertainty about the disease remains. In this article, we define informed medical decision making, review challenges to its implementation, and provide suggestions on how to improve communication with women about the diagnosis and treatment of DCIS. ES - 1745-6614 IL - 1052-6773 DI - lgq038 DO - https://dx.doi.org/10.1093/jncimonographs/lgq038 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Review ID - 20956831 [pubmed] ID - lgq038 [pii] ID - 10.1093/jncimonographs/lgq038 [doi] ID - PMC3140849 [pmc] ID - NIHMS311344 [mid] PP - ppublish GI - No: K05 CA104699 Organization: (CA) *NCI NIH HHS* Country: United States No: K05 CA104699-05 Organization: (CA) *NCI NIH HHS* Country: United States No: KO5 CA 104699 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2010 DC - 20101019 EZ - 2010/10/20 06:00 DA - 2011/02/12 06:00 DT - 2010/10/20 06:00 YR - 2010 ED - 20110211 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20956831 <268. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20811846 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jona K AU - Gerber A FA - Jona, Kemi FA - Gerber, Adam IN - Jona, Kemi. Office of STEM Education Partnerships - Learning Sciences and Computer Science, School of Education and Social Policy, Northwestern University, Evanston, IL, USA. kjona@northwestern.edu TI - MyOncofertility.org: a web-based patient education resource supporting decision making under severe emotional and cognitive overload. [Review] SO - Cancer Treatment & Research. 156:345-61, 2010 AS - Cancer Treat Res. 156:345-61, 2010 NJ - Cancer treatment and research PI - Journal available in: Print PI - Citation processed from: Print JC - ava, 8008541 IO - Cancer Treat. Res. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086487 OI - Source: NLM. NIHMS283607 SB - Index Medicus CP - United States MH - *Adaptation, Psychological MH - *Cognition MH - Decision Making MH - Female MH - Humans MH - Infertility/et [Etiology] MH - *Infertility/px [Psychology] MH - *Internet MH - Male MH - Neoplasms/co [Complications] MH - *Neoplasms/px [Psychology] MH - *Patient Education as Topic/og [Organization & Administration] AB - Kristin, a 38-year-old female with breast cancer, was scheduled to begin treatment a week after receiving her diagnosis. Although she was in a four-year-long relationship, she had never thought about having kids. Kristin was told that embryo banking (IVF) was the best option for fertility preservation, and she had to decide immediately if she wanted biological children in order to start an egg-retrieval cycle. Because no other options were provided and she was uncertain about freezing embryos with her partner, she ended up foregoing fertility preservation prior to the treatments that ultimately left her infertile. Ethan, a 19-year-old male, was in the hospital for four days awaiting surgery to remove a pelvic sarcoma. The surgery required removal of his testes rendering him infertile. During those four days, no one talked to him or his family about sperm banking, even though it could hve been accomplished in a matter of minutes. IS - 0927-3042 IL - 0927-3042 DO - https://dx.doi.org/10.1007/978-1-4419-6518-9_26 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Review ID - 20811846 [pubmed] ID - 10.1007/978-1-4419-6518-9_26 [doi] ID - PMC3086487 [pmc] ID - NIHMS283607 [mid] PP - ppublish GI - No: RL1 HD058296 Organization: (HD) *NICHD NIH HHS* Country: United States No: RL1 HD058296-03 Organization: (HD) *NICHD NIH HHS* Country: United States No: 8UL1DE019587 Organization: (DE) *NIDCR NIH HHS* Country: United States No: UL1 DE019587 Organization: (DE) *NIDCR NIH HHS* Country: United States No: UL1 DE019587-03 Organization: (DE) *NIDCR NIH HHS* Country: United States No: 5RL1HD058296 Organization: (HD) *NICHD NIH HHS* Country: United States LG - English DP - 2010 DC - 20100902 EZ - 2010/09/03 06:00 DA - 2011/02/11 06:00 DT - 2010/09/03 06:00 YR - 2010 ED - 20110210 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20811846 <269. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20848183 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wang SY AU - Kuntz K AU - Tuttle T AU - Kane R FA - Wang, Shi-Yi FA - Kuntz, Karen FA - Tuttle, Todd FA - Kane, Robert IN - Wang, Shi-Yi. Department of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street S.E. MMC 729, Minneapolis, MN 55455, USA. wang1018@umn.edu TI - Incorporating margin status information in treatment decisions for women with ductal carcinoma in situ: a decision analysis. SO - Breast Cancer Research & Treatment. 124(2):393-402, 2010 Nov AS - Breast Cancer Res Treat. 124(2):393-402, 2010 Nov NJ - Breast cancer research and treatment PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. SB - Index Medicus CP - Netherlands MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma, Intraductal, Noninfiltrating/mo [Mortality] MH - Carcinoma, Intraductal, Noninfiltrating/rt [Radiotherapy] MH - Carcinoma, Intraductal, Noninfiltrating/sc [Secondary] MH - Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - *Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - *Decision Support Techniques MH - Female MH - Humans MH - Markov Chains MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Recurrence, Local MH - Patient Preference MH - *Patient Selection MH - Quality-Adjusted Life Years MH - Radiotherapy, Adjuvant/ae [Adverse Effects] MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome AB - To integrate margin status information into the decision to undergo radiation therapy (RT) following breast-conserving surgery (BCS) for women with ductal carcinoma in situ (DCIS). We developed a decision-analytic Markov model to project quality-adjusted life years (QALYs) for a hypothetical cohort of 55-year-old women with DCIS over a lifetime horizon treated with or without RT following BCS. We estimated the transition probabilities of local DCIS and invasive recurrences based on the margin status (free, close, or positive) from a systematic literature review. Other probability estimates and utilities were collected from the published literature. Using the conditions defined in this model, expected QALYs after BCS alone were better than those after BCS with RT under the free-margin scenario (15.72 vs. 15.58) and worse in the close-margin (15.44 vs. 15.50) and positive-margin scenarios (15.20 vs. 15.33). The probability of receiving a salvage mastectomy varied from 10 to 28%, depending on margin status and treatment. One-way sensitivity analyses showed that the optimal treatment was sensitive to patients' preferences and RT side effects. Probabilistic sensitivity analyses revealed that BCS alone would be the best strategy in 54% of the cases under the free-margin scenario, 48% under the close-margin scenario, and 44% under the positive-margin scenario. This study illustrates that margin status is able to provide supplementary information on the decision of DCIS treatment. Our analyses also highlight the importance of patients' preferences in decision making. Our findings suggest that RT is not necessary for all patients with DCIS undergoing BCS. ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-010-1166-7 PT - Journal Article ID - 20848183 [pubmed] ID - 10.1007/s10549-010-1166-7 [doi] PP - ppublish PH - 2010/06/17 [received] PH - 2010/09/03 [accepted] LG - English EP - 20100917 DP - 2010 Nov DC - 20101018 EZ - 2010/09/18 06:00 DA - 2011/02/10 06:00 DT - 2010/09/18 06:00 YR - 2010 ED - 20110209 RD - 20101018 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20848183 <270. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20880821 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kydd LA AU - Reid SA AU - Adams J FA - Kydd, Lesley A FA - Reid, Sheryl A FA - Adams, Jillian IN - Kydd, Lesley A. Royal Perth Hospital, Perth, Western Australia. lesley.kydd@health.wa.gov.au TI - The Breast Surgery Gallery: an educational and counseling tool for people with breast cancer or having prophylactic breast surgery. SO - Clinical Journal of Oncology Nursing. 14(5):643-8, 2010 Oct AS - Clin J Oncol Nurs. 14(5):643-8, 2010 Oct NJ - Clinical journal of oncology nursing PI - Journal available in: Print PI - Citation processed from: Internet JC - czm, 9705336 IO - Clin J Oncol Nurs SB - Nursing Journal CP - United States MH - Australia MH - *Breast Neoplasms/su [Surgery] MH - Counseling MH - Female MH - Humans MH - Mastectomy MH - Mastectomy, Segmental MH - *Patient Education as Topic MH - *Photography MH - *Software MH - User-Computer Interface AB - The Breast Surgery Gallery is a unique and innovative computer program of digital photographs depicting sequential images of oncoplastic and prophylactic breast surgery. Specialist breast nurse counselors developed the tool to provide education and assist in decision making for people facing oncoplastic and prophylactic breast surgery. This article presents a historical perspective of the development of the gallery and how it can be used during education and counseling. The authors discuss background validation, structure, and testing of the gallery, with case studies that illustrate its flexibility. Data from regular audits of the breast surgery gallery demonstrate the tool's value. The Breast Surgery Gallery is a user-friendly tool that enables patients to make informed decisions while providing realistic photographs of the postoperative recovery phase. ES - 1538-067X IL - 1092-1095 DI - RM1225JX82820700 DO - https://dx.doi.org/10.1188/10.CJON.643-648 PT - Journal Article ID - 20880821 [pubmed] ID - RM1225JX82820700 [pii] ID - 10.1188/10.CJON.643-648 [doi] PP - ppublish LG - English DP - 2010 Oct DC - 20100930 EZ - 2010/10/01 06:00 DA - 2011/02/05 06:00 DT - 2010/10/01 06:00 YR - 2010 ED - 20110204 RD - 20110916 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20880821 <271. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21200195 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee CN AU - Belkora J AU - Chang Y AU - Moy B AU - Partridge A AU - Sepucha K FA - Lee, Clara N FA - Belkora, Jeff FA - Chang, Yuchiao FA - Moy, Beverly FA - Partridge, Ann FA - Sepucha, Karen IN - Lee, Clara N. Division of Plastic and Reconstructive Surgery, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599-7195, USA. cnlee@med.unc.edu TI - Are patients making high-quality decisions about breast reconstruction after mastectomy? [outcomes article]. SO - Plastic & Reconstructive Surgery. 127(1):18-26, 2011 Jan AS - Plast Reconstr Surg. 127(1):18-26, 2011 Jan NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100583 OI - Source: NLM. NIHMS511497 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Breast Neoplasms/su [Surgery] MH - Cross-Sectional Studies MH - *Decision Making MH - Female MH - Goals MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Logistic Models MH - Mammaplasty/mt [Methods] MH - *Mammaplasty/px [Psychology] MH - *Mastectomy MH - Middle Aged MH - *Patients/px [Psychology] AB - BACKGROUND: Variation in rates of breast reconstruction after mastectomy has raised concerns about the quality of decisions about reconstruction. The authors sought to evaluate patient decision making about reconstruction, using a validated measure of knowledge and preferences related to reconstruction. AB - METHODS: A cross-sectional survey of early-stage breast cancer survivors from four university medical centers was conducted. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making. A multivariable linear regression model of characteristics associated with knowledge and a logistic regression model of factors associated with having reconstruction were developed. AB - RESULTS: A total of 84 patients participated (59 percent response rate). Participants answered 37.9 percent of knowledge questions correctly. Higher education (beta, 15 percent; p = 0.003) and having reconstruction (beta, 21 percent; p < 0.0001) were associated with higher knowledge. The goals "use your own tissue to make a breast" (odds ratio, 1.53; 95 percent CI, 1.15, 2.05) and "wake up after mastectomy with reconstruction underway" (odds ratio, 1.66; 95 percent CI, 1.30, 2.12) were associated with reconstruction. The goal "avoid putting foreign material in your body" was associated with no reconstruction (odds ratio, 0.64; 95 percent CI, 0.48, 0.86). Most patients reported they mainly made the decision or made the decision with the doctor equally (93 percent; 95 percent CI, 85 to 97 percent) and that their degree of involvement was about right (85 percent; 95 percent CI, 75 to 91 percent). AB - CONCLUSIONS: Women treated with mastectomy in this study were not well-informed about breast reconstruction. Treatments were associated with patients' goals and concerns, however, and patients were highly involved in their decisions. Knowledge deficits suggest that breast cancer patients would benefit from interventions to support their decision making. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201101000-00004 DO - https://dx.doi.org/10.1097/PRS.0b013e3181f958de PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 21200195 [pubmed] ID - 10.1097/PRS.0b013e3181f958de [doi] ID - 00006534-201101000-00004 [pii] ID - PMC4100583 [pmc] ID - NIHMS511497 [mid] PP - ppublish GI - No: K07 CA154850 Organization: (CA) *NCI NIH HHS* Country: United States No: KL2 RR025746 Organization: (RR) *NCRR NIH HHS* Country: United States No: 1KL2RR025746 Organization: (RR) *NCRR NIH HHS* Country: United States LG - English DP - 2011 Jan DC - 20110104 EZ - 2011/01/05 06:00 DA - 2011/02/04 06:00 DT - 2011/01/05 06:00 YR - 2011 ED - 20110203 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med7&AN=21200195 <272. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20162470 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Glasspool DW AU - Oettinger A AU - Braithwaite D AU - Fox J FA - Glasspool, David W FA - Oettinger, Ayelet FA - Braithwaite, Dejana FA - Fox, John IN - Glasspool, David W. School of Informatics, University of Edinburgh, Informatics Forum, 10 Crichton Street, Edinburgh EH8 9AB, Scotland. dglasspo@inf.ed.ac.uk TI - Interactive decision support for risk management: a qualitative evaluation in cancer genetic counselling sessions. SO - Journal of Cancer Education. 25(3):312-6, 2010 Sep AS - J Cancer Educ. 25(3):312-6, 2010 Sep NJ - Journal of cancer education : the official journal of the American Association for Cancer Education PI - Journal available in: Print PI - Citation processed from: Internet JC - avy, 8610343 IO - J Cancer Educ PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933800 SB - Index Medicus CP - England MH - *Breast Neoplasms/ge [Genetics] MH - *Decision Making, Computer-Assisted MH - Feasibility Studies MH - Female MH - *Genetic Counseling/mt [Methods] MH - *Genetic Predisposition to Disease MH - *Genetic Testing/mt [Methods] MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Patient Education as Topic MH - Patient Satisfaction MH - *Risk Management MH - Software AB - Genetic counselling for inherited susceptibility to cancer involves communication of a significant amount of information about possible consequences of different interventions. This study explores counsellors' attitudes to computer software designed to aid this process. Eight genetic counsellors used the software with actors playing patients. Clinicians' rating of expected patient satisfaction, content, accuracy, timeliness, format, overall value, ease of use, effect on the patient-provider relationship and effect on clinician's performance were evaluated via qualitative and quantitative analysis of interviews, training tasks and questionnaires. Most counsellors found the software effective. Concerns related to possible impact on consultation dynamics and content. Participants suggested countering these through appropriate new counselling skills and selective use of the computer. The REACT software could provide effective support for genetic risk management counselling. ES - 1543-0154 IL - 0885-8195 DO - https://dx.doi.org/10.1007/s13187-009-0035-8 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20162470 [pubmed] ID - 10.1007/s13187-009-0035-8 [doi] ID - PMC2933800 [pmc] PP - ppublish GI - Organization: *Cancer Research UK* Country: United Kingdom LG - English DP - 2010 Sep DC - 20100907 EZ - 2010/02/18 06:00 DA - 2011/02/04 06:00 DT - 2010/02/18 06:00 YR - 2010 ED - 20110203 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20162470 <273. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19850438 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Belkora JK AU - Loth MK AU - Volz S AU - Rugo HS FA - Belkora, Jeffrey K FA - Loth, Meredith K FA - Volz, Shelley FA - Rugo, Hope S IN - Belkora, Jeffrey K. University of California, San Francisco, CA, United States. jeff.belkora@ucsfmedctr.org TI - Implementing decision and communication aids to facilitate patient-centered care in breast cancer: a case study. SO - Patient Education & Counseling. 77(3):360-8, 2009 Dec AS - Patient Educ Couns. 77(3):360-8, 2009 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - *Breast Neoplasms MH - *Communication MH - *Decision Making MH - Female MH - Genetic Counseling MH - Health Knowledge, Attitudes, Practice MH - Humans MH - *Patient-Centered Care MH - *Physician-Patient Relations MH - Tape Recording AB - OBJECTIVE: Decision Services (DS) provide support for breast cancer patients at the University of California, San Francisco to help ensure patient-centered care. AB - METHODS: We examined a case study to explore whether our program practices matched our program theory, and what the patient in the case thought was effective and ineffective about our decision support interventions. AB - RESULTS: The patient relied on a decision aid to educate her husband about her condition; felt that her question list contributed to a productive and efficient consultation with her oncologist; credited an audio-recording with helping her remember to follow-up with a genetic counselor; and reviewed the consultation summary 30 days into treatment in order to reflect on her decision. The patient rated the interventions highly on surveys, and experienced desirable reductions in decisional conflict, and improvements in knowledge. However, the question-prompting intervention was associated with a small decrease in self-efficacy, and the patient criticized the decision aid for omitting mention of a prognostic test. AB - CONCLUSION: This case illustrates how decision support interventions can be deployed to promote patient-centered care. AB - PRACTICE IMPLICATIONS: Breast care centers should consider distributing decision aids and assisting patients in listing questions, recording consultations, and obtaining written consultation summaries. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(09)00428-5 DO - https://dx.doi.org/10.1016/j.pec.2009.09.012 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19850438 [pubmed] ID - S0738-3991(09)00428-5 [pii] ID - 10.1016/j.pec.2009.09.012 [doi] PP - ppublish PH - 2008/09/30 [received] PH - 2009/09/09 [revised] PH - 2009/09/15 [accepted] LG - English EP - 20091021 DP - 2009 Dec DC - 20091201 EZ - 2009/10/24 06:00 DA - 2011/01/14 06:00 DT - 2009/10/24 06:00 YR - 2009 ED - 20110113 RD - 20091201 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19850438 <274. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19548125 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Urbas T AU - Agee N AU - Bouton ME AU - Komenaka IK FA - Urbas, Tadeja FA - Agee, Neal FA - Bouton, Marcia E FA - Komenaka, Ian K IN - Urbas, Tadeja. Breast Center, Maricopa Medical Center, Hogan Building, 2nd Floor, 2601 E Roosevelt Street, Phoenix, AZ 85008, USA. TI - Verification of a prolonged untreated natural history of breast cancer by the multigene assay. SO - Medical Oncology. 27(3):624-7, 2010 Sep AS - Med Oncol. 27(3):624-7, 2010 Sep NJ - Medical oncology (Northwood, London, England) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b3a, 9435512 IO - Med. Oncol. SB - Index Medicus CP - United States MH - *Breast Neoplasms/ch [Chemistry] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Carcinoma, Lobular/ch [Chemistry] MH - Carcinoma, Lobular/ge [Genetics] MH - Carcinoma, Lobular/pa [Pathology] MH - Carcinoma, Lobular/su [Surgery] MH - Chemotherapy, Adjuvant MH - *Decision Support Techniques MH - Disease Progression MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - *Neoplasm Proteins/ge [Genetics] MH - Paraffin Embedding MH - *RNA, Messenger/an [Analysis] MH - *RNA, Neoplasm/an [Analysis] MH - Receptor, ErbB-2/an [Analysis] MH - Receptors, Estrogen/an [Analysis] MH - Receptors, Progesterone/an [Analysis] MH - Recurrence MH - Risk MH - Sentinel Lymph Node Biopsy MH - Tumor Burden AB - Individualization of therapy for breast cancer patients has progressed significantly over the last 5 years. A 54-year-old female went over 2 years after her diagnosis of breast cancer with no treatment. The pathologic size, however, indicated that the tumor may not have progressed from diagnosis to operation. Due to the apparent lack of progression over 2 years without treatment, a multigene assay was ordered. The recurrence score was 15, indicating a less than 10% risk of distant recurrence at 10 years. The recurrence score also falls into the "low risk" category. The prolonged natural history of this breast cancer patient suggested an indolent cancer. The "low risk" recurrence score confirmed this history and indicated that adjuvant chemotherapy is probably not beneficial to this patient. RN - 0 (Neoplasm Proteins) RN - 0 (RNA, Messenger) RN - 0 (RNA, Neoplasm) RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) RN - EC 2-7-10-1 (ERBB2 protein, human) RN - EC 2-7-10-1 (Receptor, ErbB-2) ES - 1559-131X IL - 1357-0560 DO - https://dx.doi.org/10.1007/s12032-009-9258-0 PT - Case Reports PT - Journal Article ID - 19548125 [pubmed] ID - 10.1007/s12032-009-9258-0 [doi] PP - ppublish PH - 2009/04/02 [received] PH - 2009/06/08 [accepted] LG - English EP - 20090623 DP - 2010 Sep DC - 20100820 EZ - 2009/06/24 09:00 DA - 2010/12/31 06:00 DT - 2009/06/24 09:00 YR - 2010 ED - 20101230 RD - 20141120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19548125 <275. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 21042102 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Salgarello M AU - Visconti G AU - Barone-Adesi L FA - Salgarello, Marzia FA - Visconti, Giuseppe FA - Barone-Adesi, Liliana IN - Salgarello, Marzia. Department of Plastic and Reconstructive Surgery and the Breast Unit, Catholic University of Sacro Cuore, University Hospital Agostino Gemelli, Rome, Italy. m.salgarello@mclink.it TI - Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. SO - Plastic & Reconstructive Surgery. 126(5):1460-71, 2010 Nov AS - Plast Reconstr Surg. 126(5):1460-71, 2010 Nov NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Breast Implants/ae [Adverse Effects] MH - *Breast Implants MH - Esthetics MH - Female MH - Humans MH - Mammaplasty/ae [Adverse Effects] MH - *Mammaplasty/mt [Methods] MH - *Mastectomy/mt [Methods] MH - Nipples MH - Patient Satisfaction AB - BACKGROUND: Nipple-sparing mastectomy is gaining widespread popularity, as it could allow improved aesthetic outcome without increasing oncologic risk. To investigate the reconstructive issues experienced with immediate implant reconstruction, the authors reviewed the cosmetic outcomes of their series. AB - METHODS: The authors retrospectively analyzed the data on 33 cases of nipple-sparing mastectomy for both cancer and prophylaxis with immediate implant reconstruction using the submusculo-subfascial pocket. Cosmetic evaluation methods were clinical and photography-based assessments and a patient-satisfaction survey. AB - RESULTS: The average follow-up period was 26.8 months. No nipple-areola complex cancer involvement was registered. The reconstructive outcomes ranged from good to excellent in 83 percent of the cases. Patients' satisfaction was high to very high, except in one patient who experienced total nipple-areola complex loss (one breast, 2.4 percent). Overall, early minor complications were registered in four breasts (9.5 percent) and late minor complications in five cases (12 percent). AB - CONCLUSIONS: The authors' series suggest that nipple-sparing mastectomy is an option for carefully selected and screened patients. Larger studies with longer follow-up are needed, however. On the whole, the immediate one-stage implant reconstruction with hyperprojected anatomical gel implants represents a valid option. The skin incision algorithm proposed, which is based on the breast size, shape, and previous scars, might aid in the decision-making process to achieve satisfying results using this procedure. The radial approaches represent a good compromise between the oncologic and reconstructive procedures. ES - 1529-4242 IL - 0032-1052 DI - 00006534-201011000-00006 DO - https://dx.doi.org/10.1097/PRS.0b013e3181ef8bce PT - Journal Article ID - 21042102 [pubmed] ID - 10.1097/PRS.0b013e3181ef8bce [doi] ID - 00006534-201011000-00006 [pii] PP - ppublish LG - English DP - 2010 Nov DC - 20101102 EZ - 2010/11/03 06:00 DA - 2010/12/14 06:00 DT - 2010/11/03 06:00 YR - 2010 ED - 20101130 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=21042102 <276. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20004545 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ubel PA AU - Smith DM AU - Zikmund-Fisher BJ AU - Derry HA AU - McClure J AU - Stark A AU - Wiese C AU - Greene S AU - Jankovic A AU - Fagerlin A FA - Ubel, Peter A FA - Smith, Dylan M FA - Zikmund-Fisher, Brian J FA - Derry, Holly A FA - McClure, Jennifer FA - Stark, Azadeh FA - Wiese, Cheryl FA - Greene, Sarah FA - Jankovic, Aleksandra FA - Fagerlin, Angela IN - Ubel, Peter A. VA Health Services Research and Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. paubel@med.umich.edu TI - Testing whether decision aids introduce cognitive biases: results of a randomized trial. SO - Patient Education & Counseling. 80(2):158-63, 2010 Aug AS - Patient Educ Couns. 80(2):158-63, 2010 Aug NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2889196 OI - Source: NLM. NIHMS158927 SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - *Breast Neoplasms/pc [Prevention & Control] MH - Cognition MH - *Comprehension MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - Risk Assessment MH - *Selective Estrogen Receptor Modulators/tu [Therapeutic Use] MH - *Tamoxifen/tu [Therapeutic Use] AB - OBJECTIVE: Women at high risk of breast cancer face a difficult decision whether to take medications like tamoxifen to prevent a first breast cancer diagnosis. Decision aids (DAs) offer a promising method of helping them make this decision. But concern lingers that DAs might introduce cognitive biases. AB - METHODS: We recruited 663 women at high risk of breast cancer and presented them with a DA designed to experimentally test potential methods of identifying and reducing cognitive biases that could influence this decision, by varying specific aspects of the DA across participants in a factorial design. AB - RESULTS: Participants were susceptible to a cognitive bias - an order effect - such that those who learned first about the risks of tamoxifen thought more favorably of the drug than women who learned first about the benefits. This order effect was eliminated among women who received additional information about competing health risks. AB - CONCLUSION: We discovered that the order of risk/benefit information influenced women's perceptions of tamoxifen. This bias was eliminated by providing contextual information about competing health risks. AB - PRACTICE IMPLICATIONS: We have demonstrated the feasibility of using factorial experimental designs to test whether DAs introduce cognitive biases, and whether specific elements of DAs can reduce such biases. AB - Copyright Published by Elsevier Ireland Ltd. RN - 0 (Selective Estrogen Receptor Modulators) RN - 094ZI81Y45 (Tamoxifen) ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(09)00511-4 DO - https://dx.doi.org/10.1016/j.pec.2009.10.021 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural ID - 20004545 [pubmed] ID - S0738-3991(09)00511-4 [pii] ID - 10.1016/j.pec.2009.10.021 [doi] ID - PMC2889196 [pmc] ID - NIHMS158927 [mid] PP - ppublish PH - 2009/02/12 [received] PH - 2009/09/30 [revised] PH - 2009/10/03 [accepted] GI - No: P50 CA101451 Organization: (CA) *NCI NIH HHS* Country: United States No: P50 CA101451-060006 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA087595 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA087595-06A1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20091209 DP - 2010 Aug DC - 20100706 EZ - 2009/12/17 06:00 DA - 2010/11/03 06:00 DT - 2009/12/17 06:00 YR - 2010 ED - 20101101 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20004545 <277. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20687957 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Howard AF AU - Bottorff JL AU - Balneaves LG AU - Kim-Sing C FA - Howard, A Fuchsia FA - Bottorff, Joan L FA - Balneaves, Lynda G FA - Kim-Sing, Charmaine IN - Howard, A Fuchsia. School of Population and Public Health, University of British Columbia, Canada. fuchsia.howard@ubc.ca TI - Women's constructions of the 'right time' to consider decisions about risk-reducing mastectomy and risk-reducing oophorectomy. SO - BMC Women's Health. 10:24, 2010 Aug 05 AS - BMC Womens Health. 10:24, 2010 Aug 05 NJ - BMC women's health PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088690 IO - BMC Womens Health PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927493 SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Body Image MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Predisposition to Disease/px [Psychology] MH - Genetic Testing/px [Psychology] MH - Humans MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovarian Neoplasms/su [Surgery] MH - *Ovariectomy/px [Psychology] MH - Risk Reduction Behavior MH - Time Factors AB - BACKGROUND: Women who are notified they carry a BRCA1/2 mutation are presented with surgical options to reduce their risk of breast and ovarian cancer, including risk-reducing mastectomy (RRM) and risk-reducing oophorectomy (RRO). Growing evidence suggests that a sub-group of women do not make decisions about RRM and RRO immediately following genetic testing, but rather, consider these decisions years later. Women's perspectives on the timing of these decisions are not well understood. Accordingly, the purpose of this research was to describe how women construct the 'right time' to consider decisions about RRM and RRO. AB - METHODS: In-depth interviews were conducted with 22 BRCA1/2 carrier women and analyzed using qualitative, constant comparative methods. AB - RESULTS: The time that lapsed between receipt of genetic test results and receipt of RRM or RRO ranged from three months to nine years. The findings highlighted the importance of considering decisions about RRM and RRO one at a time. The women constructed the 'right time' to consider these decisions to be when: (1) decisions fit into their lives, (2) they had enough time to think about decisions, (3) they were ready emotionally to deal with the decisions and the consequences, (4) all the issues and conflicts were sorted out, (5) there were better options available, and (6) the health care system was ready for them. AB - CONCLUSIONS: These findings offer novel insights relevant to health care professionals who provide decision support to women considering RRM and RRO. ES - 1472-6874 IL - 1472-6874 DI - 1472-6874-10-24 DO - https://dx.doi.org/10.1186/1472-6874-10-24 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20687957 [pubmed] ID - 1472-6874-10-24 [pii] ID - 10.1186/1472-6874-10-24 [doi] ID - PMC2927493 [pmc] PP - epublish PH - 2010/01/14 [received] PH - 2010/08/05 [accepted] GI - Organization: *Canadian Institutes of Health Research* Country: Canada LG - English EP - 20100805 DP - 2010 Aug 05 DC - 20100825 EZ - 2010/08/07 06:00 DA - 2010/10/26 06:00 DT - 2010/08/07 06:00 YR - 2010 ED - 20101025 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20687957 <278. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20472659 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bancroft EK AU - Locke I AU - Ardern-Jones A AU - D'Mello L AU - McReynolds K AU - Lennard F AU - Barbachano Y AU - Barwell J AU - Walker L AU - Mitchell G AU - Dorkins H AU - Cummings C AU - Paterson J AU - Kote-Jarai Z AU - Mitra A AU - Jhavar S AU - Thomas S AU - Houlston R AU - Shanley S AU - Eeles RA FA - Bancroft, E K FA - Locke, I FA - Ardern-Jones, A FA - D'Mello, L FA - McReynolds, K FA - Lennard, F FA - Barbachano, Y FA - Barwell, J FA - Walker, L FA - Mitchell, G FA - Dorkins, H FA - Cummings, C FA - Paterson, J FA - Kote-Jarai, Z FA - Mitra, A FA - Jhavar, S FA - Thomas, S FA - Houlston, R FA - Shanley, S FA - Eeles, R A IN - Bancroft, E K. The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, UK. TI - The carrier clinic: an evaluation of a novel clinic dedicated to the follow-up of BRCA1 and BRCA2 carriers--implications for oncogenetics practice. SO - Journal of Medical Genetics. 47(7):486-91, 2010 Jul AS - J Med Genet. 47(7):486-91, 2010 Jul NJ - Journal of medical genetics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - j1f, 2985087r IO - J. Med. Genet. SB - Index Medicus CP - England MH - Adult MH - Aged MH - Apoptosis Regulatory Proteins MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/su [Surgery] MH - Data Collection MH - Female MH - Humans MH - Male MH - Middle Aged MH - Mutation MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovarian Neoplasms/su [Surgery] MH - Preventive Medicine MH - Retrospective Studies MH - Risk Reduction Behavior AB - BACKGROUND: A novel oncogenetic clinic was established in 2002 at the Royal Marsden NHS Foundation Trust offering advice and specialist follow-up for families with a germline mutation in BRCA1 or BRCA2. The remit of this multidisciplinary clinic, staffed by individuals in both oncology and genetics, is to provide individualised screening recommendations, support in decision making, risk reducing strategies, cascade testing, and an extensive research portfolio. AB - METHODS: A retrospective analysis was performed to evaluate uptake of genetic testing, risk reducing surgery and cancer prevalence in 346 BRCA1/BRCA2 families seen between January 1996 and December 2006. AB - RESULTS: 661 individuals attended the clinic and 406 mutation carriers were identified; 85.8% mutation carriers have chosen to attend for annual follow-up. 70% of mutation carriers elected for risk reducing bilateral salpingo-oophorectomy (RRBSO). 32% of unaffected women chose risk reducing bilateral mastectomy. 32% of women with breast cancer chose contralateral risk reducing mastectomy at time of diagnosis. Some women took over 8 years to decide to have surgery. 91% of individuals approached agreed to participate in research programmes. AB - INTERPRETATION: A novel specialist clinic for BRCA1/2 mutation carriers has been successfully established. The number of mutation positive families is increasing. This, and the high demand for RRBSO in women over 40, is inevitably going to place an increasing demand on existing health resources. Our clinic model has subsequently been adopted in other centres and this will greatly facilitate translational studies and provide a healthcare structure for management and follow-up of such people who are at a high cancer risk. RN - 0 (Apoptosis Regulatory Proteins) RN - 0 (BLID protein, human) RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) RN - 0 (BRCA2 Protein) RN - 0 (BRCA2 protein, human) ES - 1468-6244 IL - 0022-2593 DI - jmg.2009.072728 DO - https://dx.doi.org/10.1136/jmg.2009.072728 PT - Journal Article ID - 20472659 [pubmed] ID - jmg.2009.072728 [pii] ID - 10.1136/jmg.2009.072728 [doi] PP - ppublish LG - English EP - 20100514 DP - 2010 Jul DC - 20100701 EZ - 2010/05/18 06:00 DA - 2010/10/16 06:00 DT - 2010/05/18 06:00 YR - 2010 ED - 20101015 RD - 20101118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20472659 <279. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19329775 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sepucha KR AU - Ozanne EM AU - Partridge AH AU - Moy B FA - Sepucha, Karen R FA - Ozanne, Elissa M FA - Partridge, Ann H FA - Moy, Beverly IN - Sepucha, Karen R. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. ksepucha@partners.org TI - Is there a role for decision aids in advanced breast cancer?. SO - Medical Decision Making. 29(4):475-82, 2009 Jul-Aug AS - Med Decis Making. 29(4):475-82, 2009 Jul-Aug NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Choice Behavior MH - Confidence Intervals MH - Data Collection MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - Neoplasm Metastasis MH - *Patient Education as Topic MH - Patient Participation MH - *Patients/px [Psychology] MH - Pilot Projects AB - BACKGROUND: A diagnosis of metastatic breast cancer (BC) forces patients and providers to make difficult treatment decisions. AB - OBJECTIVE: To pilot test a decision aid (DA) for advanced BC. AB - DESIGN: Pretest, posttest study. AB - SETTING: Two academic cancer centers in Boston, Massachusetts. AB - PATIENTS: Fifty patients diagnosed with advanced BC. AB - INTERVENTION: A patient DA that consisted of a 30-minute DVD and booklet. AB - MEASUREMENTS: Patients were surveyed at baseline, after the intervention, and at 3 months. AB - MEASURES: included use and acceptability of DA, distress, treatment goals, and preference for and actual participation in decisions. Physicians were surveyed at baseline and 3 months. Measures included treatment goals, assessment of patients' experience with treatments, and patients' preference for and actual participation in decisions. AB - RESULTS: Thirty-two patients (64%) enrolled and completed the baseline survey, 30 completed the postvideo survey, and 25 completed the 3-month survey. The DA was acceptable and did not increase distress. The majority desired to share decision making with their doctor. Only 38% achieved their desired level of participation. At baseline, agreement between patients and providers on the main goal of treatment (lengthen life v. relieve symptoms) was 50% (kappa = -0.045, P = 0.71), and at 3 months it was 74% (kappa = 0.125, P = 0.48). AB - CONCLUSIONS: . It is feasible to perform a clinical trial of a DA with advanced BC patients. Most participants wanted to participate in decisions about their care and found the DA acceptable. This study highlights several issues in developing and implementing DAs in this vulnerable population facing complex decisions. IS - 0272-989X IL - 0272-989X DI - 0272989X09333124 DO - https://dx.doi.org/10.1177/0272989X09333124 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19329775 [pubmed] ID - 0272989X09333124 [pii] ID - 10.1177/0272989X09333124 [doi] PP - ppublish LG - English EP - 20090327 DP - 2009 Jul-Aug DC - 20090727 EZ - 2009/03/31 09:00 DA - 2010/09/24 06:00 DT - 2009/03/31 09:00 YR - 2009 ED - 20100923 RD - 20090727 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19329775 <280. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20059483 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Skytte AB AU - Gerdes AM AU - Andersen MK AU - Sunde L AU - Brondum-Nielsen K AU - Waldstrom M AU - Kolvraa S AU - Cruger D FA - Skytte, A-B FA - Gerdes, A-M FA - Andersen, M K FA - Sunde, L FA - Brondum-Nielsen, K FA - Waldstrom, M FA - Kolvraa, S FA - Cruger, D IN - Skytte, A-B. Department of Clinical Genetics, Vejle Hospital, Vejle. anne-bine.skytte@slb.regionsyddanmark.dk TI - Risk-reducing mastectomy and salpingo-oophorectomy in unaffected BRCA mutation carriers: uptake and timing. SO - Clinical Genetics. 77(4):342-9, 2010 Apr AS - Clin Genet. 77(4):342-9, 2010 Apr NJ - Clinical genetics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ddt, 0253664 IO - Clin. Genet. SB - Index Medicus CP - Denmark MH - Adult MH - Aged MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - *Fallopian Tubes/su [Surgery] MH - Female MH - *Heterozygote MH - Humans MH - *Mastectomy/mt [Methods] MH - Middle Aged MH - *Mutation/ge [Genetics] MH - *Ovariectomy/mt [Methods] MH - Risk Factors MH - Time Factors AB - Once female carriers of a BRCA mutation are identified they have to make decisions on risk management. The aim of this study is to outline the uptake of risk-reducing surgery in the Danish population of BRCA mutation positive women and to search for factors affecting this decision. We analysed data from 306 healthy BRCA carriers with no personal history of ovarian or breast cancer. We found a 10-year uptake of 75% for risk-reducing salpingo-oophorectomy and 50% for risk-reducing mastectomy by time to event analysis. Age and childbirth influenced this decision. The uptake rate has not changed significantly over the last decade. Risk-reducing surgeries are widely acceptable among Danish BRCA mutation positive women and the uptake of prophylactic mastectomy is higher than in most other countries. RN - 0 (BRCA1 Protein) RN - 0 (BRCA2 Protein) ES - 1399-0004 IL - 0009-9163 DI - CGE1329 DO - https://dx.doi.org/10.1111/j.1399-0004.2009.01329.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20059483 [pubmed] ID - CGE1329 [pii] ID - 10.1111/j.1399-0004.2009.01329.x [doi] PP - ppublish LG - English EP - 20100106 DP - 2010 Apr DC - 20100507 EZ - 2010/01/12 06:00 DA - 2010/09/15 06:00 DT - 2010/01/12 06:00 YR - 2010 ED - 20100914 RD - 20100507 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20059483 <281. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19768651 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Freedman GM AU - Li T AU - Anderson PR AU - Nicolaou N AU - Konski A FA - Freedman, Gary M FA - Li, Tianyu FA - Anderson, Penny R FA - Nicolaou, Nicos FA - Konski, Andre IN - Freedman, Gary M. Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA. Gary.Freedman@FCCC.edu TI - Health states of women after conservative surgery and radiation for breast cancer. SO - Breast Cancer Research & Treatment. 121(2):519-26, 2010 Jun AS - Breast Cancer Res Treat. 121(2):519-26, 2010 Jun NJ - Breast cancer research and treatment PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874617 OI - Source: NLM. NIHMS145599 SB - Index Medicus CP - Netherlands MH - Activities of Daily Living MH - Adolescent MH - Adult MH - Aged MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Breast Neoplasms MH - Female MH - *Health Status MH - Health Status Indicators MH - Humans MH - Mastectomy MH - Middle Aged MH - *Outcome Assessment (Health Care) MH - *Quality of Life MH - Radiotherapy MH - Young Adult AB - The aim of the study is to use the EQ-5D instrument to evaluate the long-term health states of women with early stage breast cancer treated by breast-conserving surgery and radiation. A total of 1,050 women treated with conservative surgery and radiation with or without systemic therapy completed 2,480 questionnaires during follow-up visits. The EQ-5D is a standardized and validated instrument for measuring quality of life outcomes. The descriptive system uses 5 dimensions of health with three possible levels of response that combine into 243 (3(5)) possible unique health states that are each assigned a values-based index score from 0 to 1. The visual analog scale (VAS) rates health on a simple vertical line from 0 to 100. Higher scores correspond to better health status. The mean index scores were 0.89 (95% CI: 0.87-0.91) at 5 years, 0.9 (95% CI: 0.86-0.94) at 10 years, and 0.9 (95% CI: 0.83-1.0) at 15 years. There were no significant differences in health states between patients by age when compared with U.S. controls. There was a statistically significant positive correlation between the results of the VAS and descriptive system. Significant trends in health dimensions over 15 years were increased problems with self-care and decreased problems with anxiety/depression, pain/discomfort, and performing usual activities. This study of EQ-5D is unique and demonstrates very high quality of life in patients long-term after breast-conserving surgery and radiation. These health states are comparable to the adult female U.S. population. These data will provide valuable patient utility information for informing decision analyses investigating new treatments in women with breast cancer. ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-009-0552-5 PT - Journal Article ID - 19768651 [pubmed] ID - 10.1007/s10549-009-0552-5 [doi] ID - PMC2874617 [pmc] ID - NIHMS145599 [mid] PP - ppublish PH - 2009/04/17 [received] PH - 2009/09/10 [accepted] GI - No: P30 CA006927 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA006927-46 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20090920 DP - 2010 Jun DC - 20100521 EZ - 2009/09/22 06:00 DA - 2010/08/21 06:00 DT - 2009/09/22 06:00 YR - 2010 ED - 20100820 RD - 20161118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19768651 <282. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20609548 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mack LA AU - Dabbs K AU - Temple WJ FA - Mack, L A FA - Dabbs, K FA - Temple, W J IN - Mack, L A. Department of Surgery and Oncology, University of Calgary, 1331-29th Street NW, Calgary, Alberta, Canada. TI - Synoptic operative record for point of care outcomes: a leap forward in knowledge translation. SO - European Journal of Surgical Oncology. 36 Suppl 1:S44-9, 2010 Sep AS - Eur J Surg Oncol. 36 Suppl 1:S44-9, 2010 Sep NJ - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 8504356, eur IO - Eur J Surg Oncol SB - Index Medicus CP - England MH - Alberta MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Electronic Health Records/st [Standards] MH - Female MH - Humans MH - Information Management MH - International Cooperation MH - Knowledge MH - Mastectomy MH - *Point-of-Care Systems MH - Software AB - INTRODUCTION: Modern information technology coupled with synoptic methodology allows point of care, real time outcomes generation. Our objective was to review province-wide breast cancer surgery outcomes from a prospective synoptic operative record to demonstrate its value in knowledge translation. AB - METHODS: All synoptic reports for breast cancer procedures from 2006 until March 2010 were reviewed and descriptively analyzed. Key outcomes included frequency of breast cancer procedures captured over time, methods of breast cancer detection, clinical staging, method of axillary staging, breast conservation and reconstruction rates. Further analysis involved important decision-making for mastectomy and resource allocation for surgery. AB - RESULTS: Four thousand nine hundred fifty-five breast cancer procedures were recorded synoptically; greater than 80% of cases provincially. Method of breast cancer detection was 49%, 45% and 4% by screening radiology, patient or family, and physician, respectively. Pathologic diagnoses were via core or mammotome biopsy in 94%; nearly half of all patients were clinical Stage I at time of operation. Overall rate of breast conservation was 48%. Of the 65% who had no contra-indication to breast conservation surgery, 76% had breast conservation and 4% had primary reconstruction. Of those having mastectomy, one third were due to patient choice. Seventy-nine percent had sentinel node staging, 18% had full axillary dissection and 3% had no axillary staging. AB - CONCLUSION: A new paradigm of creating medical records using synoptic electronic templates allows prospective outcomes generation at point of care by the surgeon which is unparalleled in its depth of surgical detail capturing surgical decision-making. AB - Copyright (c) 2010 Elsevier Ltd. All rights reserved. ES - 1532-2157 IL - 0748-7983 DI - S0748-7983(10)00181-2 DO - https://dx.doi.org/10.1016/j.ejso.2010.06.005 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20609548 [pubmed] ID - S0748-7983(10)00181-2 [pii] ID - 10.1016/j.ejso.2010.06.005 [doi] PP - ppublish PH - 2010/06/01 [received] PH - 2010/06/01 [accepted] LG - English EP - 20100706 DP - 2010 Sep DC - 20100802 EZ - 2010/07/09 06:00 DA - 2010/08/20 06:00 DT - 2010/07/09 06:00 YR - 2010 ED - 20100819 RD - 20100802 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20609548 <283. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19811545 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bhavnani V AU - Fisher B FA - Bhavnani, Vanita FA - Fisher, Brian IN - Bhavnani, Vanita. Honorary Research Associate, Department of General Practice and Primary Care, Kings College London, London, UK. TI - Patient factors in the implementation of decision aids in general practice: a qualitative study. SO - Health Expectations. 13(1):45-54, 2010 Mar AS - Health Expect. 13(1):45-54, 2010 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - *Decision Support Systems, Clinical MH - *Family Practice MH - Female MH - Focus Groups MH - Humans MH - Male MH - Middle Aged MH - *Patient Participation MH - United Kingdom AB - BACKGROUND: Decision aids (DAs) have been developed to help patients make treatment decisions. Research shows that they are effective in increasing patients' knowledge of treatment options without raising anxiety or conflict. However, they have not been routinely adopted for use in general practice in the UK and there are few reports addressing strategies to introduce them. AB - OBJECTIVE: To examine patients' views about a variety of DAs for different conditions (heart disease, osteoporosis, osteoarthritis and breast cancer) in order to inform a strategy to introduce them into general practice. AB - SETTING AND PARTICIPANTS: General practice patients over the age of 18 years being or having been treated for one of the conditions above. AB - METHODS: Qualitative study involving 12 focus groups with 77 patients evaluating decision aids relevant to their conditions. A semi-structured interview guide was used to generate discussions about the applicability of the DAs in routine general practice. AB - RESULTS: Patients welcomed DAs for their educational and informational content. Reactions to the DAs were influenced by patients' own personal desires for involvement. The main concerns were that the use of DAs would potentially shift the onus of decision making responsibility on to the patient and about the practical challenges to implementation. AB - CONCLUSIONS: Clinicians will need to make explicit to patients that DAs are an adjunct to routine care and not a replacement, and therefore do not represent a derogation of responsibility. DAs need to be used as an integral part of the communication and support process for patients who want them. ES - 1369-7625 IL - 1369-6513 DI - HEX556 DO - https://dx.doi.org/10.1111/j.1369-7625.2009.00556.x PT - Journal Article ID - 19811545 [pubmed] ID - HEX556 [pii] ID - 10.1111/j.1369-7625.2009.00556.x [doi] ID - PMC5060516 [pmc] PP - ppublish LG - English EP - 20091007 DP - 2010 Mar DC - 20100506 EZ - 2009/10/09 06:00 DA - 2010/08/05 06:00 DT - 2009/10/09 06:00 YR - 2010 ED - 20100804 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=19811545 <284. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19811545 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bhavnani V AU - Fisher B FA - Bhavnani, Vanita FA - Fisher, Brian IN - Bhavnani, Vanita. Honorary Research Associate, Department of General Practice and Primary Care, Kings College London, London, UK. TI - Patient factors in the implementation of decision aids in general practice: a qualitative study. SO - Health Expectations. 13(1):45-54, 2010 Mar AS - Health Expect. 13(1):45-54, 2010 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - *Decision Support Systems, Clinical MH - *Family Practice MH - Female MH - Focus Groups MH - Humans MH - Male MH - Middle Aged MH - *Patient Participation MH - United Kingdom AB - BACKGROUND: Decision aids (DAs) have been developed to help patients make treatment decisions. Research shows that they are effective in increasing patients' knowledge of treatment options without raising anxiety or conflict. However, they have not been routinely adopted for use in general practice in the UK and there are few reports addressing strategies to introduce them. AB - OBJECTIVE: To examine patients' views about a variety of DAs for different conditions (heart disease, osteoporosis, osteoarthritis and breast cancer) in order to inform a strategy to introduce them into general practice. AB - SETTING AND PARTICIPANTS: General practice patients over the age of 18 years being or having been treated for one of the conditions above. AB - METHODS: Qualitative study involving 12 focus groups with 77 patients evaluating decision aids relevant to their conditions. A semi-structured interview guide was used to generate discussions about the applicability of the DAs in routine general practice. AB - RESULTS: Patients welcomed DAs for their educational and informational content. Reactions to the DAs were influenced by patients' own personal desires for involvement. The main concerns were that the use of DAs would potentially shift the onus of decision making responsibility on to the patient and about the practical challenges to implementation. AB - CONCLUSIONS: Clinicians will need to make explicit to patients that DAs are an adjunct to routine care and not a replacement, and therefore do not represent a derogation of responsibility. DAs need to be used as an integral part of the communication and support process for patients who want them. ES - 1369-7625 IL - 1369-6513 DI - HEX556 DO - https://dx.doi.org/10.1111/j.1369-7625.2009.00556.x PT - Journal Article ID - 19811545 [pubmed] ID - HEX556 [pii] ID - 10.1111/j.1369-7625.2009.00556.x [doi] PP - ppublish LG - English EP - 20091007 DP - 2010 Mar DC - 20100506 EZ - 2009/10/09 06:00 DA - 2010/08/05 06:00 DT - 2009/10/09 06:00 YR - 2010 ED - 20100804 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19811545 <285. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20458026 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ropka ME AU - Keim J AU - Philbrick JT FA - Ropka, Mary E FA - Keim, Jess FA - Philbrick, John T IN - Ropka, Mary E. Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. mer2e@virginia.edu TI - Patient decisions about breast cancer chemoprevention: a systematic review and meta-analysis. [Review] [49 refs] SO - Journal of Clinical Oncology. 28(18):3090-5, 2010 Jun 20 AS - J Clin Oncol. 28(18):3090-5, 2010 Jun 20 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903338 SB - Index Medicus CP - United States MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Making MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Meta-Analysis as Topic AB - PURPOSE: Women at high risk of breast cancer face the complex decision of whether to take tamoxifen or raloxifene for breast cancer chemoprevention. We investigated what is known about decisions of women regarding chemoprevention. AB - METHODS: Using MEDLINE, CINAHL, and PSYCINFO, plus reviewing reference lists of relevant articles, in December 2009 we identified 13 studies that addressed patient decisions about breast cancer chemoprevention, were published in 1995 or later, were peer-reviewed primary clinical studies, and reported rates at which participants showed interest in (hypothetical uptake) or accepted (real uptake) chemoprevention medications. AB - RESULTS: Nine studies provided information about hypothetical breast cancer chemoprevention decisions (mean uptake rate, 24.7%) and five provided information about real decisions (mean uptake rate, 14.8%). The range of rates was wide, and each of the hypothetical uptake studies assessed interest differently. A logistic regression model found significant correlation with uptake of decision type (hypothetical versus real, odds ratio [OR] = 1.65; 95% CI, 1.26 to 2.16), educational or decision support intervention (provided v not, OR = 0.21; 95% CI, 0.17 to 0.27), and cohort risk for breast cancer (high-risk v general population, OR = 0.65; 95% CI, 0.56 to 0.75). Perceived vulnerability to breast cancer was consistently correlated with increased uptake, and concern for adverse effects was correlated with reduced uptake. All studies used a correlational/descriptive design, and most studies used convenience sampling strategies. AB - CONCLUSION: Breast cancer chemoprevention uptake rates are low and variation is wide. Hypothetical uptake rates are higher than real uptake, and interventions markedly reduce uptake. Research is needed that uses reproducible sampling methods and examines decision support strategies that lead to quality decisions. [References: 49] RN - 0 (Antineoplastic Agents) ES - 1527-7755 IL - 0732-183X DI - JCO.2009.27.8077 DO - https://dx.doi.org/10.1200/JCO.2009.27.8077 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Review ID - 20458026 [pubmed] ID - JCO.2009.27.8077 [pii] ID - 10.1200/JCO.2009.27.8077 [doi] ID - PMC2903338 [pmc] PP - ppublish GI - No: R21 NR009868 Organization: (NR) *NINR NIH HHS* Country: United States No: 1R21 NR 009868-01A1 Organization: (NR) *NINR NIH HHS* Country: United States LG - English EP - 20100510 DP - 2010 Jun 20 DC - 20100618 EZ - 2010/05/12 06:00 DA - 2010/07/07 06:00 DT - 2010/05/12 06:00 YR - 2010 ED - 20100706 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20458026 <286. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19809867 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Morgan D AU - Sylvester H AU - Lucas FL AU - Miesfeldt S FA - Morgan, Debra FA - Sylvester, Heather FA - Lucas, F Lee FA - Miesfeldt, Susan IN - Morgan, Debra. Maine Medical Center Research Institute, Scarborough, ME, USA. TI - Perceptions of high-risk care and barriers to care among women at risk for hereditary breast and ovarian cancer following genetic counseling in the community setting. SO - Journal of Genetic Counseling. 19(1):44-54, 2010 Feb AS - J Genet Couns. 19(1):44-54, 2010 Feb NJ - Journal of genetic counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9206865 IO - J Genet Couns SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - *Community Health Services MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - *Genetic Counseling MH - Humans MH - Middle Aged MH - *Ovarian Neoplasms/ge [Genetics] MH - Point Mutation/ge [Genetics] MH - Risk Factors MH - *Women's Health Services/ut [Utilization] MH - Young Adult AB - Data are limited regarding barriers to care among women, with or at risk for hereditary breast and ovarian cancer (HBOC), following genetic counseling in the community setting. Using a telephone survey, we retrospectively addressed perceptions of post-genetic counseling medical care and barriers to care among 69 at-risk women from the non-academic setting. Of these, all agreed that following cancer screening recommendations was better than not following them; none felt recommendations were too difficult to follow; all believed screening would help keep them healthy; 57% believed screening would prevent cancer. Twenty-five percent noted discomfort with breast imaging; 29% found ovarian cancer screening uncomfortable. Close to a quarter of participants reported difficulty deciding whether or not to undergo risk-reducing mastectomy while 10% noted difficulty deciding for or against bilateral salpingo-oophorectomy. There were no perceived major barriers to care, although 38% felt that screening reminders would be helpful, and 10% needed more help in following through with care. Overall, participants believed that they were benefiting from their post-genetic counseling medical care. This work identified HBOC-related support needs to include: informational resources that promote improved understanding of cancer risk and high-risk management; screening reminder systems; and decision support tools. ES - 1573-3599 IL - 1059-7700 DO - https://dx.doi.org/10.1007/s10897-009-9261-9 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19809867 [pubmed] ID - 10.1007/s10897-009-9261-9 [doi] PP - ppublish PH - 2009/04/17 [received] PH - 2009/09/10 [accepted] LG - English EP - 20091007 DP - 2010 Feb DC - 20100223 EZ - 2009/10/08 06:00 DA - 2010/06/09 06:00 DT - 2009/10/08 06:00 YR - 2010 ED - 20100608 RD - 20100223 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19809867 <287. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19609726 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Peshkin BN AU - Demarco TA AU - Tercyak KP FA - Peshkin, Beth N FA - Demarco, Tiffani A FA - Tercyak, Kenneth P IN - Peshkin, Beth N. Jess & Mildred Fisher Center for Familial Cancer Research, Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007-2401, USA. peshkinb@georgetown.edu TI - On the development of a decision support intervention for mothers undergoing BRCA1/2 cancer genetic testing regarding communicating test results to their children. SO - Familial Cancer. 9(1):89-97, 2010 Mar AS - Fam Cancer. 9(1):89-97, 2010 Mar NJ - Familial cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100898211 IO - Fam. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3556511 OI - Source: NLM. NIHMS433351 SB - Index Medicus CP - Netherlands MH - Adaptation, Psychological MH - *BRCA1 Protein/ge [Genetics] MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/ge [Genetics] MH - Child MH - Decision Making MH - Disclosure/lj [Legislation & Jurisprudence] MH - Female MH - *Genetic Counseling/lj [Legislation & Jurisprudence] MH - *Genetic Predisposition to Disease/ge [Genetics] MH - *Genetic Testing/mt [Methods] MH - Humans MH - Informed Consent/es [Ethics] MH - Mothers MH - Mutation MH - Patient Education as Topic MH - Physician's Role/px [Psychology] MH - Risk Assessment/mt [Methods] AB - Parent communication of BRCA1/2 test results to minor-age children is an important, yet understudied, clinical issue that is commonly raised in the management of familial cancer risk. Genetic counseling professionals and others who work with parents undergoing this form of testing often confront questions about the risks/benefits and timing of such disclosures, as well as the psychosocial impact of disclosure and nondisclosure on children's health and development. This paper briefly reviews literature on the prevalence and outcome of parent-child communication surrounding maternal BRCA1/2 test results. It also describes a formative research process that was used to develop a decision support intervention for mothers participating in genetic counseling and testing for BRCA1/2 mutations to address this issue, and highlights the conceptual underpinnings that guided and informed the intervention's development. The intervention consists of a print-based decision aid to facilitate parent education and counseling regarding if, when, and potentially how to disclose hereditary cancer risk information to children. We conclude with a summary of the role of social, behavioral, and decision science research to support the efforts of providers of familial cancer care regarding this important decision, and to improve the outcomes of cancer genetic testing for tested parents and their nontested children. RN - 0 (BRCA1 Protein) ES - 1573-7292 IL - 1389-9600 DO - https://dx.doi.org/10.1007/s10689-009-9267-3 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 19609726 [pubmed] ID - 10.1007/s10689-009-9267-3 [doi] ID - PMC3556511 [pmc] ID - NIHMS433351 [mid] PP - ppublish PH - 2009/01/28 [received] PH - 2009/07/03 [accepted] GI - No: R01 HG002686 Organization: (HG) *NHGRI NIH HHS* Country: United States No: R03 HG003686 Organization: (HG) *NHGRI NIH HHS* Country: United States No: R01HG02686 Organization: (HG) *NHGRI NIH HHS* Country: United States No: R03HG003686 Organization: (HG) *NHGRI NIH HHS* Country: United States LG - English EP - 20090717 DP - 2010 Mar DC - 20100217 EZ - 2009/07/18 09:00 DA - 2010/06/04 06:00 DT - 2009/07/18 09:00 YR - 2010 ED - 20100603 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19609726 <288. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20039216 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee BT AU - Chen C AU - Yueh JH AU - Nguyen MD AU - Lin SJ AU - Tobias AM FA - Lee, Bernard T FA - Chen, Chen FA - Yueh, Janet H FA - Nguyen, Minh-Doan FA - Lin, Samuel J FA - Tobias, Adam M IN - Lee, Bernard T. Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. blee3@bidmc.harvard.edu TI - Computer-based learning module increases shared decision making in breast reconstruction. CM - Comment in: Ann Surg Oncol. 2010 Mar;17(3):674-5; PMID: 20039213 SO - Annals of Surgical Oncology. 17(3):738-43, 2010 Mar AS - Ann Surg Oncol. 17(3):738-43, 2010 Mar NJ - Annals of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - *Computer-Assisted Instruction MH - Cross-Sectional Studies MH - *Decision Making MH - Female MH - Humans MH - Logistic Models MH - *Mammaplasty MH - Mastectomy MH - Middle Aged MH - Outcome Assessment (Health Care) AB - BACKGROUND: Shared decision making (SDM) combines evidence-based medicine with individual patient preferences. Patients who are actively engaged in their own health care management with their physicians have been shown to experience not only increased compliance, but also higher satisfaction and better outcomes. We hypothesize that a computer-based learning module for breast reconstruction increases patient involvement in the decision-making process. AB - MATERIALS AND METHODS: Women who underwent either immediate or delayed breast reconstruction at an academic teaching hospital from 2004 to 2007 were identified. Patients meeting inclusion criteria were mailed questionnaires on demographics, informational resources, and decision-making processes. Questionnaire results were divided into 2 groups for analysis: patients who received a standard surgeon consultation and patients who were shown a computer-based decision aid in addition to the standard consultation. AB - RESULTS: There were 358 women eligible for our study. A total of 255 patients (75.9%) responded to the survey; 168 patients were shown the computer-based decision aid and 87 patients were not. Patients who used the computer-based learning module reported a greater role in choosing the type of reconstruction (P < .001). Additionally, these patients reported a greater number of reconstructive options offered to them (P < .001) and were more satisfied with the amount of information provided by their reconstructive surgeon (P = .049). AB - CONCLUSIONS: A computer-based learning module allows patients to assimilate information and actively participate in choosing type of breast reconstruction. Use of this educational modality represents a simple and effective way to improve the shared decision-making process. ES - 1534-4681 IL - 1068-9265 DO - https://dx.doi.org/10.1245/s10434-009-0869-7 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20039216 [pubmed] ID - 10.1245/s10434-009-0869-7 [doi] PP - ppublish PH - 2009/05/18 [received] LG - English EP - 20091229 DP - 2010 Mar DC - 20100212 EZ - 2009/12/30 06:00 DA - 2010/05/21 06:00 DT - 2009/12/30 06:00 YR - 2010 ED - 20100520 RD - 20100212 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20039216 <289. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20189137 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Quinn GP AU - Vadaparampil ST AU - Jacobsen PB AU - Knapp C AU - Keefe DL AU - Bell GE AU - Moffitt Fertility Preservation Group FA - Quinn, Gwendolyn P FA - Vadaparampil, Susan T FA - Jacobsen, Paul B FA - Knapp, Caprice FA - Keefe, David L FA - Bell, Geri E FA - Moffitt Fertility Preservation Group IN - Quinn, Gwendolyn P. Moffitt Cancer Center - USF Health Outcomes, 12902 Magnolia Drive, MRC CANCONT, Tampa, FL 33612, USA. gwen.quinn@moffitt.org TI - Frozen hope: fertility preservation for women with cancer. SO - Journal of Midwifery & Women's Health. 55(2):175-80, 2010 Mar-Apr AS - J Midwifery Womens Health. 55(2):175-80, 2010 Mar-Apr NJ - Journal of midwifery & women's health PI - Journal available in: Print PI - Citation processed from: Internet JC - dml, 100909407 IO - J Midwifery Womens Health SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - *Antineoplastic Agents/ae [Adverse Effects] MH - Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/co [Complications] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - Cryopreservation MH - Female MH - Fertility/de [Drug Effects] MH - Fertility/ph [Physiology] MH - Genetic Counseling MH - Humans MH - Infertility/et [Etiology] MH - *Infertility/pc [Prevention & Control] MH - *Infertility/px [Psychology] MH - Patient Education as Topic MH - Reproductive Techniques, Assisted/es [Ethics] MH - Reproductive Techniques, Assisted/px [Psychology] MH - *Reproductive Techniques, Assisted AB - Young women diagnosed with cancer have the option of preserving their fertility by using assisted reproductive technology (ART) techniques prior to undergoing cancer treatment. This article presents a composite case of a young woman with cancer who had many unanswered emotional and ethical questions about her future as a parent. Fertility preservation techniques, including preimplantation genetic diagnosis (PGD), and related patient education are described. Current literature regarding reproductive counseling for cancer survivors is reviewed. Resources for providing psychosocial support for decisions about fertility preservation are lagging behind the rapid pace of scientific advancements in cancer treatment and ART. As more young women are surviving cancer and taking steps to preserve fertility, there is great need for the provision of psychologic support services and the establishment of ethical guidelines to aid them on this path. Women's health care providers can provide support to cancer survivors facing fertility and parenting issues by becoming knowledgeable about the long-term aspects of decision making and developing educational materials and guidelines for these patients. RN - 0 (Antineoplastic Agents) ES - 1542-2011 IL - 1526-9523 DI - S1526-9523(09)00232-3 DO - https://dx.doi.org/10.1016/j.jmwh.2009.07.009 PT - Case Reports PT - Clinical Conference PT - Journal Article ID - 20189137 [pubmed] ID - S1526-9523(09)00232-3 [pii] ID - 10.1016/j.jmwh.2009.07.009 [doi] PP - ppublish PH - 2009/03/01 [received] PH - 2009/07/23 [revised] PH - 2009/07/23 [accepted] LG - English DP - 2010 Mar-Apr DC - 20100301 EZ - 2010/03/02 06:00 DA - 2010/05/21 06:00 DT - 2010/03/02 06:00 YR - 2010 ED - 20100519 RD - 20100301 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20189137 <290. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19883996 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Warner E AU - Chow E AU - Fairchild A AU - Franssen E AU - Paszat L AU - Szumacher E FA - Warner, E FA - Chow, E FA - Fairchild, A FA - Franssen, E FA - Paszat, L FA - Szumacher, E IN - Warner, E. Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada. TI - Attitudes of Canadian radiation oncologists towards post-lumpectomy radiotherapy for elderly women with stage I hormone-responsive breast cancer. SO - Clinical Oncology (Royal College of Radiologists). 22(2):97-106, 2010 Mar AS - Clin Oncol (R Coll Radiol). 22(2):97-106, 2010 Mar NJ - Clinical oncology (Royal College of Radiologists (Great Britain)) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - ayi, 9002902 IO - Clin Oncol (R Coll Radiol) SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - *Attitude of Health Personnel MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Canada MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Female MH - Humans MH - Male MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Staging MH - Neoplasms, Hormone-Dependent/pa [Pathology] MH - *Neoplasms, Hormone-Dependent/rt [Radiotherapy] MH - Neoplasms, Hormone-Dependent/su [Surgery] MH - Postoperative Period MH - Practice Patterns, Physicians' MH - *Radiation Oncology MH - Radiotherapy Planning, Computer-Assisted MH - Survival Rate MH - Treatment Outcome AB - AIMS: Post-lumpectomy breast radiation is the standard of care for all patient subgroups. However, elderly women with stage I breast cancer on adjuvant tamoxifen therapy have a 4% risk of local recurrence after lumpectomy without adjuvant breast radiation. The purpose of this study was to explore the attitudes of Canadian radiation oncologists who treat breast cancer with respect to their use of adjuvant post-lumpectomy radiotherapy, and their willingness to implement a decision aid for this patient population. AB - MATERIALS AND METHODS: The questionnaire was mailed to 141 Canadian radiation oncologists who treat breast cancer. The respondents were asked to complete an online survey consisting of four parts: (1) demographic information; (2) factors determining post-lumpectomy radiation treatment decisions; (3) hypothetical case scenarios; (4) interest in using a decision aid in their practice. AB - RESULTS: Among the 61 (43%) physicians who completed the survey, there was substantial response variation. After contraindications to radiotherapy, patient overall health and patient preference had the greatest influence on their decision to offer radiotherapy to this patient subgroup. Margin status and use of hormonal therapy were given less importance. For each of the case scenarios, 60-83% of physicians (depending on the case scenario) would offer the patient a choice; far fewer (12-57%) would be comfortable not irradiating. Sixty-four per cent of respondents welcomed the concept of a decision aid for this population. AB - CONCLUSIONS: Although there is significant variation in practice patterns and attitudes among radiation oncologists regarding post-lumpectomy radiotherapy for elderly, low-risk breast cancer patients, the vast majority value patient choice and would be willing to use a decision aid designed for this population in their practice. AB - Copyright 2009 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved. ES - 1433-2981 IL - 0936-6555 DI - S0936-6555(09)00328-8 DO - https://dx.doi.org/10.1016/j.clon.2009.10.001 PT - Case Reports PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19883996 [pubmed] ID - S0936-6555(09)00328-8 [pii] ID - 10.1016/j.clon.2009.10.001 [doi] PP - ppublish PH - 2009/03/13 [received] PH - 2009/09/09 [revised] PH - 2009/10/01 [accepted] LG - English EP - 20091101 DP - 2010 Mar DC - 20100215 EZ - 2009/11/04 06:00 DA - 2010/05/12 06:00 DT - 2009/11/04 06:00 YR - 2010 ED - 20100511 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19883996 <291. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20159458 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - McCaffery KJ AU - Jansen J FA - McCaffery, Kirsten J FA - Jansen, Jesse IN - McCaffery, Kirsten J. Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia. TI - Pre-operative MRI for women with newly diagnosed breast cancer: perspectives on clinician and patient decision-making when evidence is uncertain. [Review] [35 refs] CM - Comment in: Breast. 2010 Oct;19(5):435-6; PMID: 20493698 SO - Breast. 19(1):10-2, 2010 Feb AS - BREAST. 19(1):10-2, 2010 Feb NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Decision Making MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Magnetic Resonance Imaging/ct [Contraindications] MH - *Magnetic Resonance Imaging/mt [Methods] MH - Mammography/mt [Methods] MH - Neoplasm Staging MH - *Patient Participation/px [Psychology] MH - *Preoperative Care/mt [Methods] MH - Preoperative Care/px [Psychology] MH - Professional-Patient Relations MH - Women's Health AB - The routine use of pre-operative MRI in women with newly diagnosed breast cancer highlights the complexities of the use of new technology when evidence of benefit is uncertain. There are both potential harms and benefits. In the short term patients may desire and feel reassured by further testing and the use of new diagnostic techniques. However, they may also experience greater anxiety and distress from further tests and related follow-up procedures such as biopsy. In the long term MRI may result in more radical treatment decisions which are associated with poorer quality of life for women. Both patients and clinicians often (wrongly) assume that more information via testing leads to better outcomes (information bias). So how should pre-operative MRI be integrated into breast cancer care? First women need to be made aware of the uncertain evidence surrounding MRI. However whether it is appropriate to burden women with complex information and yet another decision at a time of high vulnerability and emotional distress should be considered. One potential solution is to use a Community Informed Consent approach in which a representative sample of patients and healthy women are educated about the benefits and harms and give their informed opinion about whether pre-operative MRI should be offered. Another approach is to provide patients with an evidence based decision aid to support individual informed choice. Either or a combination of both approaches would be acceptable and should be investigated. At present women are poorly informed about pre operative MRI and it is likely that they assume outcomes are be improved as a result. Clear communication about the limits of MRI to patients is needed alongside randomised trials to provide the evidence that benefit indeed outweighs the harms so that all parties involved may be comprehensively informed. AB - Copyright (c) 2009 Elsevier Ltd. All rights reserved. [References: 35] ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(09)00165-9 DO - https://dx.doi.org/10.1016/j.breast.2009.11.005 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 20159458 [pubmed] ID - S0960-9776(09)00165-9 [pii] ID - 10.1016/j.breast.2009.11.005 [doi] PP - ppublish LG - English DP - 2010 Feb DC - 20100217 EZ - 2010/02/18 06:00 DA - 2010/05/08 06:00 DT - 2010/02/18 06:00 YR - 2010 ED - 20100507 RD - 20101004 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20159458 <292. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20072087 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Matros E AU - Yueh JH AU - Bar-Meir ED AU - Slavin SA AU - Tobias AM AU - Lee BT FA - Matros, Evan FA - Yueh, Janet H FA - Bar-Meir, Eran D FA - Slavin, Sumner A FA - Tobias, Adam M FA - Lee, Bernard T IN - Matros, Evan. Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. 02215, USA. TI - Sociodemographics, referral patterns, and Internet use for decision-making in microsurgical breast reconstruction. SO - Plastic & Reconstructive Surgery. 125(4):1087-94, 2010 Apr AS - Plast Reconstr Surg. 125(4):1087-94, 2010 Apr NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Breast Implants/sn [Statistics & Numerical Data] MH - *Breast Neoplasms/ep [Epidemiology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Demography MH - Female MH - Health Care Surveys MH - Health Education/sn [Statistics & Numerical Data] MH - Humans MH - *Internet/sn [Statistics & Numerical Data] MH - Mammaplasty/mt [Methods] MH - *Mammaplasty/sn [Statistics & Numerical Data] MH - Mastectomy/sn [Statistics & Numerical Data] MH - *Microsurgery/st [Standards] MH - Middle Aged MH - Patient Preference/sn [Statistics & Numerical Data] MH - *Referral and Consultation/sn [Statistics & Numerical Data] MH - Retrospective Studies MH - Surgical Flaps MH - Surveys and Questionnaires AB - BACKGROUND: Increasing numbers of patients are choosing to undergo microsurgical breast reconstruction. Currently, no information is available about the sociodemographic profile, referral patterns, or decision-making process of women who choose this reconstructive modality. AB - METHODS: All women who underwent breast reconstruction at a single institution between 2004 and 2007 were surveyed regarding demographic information, referral patterns, and decision-making processes. For data analysis, the cohort was separated by reconstructive method: nonmicrosurgical reconstruction (i.e., implant, latissimus, and pedicled transverse rectus abdominis musculocutaneous flaps) or microsurgical reconstruction (i.e., free transverse rectus abdominis musculocutaneous, deep inferior epigastric artery perforator, superficial inferior epigastric artery, and superior gluteal artery perforator flaps). AB - RESULTS: Overall, 332 women were surveyed, with a response rate of 77 percent. Patients who underwent microsurgical reconstruction were more likely to be 40 to 49 years old (p = 0.014), whereas nonmicrosurgical patients were clustered at the extremes of age. Microsurgery patients self-referred to a reconstructive surgeon, whereas other patients were sent by surgical oncologists (p < 0.001). The Internet was an important decision-making aid to help microsurgery patients identify their reconstructive modality (p < 0.001). Compared with nonmicrosurgical counterparts, microsurgery patients were independent decision-makers and more active in choosing their reconstructive procedure (p = 0.001). AB - CONCLUSIONS: Microsurgical breast reconstruction is highly sought after by a subset of patients with breast cancer. These patients are independent decision-makers in their health care choices. They use the Internet to learn about breast reconstruction techniques and are more likely to self-refer to a reconstructive surgeon. It remains unclear how many patients would choose microsurgical reconstruction if offered more widely or if awareness of the procedure were greater. ES - 1529-4242 IL - 0032-1052 DO - https://dx.doi.org/10.1097/PRS.0b013e3181d0ab63 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 20072087 [pubmed] ID - 10.1097/PRS.0b013e3181d0ab63 [doi] PP - ppublish LG - English DP - 2010 Apr DC - 20100325 EZ - 2010/01/15 06:00 DA - 2010/04/24 06:00 DT - 2010/01/15 06:00 YR - 2010 ED - 20100423 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20072087 <293. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19647966 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Butow P AU - Juraskova I AU - Chang S AU - Lopez AL AU - Brown R AU - Bernhard J FA - Butow, Phyllis FA - Juraskova, Ilona FA - Chang, Sarah FA - Lopez, Anna-Lena FA - Brown, Richard FA - Bernhard, Jurg IN - Butow, Phyllis. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, University of Sydney, Camperdown, NSW 2006, Australia. phyllisb@psych.usyd.edu.au TI - Shared decision making coding systems: how do they compare in the oncology context?. SO - Patient Education & Counseling. 78(2):261-8, 2010 Feb AS - Patient Educ Couns. 78(2):261-8, 2010 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Aged, 80 and over MH - Australia MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Forms and Records Control MH - Humans MH - Male MH - Medical Oncology MH - Middle Aged MH - New Zealand MH - Patient Participation/px [Psychology] MH - *Patient Participation/sn [Statistics & Numerical Data] MH - Patient Satisfaction MH - *Patient-Centered Care MH - *Physician-Patient Relations MH - Physicians MH - *Process Assessment (Health Care)/mt [Methods] MH - Psychometrics MH - Reproducibility of Results MH - Surveys and Questionnaires MH - Tape Recording AB - OBJECTIVE: The current study aimed to evaluate three coding systems which have been used to assess shared decision making in oncology consultations (OPTION, Decision Support Analysis Tool (DSAT) and Decision Analysis System for Oncology (DAS-O)): (i) comparing their ability to identify competencies of shared decision making, and (ii) determining their ability to predict patient outcomes in a single data set. AB - METHOD: Twenty oncologists from Australia and New Zealand participated in the IBCSG Trial 33-03. The consultations of 55 women with early stage breast cancer were audio-taped, transcribed and then coded using the OPTION, DAS-O and DSAT coding systems by three different raters. Women completed the questionnaires 2 weeks and 4 months after their consultation. AB - RESULTS: DAS-O was strongly correlated with OPTION (r=0.73). DSAT was moderately correlated with DAS-O and OPTION (r<0.6). Decisional satisfaction and satisfaction with doctor SDM skills were significantly correlated with OPTION (r=0.39 and 0.42 respectively) and the latter variable was correlated with DAS-O (r=0.40). These relationships persisted in multiple linear regression analyses. AB - CONCLUSIONS: OPTION may be the most efficient and sensitive coding system for research purposes; however, DSAT appeared to document behaviours reducing decisional conflict and both DSAT and DAS-O offer more detailed feedback to doctors. AB - PRACTICE IMPLICATIONS: Optimal coding system will depend on research goals and training purposes. AB - Copyright 2009 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(09)00251-1 DO - https://dx.doi.org/10.1016/j.pec.2009.06.009 PT - Evaluation Studies PT - Journal Article ID - 19647966 [pubmed] ID - S0738-3991(09)00251-1 [pii] ID - 10.1016/j.pec.2009.06.009 [doi] PP - ppublish PH - 2008/10/30 [received] PH - 2009/06/03 [revised] PH - 2009/06/19 [accepted] LG - English EP - 20090803 DP - 2010 Feb DC - 20100201 EZ - 2009/08/04 09:00 DA - 2010/04/15 06:00 DT - 2009/08/04 09:00 YR - 2010 ED - 20100414 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19647966 <294. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19908143 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fagerlin A AU - Zikmund-Fisher BJ AU - Nair V AU - Derry HA AU - McClure JB AU - Greene S AU - Stark A AU - Hensley Alford S AU - Lantz P AU - Hayes DF AU - Wiese C AU - Claud Zweig S AU - Pitsch R AU - Jankovic A AU - Ubel PA FA - Fagerlin, Angela FA - Zikmund-Fisher, Brian J FA - Nair, Vijayan FA - Derry, Holly A FA - McClure, Jennifer B FA - Greene, Sarah FA - Stark, Azadeh FA - Hensley Alford, Sharon FA - Lantz, Paula FA - Hayes, Daniel F FA - Wiese, Cheryl FA - Claud Zweig, Sarah FA - Pitsch, Rosemarie FA - Jankovic, Aleksandra FA - Ubel, Peter A IN - Fagerlin, Angela. Ann Arbor VA HSR&D, Center for Clinical Management Research, Ann Arbor, MI, USA. TI - Women's decisions regarding tamoxifen for breast cancer prevention: responses to a tailored decision aid. SO - Breast Cancer Research & Treatment. 119(3):613-20, 2010 Feb AS - Breast Cancer Res Treat. 119(3):613-20, 2010 Feb NJ - Breast cancer research and treatment PI - Journal available in: Print PI - Citation processed from: Internet JC - a8x, 8111104 IO - Breast Cancer Res. Treat. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736824 OI - Source: NLM. NIHMS487993 SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Making MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - *Selective Estrogen Receptor Modulators/tu [Therapeutic Use] MH - *Tamoxifen/tu [Therapeutic Use] AB - Tamoxifen reduces primary breast cancer incidence, yet causes serious side effects. To date, few women with increased breast cancer risk have elected to use tamoxifen for chemoprevention. The objective of the study was to determine women's knowledge of and attitudes toward tamoxifen following exposure to a tailored decision aid (DA). A total of 632 women with a 5-year risk of breast cancer > or = 1.66% (Mean = 2.56, range = 1.7-17.3) were recruited from two healthcare organizations. Participants viewed an online DA that informed them about their 5-year risk of breast cancer and presented individually tailored content depicting the risks/benefits of tamoxifen prophylaxis. Outcome measures included behavioral intentions (to seek additional information about tamoxifen, to talk to a physician about tamoxifen, and to take tamoxifen); knowledge; and perceived risks and benefits of tamoxifen. After viewing the DA, 29% of participants said they intended to seek more information or talk to their doctor about tamoxifen, and only 6% believed they would take tamoxifen. Knowledge was considerable, with 63% of women answering at least 5 of 6 knowledge questions correctly. Participants were concerned about the risks of tamoxifen, and many believed that the benefits of tamoxifen did not outweigh the risks. This study is the largest to date to test women's preferences for taking tamoxifen and one of the largest to have tested the impact of a tailored DA. After viewing the DA, women demonstrated good understanding of tamoxifen's risks and benefits, but most were not interested in taking tamoxifen for breast cancer chemoprevention. RN - 0 (Selective Estrogen Receptor Modulators) RN - 094ZI81Y45 (Tamoxifen) ES - 1573-7217 IL - 0167-6806 DO - https://dx.doi.org/10.1007/s10549-009-0618-4 PT - Clinical Trial PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 19908143 [pubmed] ID - 10.1007/s10549-009-0618-4 [doi] ID - PMC3736824 [pmc] ID - NIHMS487993 [mid] PP - ppublish PH - 2009/10/21 [received] PH - 2009/10/22 [accepted] GI - No: P50 CA101451 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2010 Feb DC - 20100119 EZ - 2009/11/13 06:00 DA - 2010/03/24 06:00 DT - 2009/11/13 06:00 YR - 2010 ED - 20100323 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19908143 <295. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19267384 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sheppard VB AU - Williams KP AU - Harrison TM AU - Jennings Y AU - Lucas W AU - Stephen J AU - Robinson D AU - Mandelblatt JS AU - Taylor KL FA - Sheppard, Vanessa B FA - Williams, Karen Patricia FA - Harrison, Toni Michelle FA - Jennings, Yvonne FA - Lucas, Wanda FA - Stephen, Juleen FA - Robinson, Dana FA - Mandelblatt, Jeanne S FA - Taylor, Kathryn L IN - Sheppard, Vanessa B. Cancer Control Program, Georgetown University, Washington, DC 20007, USA. vls3@georgetown.edu TI - Development of decision-support intervention for Black women with breast cancer. SO - Psycho-Oncology. 19(1):62-70, 2010 Jan AS - Psychooncology. 19(1):62-70, 2010 Jan NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136087 OI - Source: NLM. NIHMS127369 SB - Index Medicus CP - England MH - Adult MH - *African Continental Ancestry Group/px [Psychology] MH - Aged MH - Attitude to Health MH - *Breast Neoplasms/eh [Ethnology] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Chemotherapy, Adjuvant/px [Psychology] MH - Communication MH - *Decision Making MH - Female MH - Humans MH - *Mastectomy/px [Psychology] MH - *Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Motivation MH - Neoplasm Staging MH - Patient Acceptance of Health Care/px [Psychology] MH - Patient Education as Topic MH - Patient Satisfaction MH - Physician-Patient Relations MH - Pilot Projects MH - *Radiotherapy, Adjuvant/px [Psychology] MH - Social Support MH - Spirituality MH - *Survivors/px [Psychology] AB - BACKGROUND: Adjuvant therapy improves breast cancer survival but is underutilized by Black women. Few interventions have addressed this problem. This preliminary report describes the process we used to develop a decision-support intervention for Black women eligible for adjuvant therapy. Aims were to use qualitative methods to describe factors that influence Black women's adjuvant therapy decisions, use these formative data to develop messages for a treatment decision-support intervention, and pilot test the acceptability and utility of the intervention with community members and newly diagnosed women. AB - METHODS: Thirty-four in-depth interviews were conducted with breast cancer patients in active treatment, survivors and cancer providers to gather qualitative data. Participant ages ranged from 38 to 69 years. A cultural framework was used to analyze the data and to inform intervention messages. Most women relied on their providers for treatment recommendations. Several women reported problems communicating with providers and felt unprepared to ask questions and discuss adjuvant treatment options. Other factors related to treatment experiences were: spiritual coping, collectivism and sharing breast cancer experiences with other Black survivors. AB - RESULTS: Using these formative data, we developed an intervention that is survivor-based and includes an in-person session which incorporates sharing personal stories, communication skills training and decision support. Intervention materials were reviewed by community members, researchers/clinicians and patients newly diagnosed with breast cancer. AB - CONCLUSION: Patients reported satisfaction with the intervention and felt better prepared to talk with providers. The intervention will be tested in a randomized trial to enhance decision support and increase use of indicated adjuvant treatment. AB - Copyright (c) 2009 John Wiley & Sons Ltd. ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1530 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 19267384 [pubmed] ID - 10.1002/pon.1530 [doi] ID - PMC3136087 [pmc] ID - NIHMS127369 [mid] PP - ppublish GI - No: R01 CA127617 Organization: (CA) *NCI NIH HHS* Country: United States No: K05 CA096940-07 Organization: (CA) *NCI NIH HHS* Country: United States No: U10 CA084131-05S1 Organization: (CA) *NCI NIH HHS* Country: United States No: U10 CA084131 Organization: (CA) *NCI NIH HHS* Country: United States No: KO5 CA96940 Organization: (CA) *NCI NIH HHS* Country: United States No: K05 CA096940 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2010 Jan DC - 20091229 EZ - 2009/03/10 09:00 DA - 2010/03/23 06:00 DT - 2009/03/10 09:00 YR - 2010 ED - 20100322 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19267384 <296. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19726385 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lally RM FA - Lally, Robin M IN - Lally, Robin M. School of Nursing, University of Buffalo, New York, USA. rmlally@buffalo.edu TI - In the moment: women speak about surgical treatment decision making days after a breast cancer diagnosis. SO - Oncology Nursing Forum. 36(5):E257-65, 2009 Sep AS - Oncol Nurs Forum. 36(5):E257-65, 2009 Sep NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Internet JC - 7809033, 7809033 IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Emotions MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Interpersonal Relations MH - Mastectomy/nu [Nursing] MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Motivation MH - Oncology Nursing/mt [Methods] MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Qualitative Research AB - PURPOSE/OBJECTIVES: To explore the pretreatment thoughts and behaviors of women newly diagnosed with breast cancer regarding their surgical treatment decision-making experience. AB - RESEARCH APPROACH: Qualitative, descriptive. AB - SETTING: A multispecialty breast center in the midwestern region of the United States. AB - PARTICIPANTS: 18 English-speaking women, aged 37-87 years, mean of 12 days postdiagnosis of clinical stage 0-11 breast cancer. AB - METHODOLOGIC APPROACH: Open to semistructured interviews were conducted during the period following surgical consultation but prior to surgical treatment. Transcribed interviews, originally analyzed to identify the psychological processes of women in response to breast cancer diagnosis, were additionally analyzed using directed content analysis focusing on women's thoughts and behaviors related to their surgical treatment decision-making process. AB - MAIN RESEARCH VARIABLES: Breast cancer surgery and decision making pretreatment. AB - FINDINGS: Women's pretreatment thoughts and behaviors related to surgical treatment decision making were characterized by information processing, contemplating options, and interacting with others. Breast cancer information was used by women before the surgical consultation and after treatment decisions had been made. Treatment options were contemplated and preferences formed often before the initial surgical consultation. Women associated having options with a better prognosis. Age was a factor primarily in the type of information women desired. AB - CONCLUSIONS: Most women made their own surgical treatment decisions with ease, supported by the confidence instilled by their surgeons and oncology nurses. AB - INTERPRETATION: The findings provide oncology nurses with insight regarding women's desire for and use of information and their contemplation of surgical options, therefore suggesting areas on which to focus clinical assessment and to test tailored interventions. ES - 1538-0688 IL - 0190-535X DI - 60479J6810742700 DO - https://dx.doi.org/10.1188/09.ONF.E257-E265 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19726385 [pubmed] ID - 60479J6810742700 [pii] ID - 10.1188/09.ONF.E257-E265 [doi] PP - ppublish LG - English DP - 2009 Sep DC - 20090903 EZ - 2009/09/04 06:00 DA - 2010/03/13 06:00 DT - 2009/09/04 06:00 YR - 2009 ED - 20100312 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19726385 <297. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20077335 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Diekema DS AU - Fost N FA - Diekema, Douglas S FA - Fost, Norman IN - Diekema, Douglas S. University of Washington School of Medicine, USA. diek@u.washington.edu TI - Ashley revisited: a response to the critics. CM - Comment in: Am J Bioeth. 2010 Jan;10(1):52-4; PMID: 20077340 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):W4-6; PMID: 20077323 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):46-8; PMID: 20077337 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):48-50; PMID: 20077338 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):54-5; PMID: 20077341 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):57-8; PMID: 20077343 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):59-60; PMID: 20077344 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):45-6; PMID: 20077336 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):56; PMID: 20077342 CM - Comment in: Am J Bioeth. 2010 Jan;10(1):50-2; PMID: 20077339 SO - American Journal of Bioethics. 10(1):30-44, 2010 Jan AS - Am J Bioeth. 10(1):30-44, 2010 Jan NJ - The American journal of bioethics : AJOB PI - Journal available in: Print PI - Citation processed from: Internet JC - 100898738 IO - Am J Bioeth SB - Bioethics Journals SB - Index Medicus CP - United States MH - Body Height/de [Drug Effects] MH - *Body Height MH - Child MH - Child Advocacy MH - Choice Behavior/es [Ethics] MH - *Decision Making/es [Ethics] MH - *Developmental Disabilities/co [Complications] MH - *Disabled Persons MH - *Estrogens/ad [Administration & Dosage] MH - *Ethics Committees MH - Ethics, Clinical MH - Family MH - Female MH - Hospitals, Pediatric/es [Ethics] MH - Humans MH - *Hysterectomy/es [Ethics] MH - *Intellectual Disability/co [Complications] MH - *Mastectomy/es [Ethics] MH - *Parents MH - Personal Autonomy MH - Personhood MH - Prognosis MH - Puberty, Precocious/co [Complications] MH - Puberty, Precocious/dt [Drug Therapy] MH - Puberty, Precocious/su [Surgery] MH - *Puberty, Precocious/th [Therapy] MH - *Quality of Life MH - Sterilization, Involuntary/es [Ethics] MH - Uncertainty MH - *Wedge Argument AB - The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them. RN - 0 (Estrogens) ES - 1536-0075 IL - 1526-5161 DI - 918536933 DO - https://dx.doi.org/10.1080/15265160903469336 PT - Journal Article ID - 20077335 [pubmed] ID - 918536933 [pii] ID - 10.1080/15265160903469336 [doi] PP - ppublish LG - English DP - 2010 Jan DC - 20100115 EZ - 2010/01/16 06:00 DA - 2010/03/10 06:00 DT - 2010/01/16 06:00 YR - 2010 ED - 20100308 RD - 20111117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20077335 <298. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20048188 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sanghani M AU - Truong PT AU - Raad RA AU - Niemierko A AU - Lesperance M AU - Olivotto IA AU - Wazer DE AU - Taghian AG FA - Sanghani, Mona FA - Truong, Pauline T FA - Raad, Rita Abi FA - Niemierko, Andrzej FA - Lesperance, Mary FA - Olivotto, Ivo A FA - Wazer, David E FA - Taghian, Alphonse G IN - Sanghani, Mona. Department of Radiation Oncology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA. TI - Validation of a web-based predictive nomogram for ipsilateral breast tumor recurrence after breast conserving therapy. CM - Comment in: J Clin Oncol. 2010 Feb 10;28(5):709-11; PMID: 20048173 SO - Journal of Clinical Oncology. 28(5):718-22, 2010 Feb 10 AS - J Clin Oncol. 28(5):718-22, 2010 Feb 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834390 SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - British Columbia MH - Databases as Topic MH - *Decision Support Techniques MH - Female MH - Humans MH - *Internet MH - Kaplan-Meier Estimate MH - *Mastectomy, Segmental MH - Middle Aged MH - *Models, Biological MH - *Neoplasm Recurrence, Local MH - *Nomograms MH - Predictive Value of Tests MH - Proportional Hazards Models MH - Radiotherapy, Adjuvant MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - United States AB - PURPOSE IBTR! version 1.0 is a web-based tool that uses literature-derived relative risk ratios for seven clinicopathologic variables to predict ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT). Preliminary testing demonstrated over-estimation in high-risk subgroups. This study uses two independent population-based datasets to create and validate a modified nomogram, IBTR! version 2.0. METHODS Cox regression modeling was performed on 7,811 patients treated with BCT at the British Columbia Cancer Agency (median follow-up, 9.4 years). Population-based hazard ratios were generated for the seven variables in the original nomogram. A modified nomogram was then tested against 664 patients from Massachusetts General Hospital (median follow-up, 9.3 years). The mean predicted and observed 10-year estimates were compared for the entire cohort and for four groups predefined by nomogram-predicted risks: group 1: less than 3%; group 2: 3% to 5%; group 3: 5% to 10%; and group 4: more than 10%. Results IBTR! version 2.0 predicted an overall 10-year IBTR estimate of 4.0% (95% CI, 3.8 to 4.2), while the observed estimate was 2.8% (95% CI, 1.6 to 4.7; P = .10). The predicted and observed IBTR estimates were: group 1 (n = 283): 2.2% versus 1.3%, P = .40; group 2 (n = 237): 3.8% versus 3.5%, P = .80; group 3 (n = 111): 6.7% versus 3.2%, P = .05; and group 4 (n = 33): 12.5% versus 8.7%, P = .50. CONCLUSION IBTR! version 2.0 is accurate in the majority of patients with a low to moderate risk of in-breast recurrence. The nomogram still overestimates risk in a minority of patients with higher risk features. Validation in a larger prospective data set is warranted. ES - 1527-7755 IL - 0732-183X DI - JCO.2009.22.6662 DO - https://dx.doi.org/10.1200/JCO.2009.22.6662 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Validation Studies ID - 20048188 [pubmed] ID - JCO.2009.22.6662 [pii] ID - 10.1200/JCO.2009.22.6662 [doi] ID - PMC2834390 [pmc] PP - ppublish GI - No: P01 CA021239 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA050628 Organization: (CA) *NCI NIH HHS* Country: United States No: CA21239 Organization: (CA) *NCI NIH HHS* Country: United States No: CA50628 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20100104 DP - 2010 Feb 10 DC - 20100209 EZ - 2010/01/06 06:00 DA - 2010/03/05 06:00 DT - 2010/01/06 06:00 YR - 2010 ED - 20100304 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20048188 <299. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 20048173 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Solin LJ FA - Solin, Lawrence J TI - Breast conservation treatment with radiation: an ongoing success story. CM - Comment on: J Clin Oncol. 2010 Feb 10;28(5):718-22; PMID: 20048188 SO - Journal of Clinical Oncology. 28(5):709-11, 2010 Feb 10 AS - J Clin Oncol. 28(5):709-11, 2010 Feb 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - Female MH - Humans MH - Internet MH - *Mastectomy, Segmental MH - Models, Biological MH - *Neoplasm Recurrence, Local MH - Nomograms MH - Radiotherapy, Adjuvant MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome ES - 1527-7755 IL - 0732-183X DI - JCO.2009.26.1164 DO - https://dx.doi.org/10.1200/JCO.2009.26.1164 PT - Comment PT - Editorial ID - 20048173 [pubmed] ID - JCO.2009.26.1164 [pii] ID - 10.1200/JCO.2009.26.1164 [doi] PP - ppublish LG - English EP - 20100104 DP - 2010 Feb 10 DC - 20100209 EZ - 2010/01/06 06:00 DA - 2010/03/05 06:00 DT - 2010/01/06 06:00 YR - 2010 ED - 20100304 RD - 20100209 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=20048173 <300. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18708309 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Pacifico MD AU - See MS AU - Cavale N AU - Collyer J AU - Francis I AU - Jones ME AU - Hazari A AU - Boorman JG AU - Smith RW FA - Pacifico, M D FA - See, M S FA - Cavale, N FA - Collyer, J FA - Francis, I FA - Jones, M E FA - Hazari, A FA - Boorman, J G FA - Smith, R W IN - Pacifico, M D. Department of Plastic Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK. marcpacifico@dial.pipex.com TI - Preoperative planning for DIEP breast reconstruction: early experience of the use of computerised tomography angiography with VoNavix 3D software for perforator navigation. SO - Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS. 62(11):1464-9, 2009 Nov AS - J Plast Reconstr Aesthet Surg. 62(11):1464-9, 2009 Nov NJ - Journal of plastic, reconstructive & aesthetic surgery : JPRAS PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101264239 IO - J Plast Reconstr Aesthet Surg SB - Index Medicus CP - Netherlands MH - *Angiography/mt [Methods] MH - Breast Neoplasms/su [Surgery] MH - *Epigastric Arteries MH - Female MH - Follow-Up Studies MH - Graft Rejection MH - Graft Survival MH - Humans MH - Imaging, Three-Dimensional/mt [Methods] MH - Mammaplasty/is [Instrumentation] MH - *Mammaplasty/mt [Methods] MH - Mastectomy/mt [Methods] MH - Middle Aged MH - Preoperative Care/mt [Methods] MH - *Radiographic Image Interpretation, Computer-Assisted MH - Rectus Abdominis/bs [Blood Supply] MH - *Rectus Abdominis/tr [Transplantation] MH - Sampling Studies MH - Software MH - Surgical Flaps/bs [Blood Supply] MH - *Tomography, X-Ray Computed/mt [Methods] MH - Treatment Outcome MH - Wound Healing/ph [Physiology] AB - The deep inferior epigastric perforator (DIEP) flap is normally the first choice in breast reconstruction; however, due to the considerable vascular anatomical variation and the learning curve for the procedure, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM) flaps are still frequently performed to reduce the rate of complications. Accurate preoperative investigation of the perforators would allow better operative preparation and possibly shorten the learning curve. In an effort to increase accuracy of preoperative planning and to aid preoperative decision-making in free abdominal flap breast reconstruction, we have acquired the use of VoNavix, software that creates three dimensional images from computerised tomography angiography (CTA) data. The use of the VoNavix software for analysis of CTA provides superior imaging that can be viewed in theatre. It, together with CTA, enables decisions to be made preoperatively, including: which side to raise the flap; whether to aim for a medial or lateral row perforator; whether to take a segment of muscle and whether to expect an easy or difficult dissection. We have now performed over 60 free abdominal flap breast reconstructions aided with CTA, and 10 of these cases also used VoNavix technology. This paper presents our initial experience with the use of this software, illustrated with three patient examples. The advantages and disadvantages are discussed. AB - Copyright (c) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. ES - 1878-0539 IL - 1748-6815 DI - S1748-6815(08)00647-5 DO - https://dx.doi.org/10.1016/j.bjps.2008.04.056 PT - Journal Article ID - 18708309 [pubmed] ID - S1748-6815(08)00647-5 [pii] ID - 10.1016/j.bjps.2008.04.056 [doi] PP - ppublish PH - 2007/12/19 [received] PH - 2008/04/14 [revised] PH - 2008/04/19 [accepted] LG - English EP - 20080815 DP - 2009 Nov DC - 20100119 EZ - 2008/08/19 09:00 DA - 2010/02/19 06:00 DT - 2008/08/19 09:00 YR - 2009 ED - 20100218 RD - 20100119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18708309 <301. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19996031 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kurian AW AU - Sigal BM AU - Plevritis SK FA - Kurian, Allison W FA - Sigal, Bronislava M FA - Plevritis, Sylvia K IN - Kurian, Allison W. Departments of Medicine, Health Research and Policy, and Radiology, Stanford University School of Medicine, Stanford, CA, USA. TI - Survival analysis of cancer risk reduction strategies for BRCA1/2 mutation carriers. CM - Comment in: J Clin Oncol. 2010 Jan 10;28(2):189-91; PMID: 19996025 CM - Comment in: J Am Coll Surg. 2011 Sep;213(3):447-50; PMID: 21871383 SO - Journal of Clinical Oncology. 28(2):222-31, 2010 Jan 10 AS - J Clin Oncol. 28(2):222-31, 2010 Jan 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815712 SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/mo [Mortality] MH - Cause of Death MH - Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Heterozygote MH - Humans MH - Magnetic Resonance Imaging MH - Mammography MH - Mastectomy MH - Middle Aged MH - Monte Carlo Method MH - Mutation MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/mo [Mortality] MH - Ovariectomy MH - *Risk Reduction Behavior AB - PURPOSE: Women with BRCA1/2 mutations inherit high risks of breast and ovarian cancer; options to reduce cancer mortality include prophylactic surgery or breast screening, but their efficacy has never been empirically compared. We used decision analysis to simulate risk-reducing strategies in BRCA1/2 mutation carriers and to compare resulting survival probability and causes of death. AB - METHODS: We developed a Monte Carlo model of breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years, prophylactic mastectomy (PM) at various ages, and/or prophylactic oophorectomy (PO) at ages 40 or 50 years in 25-year-old BRCA1/2 mutation carriers. AB - RESULTS: With no intervention, survival probability by age 70 is 53% for BRCA1 and 71% for BRCA2 mutation carriers. The most effective single intervention for BRCA1 mutation carriers is PO at age 40, yielding a 15% absolute survival gain; for BRCA2 mutation carriers, the most effective single intervention is PM, yielding a 7% survival gain if performed at age 40 years. The combination of PM and PO at age 40 improves survival more than any single intervention, yielding 24% survival gain for BRCA1 and 11% for BRCA2 mutation carriers. PM at age 25 instead of age 40 offers minimal incremental benefit (1% to 2%); substituting screening for PM yields a similarly minimal decrement in survival (2% to 3%). AB - CONCLUSION: Although PM at age 25 plus PO at age 40 years maximizes survival probability, substituting mammography plus MRI screening for PM seems to offer comparable survival. These results may guide women with BRCA1/2 mutations in their choices between prophylactic surgery and breast screening. ES - 1527-7755 IL - 0732-183X DI - JCO.2009.22.7991 DO - https://dx.doi.org/10.1200/JCO.2009.22.7991 PT - Comparative Study PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 19996031 [pubmed] ID - JCO.2009.22.7991 [pii] ID - 10.1200/JCO.2009.22.7991 [doi] ID - PMC2815712 [pmc] PP - ppublish GI - No: R01 CA066785 Organization: (CA) *NCI NIH HHS* Country: United States No: U01 CA088248 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA66785 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA829040 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20091207 DP - 2010 Jan 10 DC - 20100108 EZ - 2009/12/10 06:00 DA - 2010/01/22 06:00 DT - 2009/12/10 06:00 YR - 2010 ED - 20100121 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19996031 <302. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19996025 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stadler ZK AU - Kauff ND FA - Stadler, Zsofia K FA - Kauff, Noah D TI - Weighing options for cancer risk reduction in carriers of BRCA1 and BRCA2 mutations. CM - Comment on: J Clin Oncol. 2010 Jan 10;28(2):222-31; PMID: 19996031 SO - Journal of Clinical Oncology. 28(2):189-91, 2010 Jan 10 AS - J Clin Oncol. 28(2):189-91, 2010 Jan 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Decision Support Techniques MH - Fallopian Tubes MH - Female MH - Genes, BRCA1 MH - *Genes, BRCA2 MH - Genital Neoplasms, Female/pc [Prevention & Control] MH - Heterozygote MH - Humans MH - Mastectomy MH - Middle Aged MH - Mutation MH - Neoplasms/ge [Genetics] MH - *Neoplasms/mo [Mortality] MH - Ovariectomy MH - *Risk Reduction Behavior ES - 1527-7755 IL - 0732-183X DI - JCO.2009.25.6875 DO - https://dx.doi.org/10.1200/JCO.2009.25.6875 PT - Comment PT - Editorial ID - 19996025 [pubmed] ID - JCO.2009.25.6875 [pii] ID - 10.1200/JCO.2009.25.6875 [doi] PP - ppublish LG - English EP - 20091207 DP - 2010 Jan 10 DC - 20100108 EZ - 2009/12/10 06:00 DA - 2010/01/22 06:00 DT - 2009/12/10 06:00 YR - 2010 ED - 20100121 RD - 20100108 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19996025 <303. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19967885 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sanguinetti A AU - Rosato L AU - Cirocchi R AU - Barberini F AU - Pezzolla A AU - Cavallaro G AU - Parmeggiani D AU - Ruggiero R AU - Docimo G AU - Procaccini E AU - Santoriello A AU - Rulli A AU - Gubitosi A AU - Canonico S AU - Taffurelli M AU - Sciannameo F AU - Barbarisi A AU - Docimo L AU - Agresti M AU - De Toma G AU - Noya G AU - Parmeggiani U AU - Avenia N FA - Sanguinetti, Alessandro FA - Rosato, Lodovico FA - Cirocchi, Roberto FA - Barberini, Francesco FA - Pezzolla, Angela FA - Cavallaro, Giuseppe FA - Parmeggiani, Domenico FA - Ruggiero, Roberto FA - Docimo, Giovanni FA - Procaccini, Eugenio FA - Santoriello, Antonio FA - Rulli, Antonio FA - Gubitosi, Adelmo FA - Canonico, Silvestro FA - Taffurelli, Mario FA - Sciannameo, Francesco FA - Barbarisi, Alfonso FA - Docimo, Ludovico FA - Agresti, Massimo FA - De Toma, Giorgio FA - Noya, Giuseppe FA - Parmeggiani, Umberto FA - Avenia, Nicola IN - Sanguinetti, Alessandro. SC Chirurgia Endocrina, Universita degli Studi di Perugia. cirrocchiroberto@yahoo.it TI - [Antibiotic prophylaxis in breast surgery. Preliminary resuls of a multicenter randomized study on 1400 cases]. [Italian] OT - Antibiotico profilassi in Chirurgia Senologica. Risultati preliminari di uno studio multicentrico randomizzato su 1400 casi trattati. SO - Annali Italiani di Chirurgia. 80(4):275-9, 2009 Jul-Aug AS - Ann Ital Chir. 80(4):275-9, 2009 Jul-Aug NJ - Annali italiani di chirurgia PI - Journal available in: Print PI - Citation processed from: Print JC - 5c0, 0372343 IO - Ann Ital Chir SB - Index Medicus CP - Italy MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Amoxicillin/ad [Administration & Dosage] MH - Amoxicillin/tu [Therapeutic Use] MH - Anti-Bacterial Agents/ad [Administration & Dosage] MH - *Anti-Bacterial Agents/tu [Therapeutic Use] MH - *Antibiotic Prophylaxis MH - *Breast Diseases/su [Surgery] MH - *Breast Neoplasms/su [Surgery] MH - Cefazolin/ad [Administration & Dosage] MH - *Cefazolin/tu [Therapeutic Use] MH - Clavulanic Acid/ad [Administration & Dosage] MH - Clavulanic Acid/tu [Therapeutic Use] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - *Mastectomy, Radical MH - *Mastectomy, Segmental MH - Middle Aged MH - Odds Ratio MH - Patient Selection MH - Surgical Wound Infection/dt [Drug Therapy] MH - *Surgical Wound Infection/pc [Prevention & Control] MH - Treatment Outcome AB - UNLABELLED: Breast surgery is classified among the procedures performed in clean surgery and is associated with a low incidence of wound infection (3-15%). The objective of this study was to evaluate the advantages antibiotic prophylaxis in patients undergoing breast surgery. A multicenter randomized controlled study was performed between January 2008 and November 2008. One thousand four hundred patients were enrolled in prospective randomized study; surgical wound infection was found in 41 patients (2.93%). In our RCT we have shown that in breast surgery antibiotic prophylaxis does not present significant advantages in patients with potential risk of infection (17 patients, 2.42%, subjected to antibiotic prophylaxis vs 24 patients, 3.43%, without antibiotic prophylaxis) (P = 0.27). In patients with drainage there is a significant minor incidence of wound infections in patients receiving antibiotic prophylaxis (5 patients, 0.92%, subjected to antibiotic prophylaxis vs 14 patients, 3.09%, without antibiotic prophylaxis) (P = 0.02). AB - CONCLUSION: This study is only a preliminary RCT to be followed by a study which should be enrolled more patients in order to get the results as statistically significant. RN - 0 (Anti-Bacterial Agents) RN - 23521W1S24 (Clavulanic Acid) RN - 804826J2HU (Amoxicillin) RN - IHS69L0Y4T (Cefazolin) IS - 0003-469X IL - 0003-469X PT - Comparative Study PT - English Abstract PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial ID - 19967885 [pubmed] PP - ppublish LG - Italian DP - 2009 Jul-Aug DC - 20091208 EZ - 2009/12/09 06:00 DA - 2010/01/16 06:00 DT - 2009/12/09 06:00 YR - 2009 ED - 20100115 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19967885 <304. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18999286 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Dabeer M AU - Kyrish M AU - Kim MS AU - Reyes P AU - Udpa N AU - Reece GP AU - Markey MK FA - Dabeer, Mugdha FA - Kyrish, Matthew FA - Kim, Min Soon FA - Reyes, Peter FA - Udpa, Nitin FA - Reece, Gregory P FA - Markey, Mia K IN - Dabeer, Mugdha. University of Texas, Department of Biomedical Engineering, Austin, TX, USA. TI - Toward decision support for breast reconstruction: automated calculation of symmetry measure on clinical photographs. SO - AMIA ... Annual Symposium Proceedings/AMIA Symposium. :1045, 2008 Nov 06 AS - AMIA Annu Symp Proc. :1045, 2008 Nov 06 NJ - AMIA ... Annual Symposium proceedings. AMIA Symposium PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101209213 IO - AMIA Annu Symp Proc SB - Index Medicus CP - United States MH - *Breast/pa [Pathology] MH - *Breast/su [Surgery] MH - *Decision Support Systems, Clinical MH - Female MH - Humans MH - *Image Interpretation, Computer-Assisted/mt [Methods] MH - *Mastectomy/mt [Methods] MH - *Pattern Recognition, Automated/mt [Methods] MH - *Photography/mt [Methods] MH - Reconstructive Surgical Procedures/mt [Methods] MH - *Surgery, Computer-Assisted/mt [Methods] AB - The quality of life of breast cancer survivors is maintained by minimizing adverse effects on their physical appearance. In this study, we present an automated method for computing a common measure of breast symmetry, the normalized Breast Retraction Assessment (pBRA), from routine clinical photographs taken to document breast reconstruction procedures. ES - 1942-597X IL - 1559-4076 PT - Journal Article ID - 18999286 [pubmed] PP - epublish PH - 2008/03/14 [received] PH - 2008/07/16 [revised] GI - No: R21 CA109040 Organization: (CA) *NCI NIH HHS* Country: United States No: R21 CA109040-01A1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20081106 DP - 2008 Nov 06 DC - 20081112 EZ - 2008/11/13 09:00 DA - 2010/01/09 06:00 DT - 2008/11/13 09:00 YR - 2008 ED - 20100108 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18999286 <305. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19935287 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Henry SL AU - Crawford JL AU - Puckett CL FA - Henry, Steven L FA - Crawford, J Lauren FA - Puckett, Charles L IN - Henry, Steven L. Division of Plastic Surgery, University of Missouri, Columbia, MO 65212, USA. TI - Risk factors and complications in reduction mammaplasty: novel associations and preoperative assessment. SO - Plastic & Reconstructive Surgery. 124(4):1040-6, 2009 Oct AS - Plast Reconstr Surg. 124(4):1040-6, 2009 Oct NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adolescent MH - Adult MH - Aged MH - Female MH - Humans MH - *Mammaplasty/ae [Adverse Effects] MH - Middle Aged MH - Postoperative Complications/ep [Epidemiology] MH - Preoperative Care MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Young Adult AB - BACKGROUND: Although risk factors for complications following reduction mammaplasty are well known, it is difficult to assess risk for specific complications among patients with multiple factors or varying gradations of a single factor. The purpose of this study was to identify all associations between patient characteristics and specific complications and to quantify the risk attributable to these factors, to assess a prospective patient's individualized risk. AB - METHODS: Patient characteristics and complications were identified through retrospective chart review of a consecutive series of patients who underwent Wise-pattern, inferior-pedicle reduction mammaplasty performed by the senior author (C.L.P.) over the past 10 years. Chi-square, t test, logistic regression, and decision tree analyses were used to identify complications attributable to specific risk factors and, when possible, to quantify the risk imparted by those factors. AB - RESULTS: The charts of 485 patients were reviewed. Factors predictive of nonspecific complications included hypertension, fibromyalgia, previous breast surgery, and fibroproliferative breast abnormality. Factors predictive of specific complications included body mass index, associated with wound-healing complications; mass of resection, associated with wound-healing complications and decreased nipple sensitivity and inversely related to hypertrophic scarring; and intraoperative hypotension, associated with hematoma. AB - CONCLUSIONS: Based on the review of a large series of reduction mammaplasties, specific and quantifiable patient characteristics were linked to specific and quantifiable complications. Novel associations were drawn, including increased risk of hematoma with intraoperative hypotension and decreased risk of hypertrophic scarring with mass of resection. A "risk assessor" was constructed that estimates a prospective patient's individualized risk based on selected preoperatively identifiable characteristics, facilitating patient selection and preoperative counseling. ES - 1529-4242 IL - 0032-1052 DI - 00006534-200910000-00005 DO - https://dx.doi.org/10.1097/PRS.0b013e3181b45410 PT - Journal Article ID - 19935287 [pubmed] ID - 10.1097/PRS.0b013e3181b45410 [doi] ID - 00006534-200910000-00005 [pii] PP - ppublish LG - English DP - 2009 Oct DC - 20091125 EZ - 2009/11/26 06:00 DA - 2009/12/25 06:00 DT - 2009/11/26 06:00 YR - 2009 ED - 20091224 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19935287 <306. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19751083 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rini C AU - O'Neill SC AU - Valdimarsdottir H AU - Goldsmith RE AU - Jandorf L AU - Brown K AU - DeMarco TA AU - Peshkin BN AU - Schwartz MD FA - Rini, Christine FA - O'Neill, Suzanne C FA - Valdimarsdottir, Heiddis FA - Goldsmith, Rachel E FA - Jandorf, Lina FA - Brown, Karen FA - DeMarco, Tiffani A FA - Peshkin, Beth N FA - Schwartz, Marc D IN - Rini, Christine. Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY 10021, USA. christine.rini@mssm.edu TI - Cognitive and emotional factors predicting decisional conflict among high-risk breast cancer survivors who receive uninformative BRCA1/2 results. SO - Health Psychology. 28(5):569-78, 2009 Sep AS - Health Psychol. 28(5):569-78, 2009 Sep NJ - Health psychology : official journal of the Division of Health Psychology, American Psychological Association PI - Journal available in: Print PI - Citation processed from: Internet JC - ejl, 8211523 IO - Health Psychol PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510002 OI - Source: NLM. NIHMS419789 SB - Index Medicus CP - United States MH - Apoptosis Regulatory Proteins MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/px [Psychology] MH - *Conflict (Psychology) MH - DNA Mutational Analysis MH - *Decision Making MH - Female MH - Genetic Counseling MH - *Genetic Predisposition to Disease/ge [Genetics] MH - *Genetic Predisposition to Disease/px [Psychology] MH - *Genetic Testing/px [Psychology] MH - Health Behavior MH - Humans MH - Longitudinal Studies MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Motivation MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/px [Psychology] MH - Prospective Studies MH - Risk Assessment MH - *Survivors/px [Psychology] AB - OBJECTIVE: To investigate high-risk breast cancer survivors' risk reduction decision making and decisional conflict after an uninformative BRCA1/2 test. AB - DESIGN: Prospective, longitudinal study of 182 probands undergoing BRCA1/2 testing, with assessments 1-, 6-, and 12-months postdisclosure. AB - MEASURES: Primary predictors were health beliefs and emotional responses to testing assessed 1-month postdisclosure. Main outcomes included women's perception of whether they had made a final risk management decision (decision status) and decisional conflict related to this issue. AB - RESULTS: There were four patterns of decision making, depending on how long it took women to make a final decision and the stability of their decision status across assessments. Late decision makers and nondecision makers reported the highest decisional conflict; however, substantial numbers of women--even early and intermediate decision makers--reported elevated decisional conflict. Analyses predicting decisional conflict 1- and 12-months postdisclosure found that, after accounting for control variables and decision status, health beliefs and emotional factors predicted decisional conflict at different timepoints, with health beliefs more important 1 month after test disclosure and emotional factors more important 1 year later. AB - CONCLUSION: Many of these women may benefit from decision making assistance. AB - Copyright 2009 APA, all rights reserved. RN - 0 (Apoptosis Regulatory Proteins) RN - 0 (BLID protein, human) RN - 0 (BRCA1 Protein) RN - 0 (BRCA1 protein, human) RN - 0 (BRCA2 Protein) RN - 0 (BRCA2 protein, human) ES - 1930-7810 IL - 0278-6133 DI - 2009-14439-008 DO - https://dx.doi.org/10.1037/a0015205 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 19751083 [pubmed] ID - 2009-14439-008 [pii] ID - 10.1037/a0015205 [doi] ID - PMC3510002 [pmc] ID - NIHMS419789 [mid] PP - ppublish GI - No: K07 CA104701 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA82346 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA082346 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA051008 Organization: (CA) *NCI NIH HHS* Country: United States No: R25 CA057726 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2009 Sep DC - 20090915 EZ - 2009/09/16 06:00 DA - 2009/12/16 06:00 DT - 2009/09/16 06:00 YR - 2009 ED - 20091202 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19751083 <307. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19768877 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Loprinzi CL AU - Ravdin PM FA - Loprinzi, Charles L FA - Ravdin, Peter M IN - Loprinzi, Charles L. Mayo Clinic, Rochester, Minnesota 550905, USA. cloprinzi@mayo.edu TI - Decision-making for patients with resectable breast cancer: individualized decisions for and by patients and their physicians. [Review] [18 refs] SO - Journal of the National Comprehensive Cancer Network. 1(2):189-96, 2003 Apr AS - J. Natl. Compr. Cancer Netw.. 1(2):189-96, 2003 Apr NJ - Journal of the National Comprehensive Cancer Network : JNCCN PI - Journal available in: Print PI - Citation processed from: Print JC - 101162515 IO - J Natl Compr Canc Netw SB - Index Medicus CP - United States MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Antineoplastic Agents, Hormonal MH - *Breast Neoplasms/dt [Drug Therapy] MH - Chemotherapy, Adjuvant MH - *Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Female MH - Humans MH - Patient Acceptance of Health Care MH - Practice Guidelines as Topic AB - Decisions regarding the use of adjuvant cytotoxic and hormonal therapies for women with breast cancer ideally should be made jointly by the patient and oncologist. For patients to be adequately involved in this decision-making process, they must be provided with appropriate education regarding the potential benefits and risks of adjuvant therapies. The recommended steps for doing this are: 1) understand baseline prognosis with locoregional therapy (surgery, radiation, or both) alone for the individual patient at hand; 2) determine the estimated benefit afforded by adjuvant therapy options for the individual patient; 3) estimate the risk of side effects of adjuvant therapy options; 4) convey the above information to the individual patient; 5) facilitate the individual patient's decision regarding adjuvant systemic therapy; and 6) support the patient's decision. Two computer-based tools (Numeracy and Adjuvant!) are available to facilitate this process. [References: 18] RN - 0 (Antineoplastic Agents) RN - 0 (Antineoplastic Agents, Hormonal) IS - 1540-1405 IL - 1540-1405 PT - Journal Article PT - Review ID - 19768877 [pubmed] PP - ppublish LG - English DP - 2003 Apr DC - 20090922 EZ - 2009/09/23 06:00 DA - 2009/11/10 06:00 DT - 2003/04/01 00:00 YR - 2003 ED - 20091109 RD - 20090922 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=19768877 <308. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19332586 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jorgensen KJ AU - Brodersen J AU - Hartling OJ AU - Nielsen M AU - Gotzsche PC FA - Jorgensen, K J FA - Brodersen, J FA - Hartling, O J FA - Nielsen, M FA - Gotzsche, P C IN - Jorgensen, K J. The Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark. kj@cochrane.dk TI - Informed choice requires information about both benefits and harms. SO - Journal of Medical Ethics. 35(4):268-9, 2009 Apr AS - J Med Ethics. 35(4):268-9, 2009 Apr NJ - Journal of medical ethics PI - Journal available in: Print PI - Citation processed from: Internet JC - j1d, 7513619 IO - J Med Ethics SB - Bioethics Journals SB - Index Medicus CP - England MH - Bias (Epidemiology) MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - *Decision Making/es [Ethics] MH - Decision Support Techniques MH - *Early Detection of Cancer MH - Female MH - Humans MH - *Informed Consent/es [Ethics] MH - Informed Consent/px [Psychology] MH - *Mammography/es [Ethics] MH - Patient Education as Topic MH - Risk Factors AB - A study found that women participating in mammography screening were content with the programme and the paternalistic invitations that directly encourage participation and include a pre-specified time of appointment. We argue that this merely reflects that the information presented to the invited women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. This short-circuits informed decision-making and the legislation on informed consent, and violates the autonomy of the women. Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility for the screening programmes must be separated from the responsibility for the information material. ES - 1473-4257 IL - 0306-6800 DI - 35/4/268 DO - https://dx.doi.org/10.1136/jme.2008.027961 PT - Journal Article ID - 19332586 [pubmed] ID - 35/4/268 [pii] ID - 10.1136/jme.2008.027961 [doi] PP - ppublish LG - English DP - 2009 Apr DC - 20090331 EZ - 2009/04/01 09:00 DA - 2009/10/15 06:00 DT - 2009/04/01 09:00 YR - 2009 ED - 20091014 RD - 20161125 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19332586 <309. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19730290 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hidalgo DA FA - Hidalgo, David A IN - Hidalgo, David A. dh@drdavidhidalgo.com TI - Discussion. A detailed analysis of the reduction mammaplasty learning curve: a statistical process model for approaching surgical performance improvement. CM - Comment on: Plast Reconstr Surg. 2009 Sep;124(3):706-14; PMID: 19730289 SO - Plastic & Reconstructive Surgery. 124(3):715-6, 2009 Sep AS - Plast Reconstr Surg. 124(3):715-6, 2009 Sep NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Clinical Competence MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Learning MH - *Mammaplasty/ed [Education] MH - Mammaplasty/st [Standards] MH - *Models, Statistical ES - 1529-4242 IL - 0032-1052 DI - 00006534-200909000-00004 DO - https://dx.doi.org/10.1097/PRS.0b013e3181b17989 PT - Comment PT - Journal Article ID - 19730290 [pubmed] ID - 10.1097/PRS.0b013e3181b17989 [doi] ID - 00006534-200909000-00004 [pii] PP - ppublish LG - English DP - 2009 Sep DC - 20090904 EZ - 2009/09/05 06:00 DA - 2009/09/24 06:00 DT - 2009/09/05 06:00 YR - 2009 ED - 20090923 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19730290 <310. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19730289 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Carty MJ AU - Chan R AU - Huckman R AU - Snow D AU - Orgill DP FA - Carty, Matthew J FA - Chan, Rodney FA - Huckman, Robert FA - Snow, Daniel FA - Orgill, Dennis P IN - Carty, Matthew J. Harvard Combined Plastic Surgery Residency Program, Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA, USA. TI - A detailed analysis of the reduction mammaplasty learning curve: a statistical process model for approaching surgical performance improvement. CM - Comment in: Plast Reconstr Surg. 2009 Sep;124(3):715-6; PMID: 19730290 SO - Plastic & Reconstructive Surgery. 124(3):706-14, 2009 Sep AS - Plast Reconstr Surg. 124(3):706-14, 2009 Sep NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - *Clinical Competence MH - Data Collection MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Learning MH - *Mammaplasty/ed [Education] MH - Mammaplasty/st [Standards] MH - *Models, Statistical MH - Quality Assurance, Health Care MH - Surgery, Plastic/ed [Education] AB - BACKGROUND: The increased focus on quality and efficiency improvement within academic surgery has met with variable success among plastic surgeons. Traditional surgical performance metrics, such as morbidity and mortality, are insufficient to improve the majority of today's plastic surgical procedures. In-process analyses that allow rapid feedback to the surgeon based on surrogate markers may provide a powerful method for quality improvement. AB - METHODS: The authors reviewed performance data from all bilateral reduction mammaplasties performed at their institution by eight surgeons between 1995 and 2007. Multiple linear regression analyses were conducted to determine the relative impact of key factors on operative time. Explanatory learning curve models were generated, and complication data were analyzed to elucidate clinical outcomes and trends. AB - RESULTS: A total of 1068 procedures were analyzed. The mean operative time for bilateral reduction mammaplasty was 134 +/- 34 minutes, with a mean operative experience of 11 +/- 4.7 years and total resection volume of 1680 +/- 930 g. Multiple linear regression analyses showed that operative time (R = 0.57) was most closely related to surgeon experience and resection volume. The complication rate diminished in a logarithmic fashion with increasing surgeon experience and in a linear fashion with declining operative time. AB - CONCLUSIONS: The results of this study suggest a three-phase learning curve in which complication rates, variance in operative time, and operative time all decrease with surgeon experience. In-process statistical analyses may represent the beginning of a new paradigm in academic surgical quality and efficiency improvement in low-risk surgical procedures. ES - 1529-4242 IL - 0032-1052 DI - 00006534-200909000-00003 DO - https://dx.doi.org/10.1097/PRS.0b013e3181b17a13 PT - Journal Article ID - 19730289 [pubmed] ID - 10.1097/PRS.0b013e3181b17a13 [doi] ID - 00006534-200909000-00003 [pii] PP - ppublish LG - English DP - 2009 Sep DC - 20090904 EZ - 2009/09/05 06:00 DA - 2009/09/24 06:00 DT - 2009/09/05 06:00 YR - 2009 ED - 20090923 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19730289 <311. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19365847 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hassett MJ AU - O'Malley AJ AU - Keating NL FA - Hassett, Michael J FA - O'Malley, A James FA - Keating, Nancy L IN - Hassett, Michael J. Center for Outcomes and Policy Research, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA. mhassett@partners.org TI - Factors influencing changes in employment among women with newly diagnosed breast cancer. CM - Comment in: Cancer. 2009 Jun 15;115(12):2598-601; PMID: 19365843 SO - Cancer. 115(12):2775-82, 2009 Jun 15 AS - Cancer. 115(12):2775-82, 2009 Jun 15 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720601 OI - Source: NLM. NIHMS124390 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Antineoplastic Agents/ae [Adverse Effects] MH - *Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/rt [Radiotherapy] MH - *Employment MH - Female MH - Humans MH - Middle Aged MH - Risk Factors MH - Time Factors MH - Treatment Outcome AB - BACKGROUND: Although studies have demonstrated that women are less likely to work after they are diagnosed with breast cancer, the influence of cancer treatments on employment is less clear. The authors of this report assessed whether chemotherapy or radiation therapy was associated with a disruption in employment during the year after a breast cancer diagnosis. AB - METHODS: Using a database of health insurance claims that covered 5.6 million US residents, 3,233 women aged or=54 years were more likely to experience a change in employment than women aged VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19473959 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Soum-Pouyalet F AU - Regnier V AU - Querre M AU - Jacquin JP AU - Hubert A AU - Debled M FA - Soum-Pouyalet, F FA - Regnier, V FA - Querre, M FA - Jacquin, J-P FA - Hubert, A FA - Debled, M IN - Soum-Pouyalet, F. Institut Bergonie, CLCC, 229, cours de l'Argonne, 33076 Bordeaux, France. soum-pouyalet@bergonie.org TI - [Influence of social and cultural patterns on decision-making in oncology]. [French] OT - Influence des facteurs socioculturels dans la prise de decision medicale en cancerologie. SO - Bulletin du Cancer. 96(6):733-9, 2009 Jun AS - Bull Cancer. 96(6):733-9, 2009 Jun NJ - Bulletin du cancer PI - Journal available in: Print PI - Citation processed from: Internet JC - 0072416 IO - Bull Cancer SB - Index Medicus CP - France MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/eh [Ethnology] MH - Chemotherapy, Adjuvant MH - Consensus MH - *Culture MH - *Decision Making MH - Decision Support Techniques MH - Female MH - France MH - Humans MH - *Medical Oncology MH - *Patient Participation MH - Professional Practice MH - Risk Assessment AB - Shared decision-making is based on the idea of an enlightened participation of the patient to the therapeutic decision process, especially when the ratio between risks and benefits of treatment options is uncertain. The physician owes to ponder the advantages and the inconveniences of chemotherapy, which can be enlightened by a discussion with the patient. Thus, neither shared decision-making nor decision tools are currently used in France. Our aim is to evaluate the variables that step in the therapeutic choice of French physicians concerning the adjuvant chemotherapy prescription in breast cancer. We focus on the impact of different medical cultures on decision processes and shared decision-making conceptions. A socio-anthropological study is carried out with the participation of six French medical centre. First results show the influence of local specificities, professional groups and individual sociocultural background of physicians. ES - 1769-6917 IL - 0007-4551 DI - bdc.2009.0882 DO - https://dx.doi.org/10.1684/bdc.2009.0882 PT - English Abstract PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 19473959 [pubmed] ID - bdc.2009.0882 [pii] ID - 10.1684/bdc.2009.0882 [doi] PP - ppublish LG - French DP - 2009 Jun DC - 20090703 EZ - 2009/05/29 09:00 DA - 2009/07/25 09:00 DT - 2009/05/29 09:00 YR - 2009 ED - 20090724 RD - 20091111 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19473959 <313. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19523124 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Aronowitz RA FA - Aronowitz, Robert A IN - Aronowitz, Robert A. University of Pennsylvania, Logan Hall, Rm. 303, 249 S. 36th Street, Philadelphia, PA 19104, USA. aronowit@wharton.upenn.edu TI - The converged experience of risk and disease. [Review] [42 refs] SO - Milbank Quarterly. 87(2):417-42, 2009 Jun AS - Milbank Q. 87(2):417-42, 2009 Jun NJ - The Milbank quarterly PI - Journal available in: Print PI - Citation processed from: Internet JC - 8607003, m9q IO - Milbank Q PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728027 OI - Source: NLM. NIHMS109126 SB - Index Medicus CP - United States MH - Attitude of Health Personnel MH - Chronic Disease/cl [Classification] MH - *Chronic Disease/ep [Epidemiology] MH - *Chronic Disease/pc [Prevention & Control] MH - Early Diagnosis MH - *Evidence-Based Medicine/og [Organization & Administration] MH - Health Status MH - Humans MH - Mass Screening/td [Trends] MH - Medical History Taking/mt [Methods] MH - *Patient Care Planning/td [Trends] MH - Patient Education as Topic/og [Organization & Administration] MH - *Primary Prevention/td [Trends] MH - Risk Assessment/td [Trends] MH - Risk Factors MH - United States AB - CONTEXT: One underappreciated consequence of modern clinical and public health practices is that the experience of being at risk for disease has been converging with the experience of disease itself. This is especially true for certain chronic diseases, in which early diagnosis and aggressive treatment have led to symptom-less and sign-less disease and in which treatments have largely been aimed at altering the disease's future course. AB - METHODS: This article reviews the historical scholarship and medical literature pertinent to transformations in the chronic disease and risk experiences. AB - FINDINGS: The experience of chronic disease increasingly resembles or has become indistinguishable from risk because of (1) new clinical interventions that have directly changed the natural history of disease; (2) increased biological, clinical, and epidemiological knowledge about the risk of chronic disease; (3) the recruitment of larger numbers into chronic disease diagnoses via new screening and diagnostic technology and disease definitions; (4) new ways of conceptualizing efficacy; and (5) intense diagnostic testing and medical interventions. AB - CONCLUSIONS: The converged experience of risk and disease has led to some unsettling and generally underappreciated consequences that might be subjected to more clinical and policy reflection and response: (1) some puzzling trends in medical decision making, such as the steep and uniform increase in the numbers of women across a broad spectrum of risk/disease in breast cancer who have opted for prophylactic mastectomies; (2) a larger and highly mobilized disease/risk population, resulting in an expanded market for interventions and greater clout for disease advocates; (3) shifts in the perceived severity of the disease, with ripple effects on how people experience and understand their illness and risk of disease; and (4) interventions that promise both to reduce the risk of disease and to treat its symptoms. [References: 42] ES - 1468-0009 IL - 0887-378X DI - MILQ563 DO - https://dx.doi.org/10.1111/j.1468-0009.2009.00563.x PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Review ID - 19523124 [pubmed] ID - MILQ563 [pii] ID - 10.1111/j.1468-0009.2009.00563.x [doi] ID - PMC2728027 [pmc] ID - NIHMS109126 [mid] PP - ppublish GI - No: G13 LM009587 Organization: (LM) *NLM NIH HHS* Country: United States No: G13 LM009587-01A1 Organization: (LM) *NLM NIH HHS* Country: United States No: 1G13 LM009587-01A1 Organization: (LM) *NLM NIH HHS* Country: United States LG - English DP - 2009 Jun DC - 20090615 EZ - 2009/06/16 09:00 DA - 2009/07/08 09:00 DT - 2009/06/16 09:00 YR - 2009 ED - 20090707 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19523124 <314. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19377163 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Qualter J AU - Fana M AU - Deluccia N AU - Colen K AU - Scharf C AU - Hazen A FA - Qualter, John FA - Fana, Melissa FA - Deluccia, Nicolette FA - Colen, Kari FA - Scharf, Carrie FA - Hazen, Alexes IN - Qualter, John. NYU School of Medicine, Division of Educational Informatics, New York, NY10016, USA. TI - Visualizing treatment options for breast reconstructive surgery. SO - Studies in Health Technology & Informatics. 142:262-4, 2009 AS - Stud Health Technol Inform. 142:262-4, 2009 NJ - Studies in health technology and informatics PI - Journal available in: Print PI - Citation processed from: Print JC - ck1, 9214582 IO - Stud Health Technol Inform SB - Health Technology Assessment Journals CP - Netherlands MH - *Breast Neoplasms/su [Surgery] MH - Computer Simulation MH - Female MH - Humans MH - Imaging, Three-Dimensional MH - *Patient Education as Topic MH - *Reconstructive Surgical Procedures AB - We propose that high-fidelity animations enhanced with real-time 3d interactivity, that demonstrate various breast reconstruction procedures will assist in a patient's decision-making process. These computer based modules will in no way replace a consultation with the physician; instead they will be added to the armamentarium of patient education. IS - 0926-9630 IL - 0926-9630 PT - Journal Article ID - 19377163 [pubmed] PP - ppublish LG - English DP - 2009 DC - 20090420 EZ - 2009/04/21 09:00 DA - 2009/06/24 09:00 DT - 2009/04/21 09:00 YR - 2009 ED - 20090623 RD - 20090420 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19377163 <315. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19291763 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Meilleur KG AU - Littleton-Kearney MT FA - Meilleur, Katherine G FA - Littleton-Kearney, Marguerite T IN - Meilleur, Katherine G. Johns Hopkins University, School of Nursing, Bethesda, Maryland, USA. meilleurk@mail.nih.gov TI - Interventions to improve patient education regarding multifactorial genetic conditions: a systematic review. [Review] [24 refs] SO - American Journal of Medical Genetics. Part A. 149A(4):819-30, 2009 Feb 15 AS - Am J Med Genet A. 149A(4):819-30, 2009 Feb 15 NJ - American journal of medical genetics. Part A PI - Journal available in: Print PI - Citation processed from: Internet JC - 101235741 IO - Am. J. Med. Genet. A PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776676 OI - Source: NLM. NIHMS156000 SB - Index Medicus CP - United States MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - Computer-Assisted Instruction MH - Decision Making MH - Evidence-Based Practice MH - Female MH - Genetic Counseling/mt [Methods] MH - Genetic Counseling/px [Psychology] MH - Genetic Diseases, Inborn/px [Psychology] MH - *Genetic Diseases, Inborn MH - Humans MH - Knowledge MH - Male MH - *Patient Education as Topic/mt [Methods] MH - Patient Satisfaction MH - Perception MH - Risk Factors AB - The careful education of patients with complex genetic disease is essential. However, healthcare providers often have limited time to spend providing thorough genetic education. Furthermore, the number of healthcare professionals possessing strong genetics training may be inadequate to meet increasing patient demands. Due to such constraints, several interventions have been investigated over the past decade to identify potential resources for the facilitation of this specific type of patient education. This systematic literature review of these interventions for patient education attempts to elucidate the answer to the question: is there sufficient evidence for best practice for delivering genetic information to patients with multifactorial conditions? The various interventions (CD-ROM, group counseling, video/decision aid, and miscellaneous) were analyzed in terms of quality criteria and achievement of specific outcomes and were rated according to the Stetler model for evidence-based practice. Seven main outcomes were evaluated: (1) objective and subjective knowledge assessment, (2) psychological measures (general anxiety, depression, stress, cancer worry), (3) satisfaction/effectiveness of intervention, (4) time spent in counseling (time spent on basic genetic information vs. specific concerns), (5) decision-making/intent to undergo genetic testing, (6) treatment choice and value of that choice, and, finally (7) risk perception. Overall, the computer interventions resulted in more significant findings that were beneficial than any other category followed by the video category, although the group and miscellaneous categories did not measure all of the outcomes reported by the other two categories. Nevertheless, while these groups had neutral or negative findings in some of the outcomes, the computer intervention group showed significant improvement in genetics knowledge, psychological measures, satisfaction/effectiveness, time spent with counselor, and decision/intent to undergo testing. [References: 24] ES - 1552-4833 IL - 1552-4825 DO - https://dx.doi.org/10.1002/ajmg.a.32723 PT - Journal Article PT - Review ID - 19291763 [pubmed] ID - 10.1002/ajmg.a.32723 [doi] ID - PMC2776676 [pmc] ID - NIHMS156000 [mid] PP - ppublish GI - No: R01 NR005339 Organization: (NR) *NINR NIH HHS* Country: United States No: R01 NR005339-09 Organization: (NR) *NINR NIH HHS* Country: United States No: Z99 NS999999 Organization: *Intramural NIH HHS* Country: United States LG - English DP - 2009 Feb 15 DC - 20090331 EZ - 2009/03/18 09:00 DA - 2009/06/18 09:00 DT - 2009/03/18 09:00 YR - 2009 ED - 20090617 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19291763 <316. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19407644 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - La Colla L AU - Mangano A AU - Albertin A FA - La Colla, Luca FA - Mangano, Alberto FA - Albertin, Andrea TI - A prospective, randomized, double-blind, controlled trial of continuous local anesthetic infusion in cosmetic breast augmentation: what lies beyond data?. CM - Comment on: Plast Reconstr Surg. 2008 Mar;121(3):711-5; PMID: 18317120 SO - Plastic & Reconstructive Surgery. 123(5):1636-7, 2009 May AS - Plast Reconstr Surg. 123(5):1636-7, 2009 May NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Anesthetics, Local/ad [Administration & Dosage] MH - Data Interpretation, Statistical MH - Double-Blind Method MH - Female MH - Humans MH - *Mammaplasty MH - Prospective Studies MH - Randomized Controlled Trials as Topic MH - Research Design RN - 0 (Anesthetics, Local) ES - 1529-4242 IL - 0032-1052 DI - 00006534-200905000-00038 DO - https://dx.doi.org/10.1097/PRS.0b013e3181a07766 PT - Comment PT - Letter ID - 19407644 [pubmed] ID - 10.1097/PRS.0b013e3181a07766 [doi] ID - 00006534-200905000-00038 [pii] PP - ppublish LG - English DP - 2009 May DC - 20090501 EZ - 2009/05/02 09:00 DA - 2009/06/10 09:00 DT - 2009/05/02 09:00 YR - 2009 ED - 20090609 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19407644 <317. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18928767 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ramos Boyero M FA - Ramos Boyero, Manuel IN - Ramos Boyero, Manuel. Departamento de Cirugia, Unidad de Patologia Mamaria, Hospital Universitario de Salamanca, Salamanca, Espana. mramos@usal.es TI - [Skin-sparing mastectomy: an alternative to conventional mastectomy in breast cancer]. [Review] [59 refs] [Spanish] OT - La mastectomia ahorradora de piel como alternativa a la mastectomia estandar en el cancer de mama. SO - Cirugia Espanola. 84(4):181-7, 2008 Oct AS - Cir Esp. 84(4):181-7, 2008 Oct NJ - Cirugia espanola PI - Journal available in: Print PI - Citation processed from: Print JC - 1254104 IO - Cir Esp SB - Index Medicus CP - Spain MH - Breast Implants MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma in Situ/rt [Radiotherapy] MH - *Carcinoma in Situ/su [Surgery] MH - Carcinoma, Ductal, Breast/dt [Drug Therapy] MH - Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - Data Interpretation, Statistical MH - Esthetics MH - Female MH - Follow-Up Studies MH - Humans MH - Mastectomy, Subcutaneous/ct [Contraindications] MH - Mastectomy, Subcutaneous/mt [Methods] MH - *Mastectomy, Subcutaneous MH - Neoplasm Recurrence, Local/su [Surgery] MH - Nipples MH - Radiotherapy, Adjuvant MH - Reconstructive Surgical Procedures MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome AB - Women who require or desire mastectomy for breast cancer one option should be immediate breast reconstruction. Skin-sparing mastectomy (SSM) describes the surgery that maximises breast skin and infra- mammary fold preservation, significantly improves the symmetry and natural appearance and a more satisfied patient. In multiple studies, SSM seems to be oncologically safe in patients undergoing mastectomy for invasive T1-T2 tumours, multicentric tumours, ductal carcinoma in situ or risk-reduction. However, the technique should be avoided in patients with inflammatory breast cancer or in those with extensive tumour involvement of the skin. SSM with nipple areola complex preservation appears to be oncologically safe, providing that the tumour is not close to the nipple and the retro-areolar tissue is free of tumour. Though adjuvant radiotherapy is not an absolute contraindication to SSM, it should be used with caution since it decreases the final cosmetic result. [References: 59] IS - 0009-739X IL - 0009-739X DI - S0009-739X(08)72617-4 PT - Comparative Study PT - English Abstract PT - Journal Article PT - Review ID - 18928767 [pubmed] ID - S0009-739X(08)72617-4 [pii] PP - ppublish LG - Spanish DP - 2008 Oct DC - 20081020 EZ - 2008/10/22 09:00 DA - 2009/05/23 09:00 DT - 2008/10/22 09:00 YR - 2008 ED - 20090522 RD - 20081020 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18928767 <318. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19042272 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wong ST AU - Chen W AU - Bottorff JL AU - Hislop TG FA - Wong, Sabrina T FA - Chen, Weihong FA - Bottorff, Joan L FA - Hislop, T Gregory IN - Wong, Sabrina T. University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada. sabrina.wong@nursing.ubc.ca TI - Treatment decision making among Chinese women with DCIS. SO - Journal of Psychosocial Oncology. 26(4):53-73, 2008 AS - J Psychosoc Oncol. 26(4):53-73, 2008 NJ - Journal of psychosocial oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - 8309337 IO - J Psychosoc Oncol SB - Index Medicus CP - United States MH - Aged MH - *Asian Continental Ancestry Group MH - *Attitude to Health MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma, Ductal/dt [Drug Therapy] MH - Carcinoma, Ductal/su [Surgery] MH - *Carcinoma, Ductal/th [Therapy] MH - *Choice Behavior MH - *Decision Making MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - Surveys and Questionnaires AB - One result of the widespread screening mammography is a 200% increase in the rates of breast ductal carcinoma in situ (DCIS). Treatment decision making among Chinese women diagnosed with DCIS remains understudied. This study examined Chinese-Canadian women's experiences (N = 26): (1) with treatment decision making (mastectomy or breast conserving surgery) and (2) their reflections on the decision-making process. Interviews in Cantonese, Mandarin, or English were transcribed and translated, and a content analysis conducted. Women's treatment decisions reflected a lack of understanding of DCIS, the desire to rid themselves of breast cancer forever, and the influence of significant others. English as a second language and use of medical jargon impeded their ability to make informed treatment decisions. Women's reflections on the decision-making process provided insights into how to improve information and support treatment decision making in ways that are accessible to them. ES - 1540-7586 IL - 0734-7332 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19042272 [pubmed] PP - ppublish LG - English DP - 2008 DC - 20081201 EZ - 2008/12/02 09:00 DA - 2009/04/29 09:00 DT - 2008/12/02 09:00 YR - 2008 ED - 20090428 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19042272 <319. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18775622 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stalmeier PF AU - Roosmalen MS FA - Stalmeier, Peep F M FA - Roosmalen, Marielle S IN - Stalmeier, Peep F M. Department of Radiation Oncology, Radboud University Medical Center Nijmegen (PFMS, MSR), Nijmegen, The Netherlands. P.Stalmeier@ebh.umcn.nl TI - Concise evaluation of decision aids. SO - Patient Education & Counseling. 74(1):104-9, 2009 Jan AS - Patient Educ Couns. 74(1):104-9, 2009 Jan NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Choice Behavior MH - *Decision Support Techniques MH - Factor Analysis, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Life Expectancy MH - Middle Aged MH - Netherlands MH - Pamphlets MH - *Patient Acceptance of Health Care/px [Psychology] MH - Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - *Patient Education as Topic/mt [Methods] MH - Patient Education as Topic/st [Standards] MH - Patient Satisfaction/sn [Statistics & Numerical Data] MH - Prognosis MH - Quality-Adjusted Life Years MH - Risk Assessment MH - Risk Factors MH - Surveys and Questionnaires/st [Standards] MH - Videotape Recording/st [Standards] AB - OBJECTIVE: Decision aids purport to help patients make treatment related choices. Several instruments exist to evaluate decision aids. Our aim is to compare the responsiveness of several instruments. AB - METHODS: Two different decision aids were randomized in patients at high risk for breast and ovarian cancer. Treatment choices were between prophylactic surgery and screening. Effect sizes were calculated to compare the responsiveness of the measures. AB - RESULTS: One decision aid was randomized in 390 women, the other in 91 ensuing mutation carriers. Three factors were identified related to Information, Well-being and Decision Making. Within each factor, single item measures were as responsive as multi-item measures. AB - CONCLUSION: Four single items, 'the amount of information received for decision making,' 'strength of preference,' 'I weighed the pros and cons,' and 'General Health,' were adequately responsive to the decision aids. AB - PRACTICE IMPLICATIONS: These items might be considered for inclusion in questionnaires to evaluate decision aids. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(08)00385-6 DO - https://dx.doi.org/10.1016/j.pec.2008.07.043 PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 18775622 [pubmed] ID - S0738-3991(08)00385-6 [pii] ID - 10.1016/j.pec.2008.07.043 [doi] PP - ppublish PH - 2008/04/18 [received] PH - 2008/07/03 [revised] PH - 2008/07/12 [accepted] LG - English EP - 20080904 DP - 2009 Jan DC - 20081208 EZ - 2008/09/09 09:00 DA - 2009/04/04 09:00 DT - 2008/09/09 09:00 YR - 2009 ED - 20090403 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18775622 <320. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19072459 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Silverstein MJ FA - Silverstein, Melvin J IN - Silverstein, Melvin J. Hoag Hospital Breast Program, Hoag Memorial Hospital Presbyterian, One Hoag Drive, Newport Beach, CA 92658, USA. melsilver9@aol.com TI - Ductal carcinoma in situ of the breast: 11 reasons to consider treatment with excision alone. CM - Comment in: Womens Health (Lond). 2008 Nov;4(6):579-81; PMID: 19072460 SO - Women's health. 4(6):565-77, 2008 Nov AS - Womens Health (Lond Engl). 4(6):565-77, 2008 Nov NJ - Women's health (London, England) PI - Journal available in: Print PI - Citation processed from: Internet JC - 101271249 IO - Womens Health (Lond) SB - Index Medicus CP - United States MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/ep [Epidemiology] MH - Carcinoma, Ductal, Breast/px [Psychology] MH - Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - *Carcinoma, Ductal, Breast/su [Surgery] MH - Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - *Mastectomy, Segmental MH - Neoplasm Recurrence, Local/pc [Prevention & Control] MH - Neoplasm Recurrence, Local/rt [Radiotherapy] MH - Neoplasm Recurrence, Local/su [Surgery] MH - Prognosis MH - Randomized Controlled Trials as Topic MH - Survival Analysis AB - For the last 15 years, there has been a vigorous ongoing debate as to whether or not all conservatively treated patients with ductal carcinoma in situ (DCIS) require radiation therapy following excision or whether selected patients with DCIS can be treated by excision alone. At just about all breast cancer symposia where DCIS is discussed, experts are assigned to debate the pros and cons of radiation therapy after excision. The debate is often heated. This article outlines numerous reasons to consider excision alone in the treatment of selected DCIS patients. ES - 1745-5065 IL - 1745-5057 DO - https://dx.doi.org/10.2217/17455057.4.6.565 PT - Journal Article ID - 19072459 [pubmed] ID - 10.2217/17455057.4.6.565 [doi] PP - ppublish LG - English DP - 2008 Nov DC - 20081216 EZ - 2008/12/17 09:00 DA - 2009/03/31 09:00 DT - 2008/12/17 09:00 YR - 2008 ED - 20090330 RD - 20160701 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19072459 <321. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19210013 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schwartz MD AU - Valdimarsdottir HB AU - DeMarco TA AU - Peshkin BN AU - Lawrence W AU - Rispoli J AU - Brown K AU - Isaacs C AU - O'Neill S AU - Shelby R AU - Grumet SC AU - McGovern MM AU - Garnett S AU - Bremer H AU - Leaman S AU - O'Mara K AU - Kelleher S AU - Komaridis K FA - Schwartz, Marc D FA - Valdimarsdottir, Heiddis B FA - DeMarco, Tiffani A FA - Peshkin, Beth N FA - Lawrence, William FA - Rispoli, Jessica FA - Brown, Karen FA - Isaacs, Claudine FA - O'Neill, Suzanne FA - Shelby, Rebecca FA - Grumet, Sherry C FA - McGovern, Margaret M FA - Garnett, Sarah FA - Bremer, Heather FA - Leaman, Suzanne FA - O'Mara, Kathryn FA - Kelleher, Sarah FA - Komaridis, Kathryn IN - Schwartz, Marc D. Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA. schwartm@georgetown.edu TI - Randomized trial of a decision aid for BRCA1/BRCA2 mutation carriers: impact on measures of decision making and satisfaction. SO - Health Psychology. 28(1):11-9, 2009 Jan AS - Health Psychol. 28(1):11-9, 2009 Jan NJ - Health psychology : official journal of the Division of Health Psychology, American Psychological Association PI - Journal available in: Print PI - Citation processed from: Print JC - ejl, 8211523 IO - Health Psychol PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580845 OI - Source: NLM. NIHMS442299 SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - *Decision Making MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Counseling MH - *Genetic Testing/px [Psychology] MH - Humans MH - Mastectomy MH - Middle Aged MH - *Patient Satisfaction MH - Risk Assessment AB - OBJECTIVE: Genetic testing is increasingly part of routine clinical care for women with a family history of breast cancer. Given their substantially elevated risk for breast cancer, BRCA1/BRCA2 mutation carriers must make the difficult decision whether or not to opt for risk reducing mastectomy. To help BRCA1/2 carriers make this decision, the authors developed a computer-based interactive decision aid that was tested against usual care in a randomized controlled trial. AB - DESIGN: After the completion of genetic counseling, 214 female (aged 21-75) BRCA1/BRCA2 mutation carriers were randomized to Usual Care (UC; N = 114) or Usual Care plus Decision Aid (DA; N = 100) arms. UC participants received no additional intervention. DA participants were sent the CD-ROM DA to view at home. AB - MAIN OUTCOME MEASURES: The authors measured final management decision, decisional conflict, decisional satisfaction, and receipt of risk reducing mastectomy at 1-, 6-, and 12-months postrandomization. AB - RESULTS: Longitudinal analyses revealed that the DA was effective among carriers who were initially undecided about how to manage their breast cancer risk. Within this group, the DA led to an increased likelihood of reaching a management decision (OR = 3.09, 95% CI = 1.62, 5.90; p < .001), decreased decisional conflict (B = -.46, z = -3.1, p <002), and increased satisfaction (B = .27, z = 3.1, p = .002) compared to UC. Among carriers who had already made a management decision by the time of randomization, the DA had no benefit relative to UC. AB - CONCLUSION: These results demonstrate that BRCA1/BRCA2 mutation carriers who are having difficulty making a breast cancer risk management decision can benefit from adjunct decision support. AB - Copyright (c) 2009 APA, all rights reserved. IS - 0278-6133 IL - 0278-6133 DI - 2009-00026-004 DO - https://dx.doi.org/10.1037/a0013147 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural ID - 19210013 [pubmed] ID - 2009-00026-004 [pii] ID - 10.1037/a0013147 [doi] ID - PMC3580845 [pmc] ID - NIHMS442299 [mid] PP - ppublish GI - No: R01 CA082346 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA01846 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2009 Jan DC - 20090212 EZ - 2009/02/13 09:00 DA - 2009/03/27 09:00 DT - 2009/02/13 09:00 YR - 2009 ED - 20090326 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19210013 <322. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19209172 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Vodermaier A AU - Caspari C AU - Koehm J AU - Kahlert S AU - Ditsch N AU - Untch M FA - Vodermaier, A FA - Caspari, C FA - Koehm, J FA - Kahlert, S FA - Ditsch, N FA - Untch, M IN - Vodermaier, A. Department of Obstetrics and Gynaecology-Grosshadern, University of Munich, Marchioninistr. 15, Munich 81377, Germany. avoderma@psych.ubc.ca TI - Contextual factors in shared decision making: a randomised controlled trial in women with a strong suspicion of breast cancer. SO - British Journal of Cancer. 100(4):590-7, 2009 Feb 24 AS - Br J Cancer. 100(4):590-7, 2009 Feb 24 NJ - British journal of cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653746 SB - Index Medicus CP - England MH - Adult MH - Aged MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Female MH - Germany MH - Humans MH - Middle Aged MH - Patient Participation MH - Patient Satisfaction MH - Referral and Consultation MH - Young Adult AB - Decision aids in North American breast cancer outpatients have been shown to assist with treatment decision making and reduce decisional conflict. To date, appropriate delivery formats to effectively increase patient participation in newly diagnosed breast cancer inpatients have not been investigated in the context of German health care provision. The impact of a decision aid intervention was studied in patients (n=111) with a strong suspicion of breast cancer in a randomised controlled trial. The primary outcome variable was decisional conflict. Participants were followed up 1 week post-intervention with a retention rate of 92%. Analyses revealed that the intervention group felt better informed (eta(p)(2)=0.06) but did not experience an overall reduction in decisional conflict as compared with the control group. The intervention had no effect on uptake rates of treatment options, length of consultation with the surgeon, time point of treatment decision making, perceived involvement in decision making, neither decision related nor general patient satisfaction. Patients who received the decision aid intervention experienced a small benefit with regards to how informed they felt about advantages and disadvantages of relevant treatment options. Results are discussed in terms of contextual factors and individual differences as moderators of treatment decision aid effectiveness. ES - 1532-1827 IL - 0007-0920 DI - 6604916 DO - https://dx.doi.org/10.1038/sj.bjc.6604916 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 19209172 [pubmed] ID - 6604916 [pii] ID - 10.1038/sj.bjc.6604916 [doi] ID - PMC2653746 [pmc] PP - ppublish LG - English EP - 20090210 DP - 2009 Feb 24 DC - 20090219 EZ - 2009/02/12 09:00 DA - 2009/03/24 09:00 DT - 2009/02/12 09:00 YR - 2009 ED - 20090323 RD - 20141210 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19209172 <323. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18636423 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Patenaude AF AU - Orozco S AU - Li X AU - Kaelin CM AU - Gadd M AU - Matory Y AU - Mayzel K AU - Roche CA AU - Smith BL AU - Farkas W AU - Garber JE FA - Patenaude, Andrea F FA - Orozco, Sara FA - Li, Xiaochun FA - Kaelin, Carolyn M FA - Gadd, Michelle FA - Matory, Yvedt FA - Mayzel, Kathleen FA - Roche, Constance A FA - Smith, Barbara L FA - Farkas, Walden FA - Garber, Judy E IN - Patenaude, Andrea F. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA. andrea patenaude@dfci.harvard.edu TI - Support needs and acceptability of psychological and peer consultation: attitudes of 108 women who had undergone or were considering prophylactic mastectomy. SO - Psycho-Oncology. 17(8):831-43, 2008 Aug AS - Psychooncology. 17(8):831-43, 2008 Aug NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133134 OI - Source: NLM. NIHMS544806 SB - Index Medicus CP - England MH - Adaptation, Psychological MH - Adult MH - *Attitude to Health MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Making MH - Elective Surgical Procedures/ut [Utilization] MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Humans MH - *Interpersonal Relations MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Narration MH - *Peer Group MH - Point Mutation/ge [Genetics] MH - Risk Reduction Behavior MH - *Social Support MH - Surveys and Questionnaires AB - OBJECTIVE: Prophylactic mastectomy (PM) offers 90% or greater reduction in risk of breast cancer to women at increased hereditary risk. Nonetheless, acceptance in North America is low (0-27%) and 25-50% of women electing surgery report psychological distress and/or difficulty adapting following PM. Most women also report reduced cancer worry postoperatively. Psychological consultation to aid decision-making and post-surgical coping is not routinely offered. This retrospective, cross-sectional study explored interest in and acceptability of psychological consultation for issues related to PM among 108 women who had undergone or were considering surgery. AB - METHOD: Qualitative interviews were conducted with 26 healthy women who had undergone prophylactic mastectomy of both (bilateral) breasts (BPM), 45 women who had undergone prophylactic mastectomy of one breast (unilateral contralateral) (UPM) after diagnosis of invasive breast cancer in the other breast or ductal carcinoma in situ (DCIS), and 37 women who were considering having PM surgery. AB - RESULTS: Of the women who had undergone PM, more than half felt pre-surgical psychological consultation was advisable; nearly 2/3 thought post-surgical psychological consultation would be helpful. All women currently considering PM believed psychological consultation would aid decision-making and preparation for surgery. Strong support was reported in all groups for the emotional and informational value of speaking with a woman who had previously undergone PM. AB - CONCLUSIONS: Narratives illustrate the nature and intensity of the need for psychological support and describe preferences for the role of the psychologist. Suggestions are offered for integration of psychological services for women deciding about or adapting to PM. ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1279 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 18636423 [pubmed] ID - 10.1002/pon.1279 [doi] ID - PMC4133134 [pmc] ID - NIHMS544806 [mid] PP - ppublish GI - No: R03 HG003051 Organization: (HG) *NHGRI NIH HHS* Country: United States No: 1 RO3 HG003051 Organization: (HG) *NHGRI NIH HHS* Country: United States LG - English DP - 2008 Aug DC - 20080813 EZ - 2008/07/19 09:00 DA - 2009/03/06 09:00 DT - 2008/07/19 09:00 YR - 2008 ED - 20090305 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18636423 <324. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18793856 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ballinger RS AU - Mayer KF AU - Lawrence G AU - Fallowfield L FA - Ballinger, Rachel S FA - Mayer, Karl Fortes FA - Lawrence, Gill FA - Fallowfield, Lesley IN - Ballinger, Rachel S. Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9QG, UK. R.S.Ballinger@sussex.ac.uk TI - Patients' decision-making in a UK specialist centre with high mastectomy rates. SO - Breast. 17(6):574-9, 2008 Dec AS - BREAST. 17(6):574-9, 2008 Dec NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Attitude of Health Personnel MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Health Care Surveys MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Mastectomy/px [Psychology] MH - *Mastectomy/ut [Utilization] MH - Middle Aged MH - Patient Education as Topic/sn [Statistics & Numerical Data] MH - Patient Participation/px [Psychology] MH - *Patient Participation/sn [Statistics & Numerical Data] MH - Patient Satisfaction/sn [Statistics & Numerical Data] MH - Physician-Patient Relations MH - United Kingdom AB - A national audit identified one breast cancer unit as having the highest mastectomy rate in the UK: 50% compared to a national average of 14% for cancers <15mm in diameter. This anomaly needed investigation. A questionnaire was sent within 2 years of their surgery to 189 breast cancer patients probing perceived surgical choice, factors in decision-making and usefulness of information. One hundred thirty-one (69%) replied, of these 97 (74%) felt they had choice of surgery. Of these, the most important factor was minimising worry about recurrence. However, only 16% knew that recurrence rates were different between types of surgery. Sixty-one percent felt their healthcare professionals had surgical preferences for them, believed that clinical issues determined these preferences, but still knew the choice was theirs. The extent to which surgical choice is offered and patients are made aware that it is their choice, may account for the high mastectomy rate in this unit. ES - 1532-3080 IL - 0960-9776 DI - S0960-9776(08)00175-6 DO - https://dx.doi.org/10.1016/j.breast.2008.08.001 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18793856 [pubmed] ID - S0960-9776(08)00175-6 [pii] ID - 10.1016/j.breast.2008.08.001 [doi] PP - ppublish PH - 2008/07/24 [received] PH - 2008/08/01 [accepted] LG - English EP - 20080914 DP - 2008 Dec DC - 20081201 EZ - 2008/09/17 09:00 DA - 2009/02/28 09:00 DT - 2008/09/17 09:00 YR - 2008 ED - 20090227 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18793856 <325. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18789628 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Morris D AU - Drake E AU - Saarimaki A AU - Bennett C AU - O'Connor A FA - Morris, Debra FA - Drake, Elizabeth FA - Saarimaki, Anton FA - Bennett, Carol FA - O'Connor, Annette IN - Morris, Debra. Ottawa Health Research Institute, Ottawa, Canada. dmorris@ohri.ca TI - Can people find patient decision aids on the Internet?. SO - Patient Education & Counseling. 73(3):557-60, 2008 Dec AS - Patient Educ Couns. 73(3):557-60, 2008 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Arthritis/th [Therapy] MH - Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Information Services/og [Organization & Administration] MH - *Information Storage and Retrieval/mt [Methods] MH - Information Storage and Retrieval/st [Standards] MH - *Internet/og [Organization & Administration] MH - Leiomyoma/th [Therapy] MH - Low Back Pain/th [Therapy] MH - Male MH - Needs Assessment MH - *Patient Education as Topic/og [Organization & Administration] MH - Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - Prostatic Neoplasms/di [Diagnosis] MH - Vocabulary, Controlled AB - OBJECTIVE: To determine if people could find patient decision aids (PtDAs) on the Internet using the most popular general search engines. AB - METHODS: We chose five medical conditions for which English language PtDAs were available from at least three different developers. The search engines used were: Google (www.google.com), Yahoo! (www.yahoo.com), and MSN (www.msn.com). For each condition and search engine we ran six searches using a combination of search terms. We coded all non-sponsored Web pages that were linked from the first page of the search results. AB - RESULTS: Most first page results linked to informational Web pages about the condition, only 16% linked to PtDAs. PtDAs were more readily found for the breast cancer surgery decision (our searches found seven of the nine developers). The searches using Yahoo and Google search engines were more likely to find PtDAs. The following combination of search terms: condition, treatment, decision (e.g. breast cancer surgery decision) was most successful across all search engines (29%). AB - CONCLUSION: While some terms and search engines were more successful, few resulted in direct links to PtDAs. AB - PRACTICE IMPLICATIONS: Finding PtDAs would be improved with use of standardized labelling, providing patients with specific Web site addresses or access to an independent PtDA clearinghouse. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(08)00396-0 DO - https://dx.doi.org/10.1016/j.pec.2008.07.046 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18789628 [pubmed] ID - S0738-3991(08)00396-0 [pii] ID - 10.1016/j.pec.2008.07.046 [doi] PP - ppublish PH - 2007/11/28 [received] PH - 2008/07/22 [revised] PH - 2008/07/23 [accepted] LG - English EP - 20080911 DP - 2008 Dec DC - 20081118 EZ - 2008/09/16 09:00 DA - 2009/02/21 09:00 DT - 2008/09/16 09:00 YR - 2008 ED - 20090220 RD - 20081118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18789628 <326. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18755565 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - O'Brien MA AU - Whelan TJ AU - Charles C AU - Ellis PM AU - Gafni A AU - Lovrics P AU - Hasler A AU - Dimitry S FA - O'Brien, Mary Ann FA - Whelan, Timothy J FA - Charles, Cathy FA - Ellis, Peter M FA - Gafni, Amiram FA - Lovrics, Peter FA - Hasler, Adrianne FA - Dimitry, Susan IN - O'Brien, Mary Ann. Supportive Cancer Care Research Unit, Juravinski Cancer Centre and McMaster University, Hamilton, ON, Canada. maobrien@mcmaster.ca TI - Women's perceptions of their treatment decision-making about breast cancer treatment. SO - Patient Education & Counseling. 73(3):431-6, 2008 Dec AS - Patient Educ Couns. 73(3):431-6, 2008 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Aged MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Cooperative Behavior MH - *Decision Making MH - Female MH - Health Services Needs and Demand MH - Humans MH - Mastectomy MH - Medical Oncology MH - Middle Aged MH - Ontario MH - Patient Education as Topic MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Patient Selection MH - Physician's Role/px [Psychology] MH - Physician-Patient Relations MH - Qualitative Research MH - Risk Assessment MH - Surveys and Questionnaires MH - Videotape Recording MH - Women/ed [Education] MH - *Women/px [Psychology] AB - OBJECTIVE: There is limited understanding about what treatment decision making (TDM) means to patients. The study objective was to identify any processes or stages of TDM as perceived by women with early stage breast cancer (ESBC). AB - METHODS: Initial consultations with a surgeon or medical oncologist were videotaped. Subsequently, women viewed their consultation using a qualitative approach with video-stimulated recall (VSR) interviews. Interviews were taped, transcribed, and analyzed. AB - RESULTS: There were 6 surgical and 15 medical oncology (MO) consultations. Most women described TDM as beginning soon after diagnosis and involving several processes including gathering information from informal and formal networks and identifying preferred treatment options before the specialist consultation. Many women wanted more information from their surgeon so they could engage in subsequent TDM with their medical oncologist. AB - CONCLUSION: In this study, women with ESBC began TDM soon after diagnosis and used several iterative processes to arrive at a decision about their cancer treatment. VSR interviews can be useful to investigate TDM occurring during the consultation. AB - PRACTICE IMPLICATIONS: Women with ESBC rely on information provided by their surgeons and family physicians to make treatment decisions about surgery and also to prepare them for subsequent discussions with medical oncologists about chemotherapy. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(08)00352-2 DO - https://dx.doi.org/10.1016/j.pec.2008.07.015 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 18755565 [pubmed] ID - S0738-3991(08)00352-2 [pii] ID - 10.1016/j.pec.2008.07.015 [doi] PP - ppublish PH - 2008/01/14 [received] PH - 2008/06/10 [revised] PH - 2008/07/04 [accepted] LG - English EP - 20080828 DP - 2008 Dec DC - 20081118 EZ - 2008/08/30 09:00 DA - 2009/02/21 09:00 DT - 2008/08/30 09:00 YR - 2008 ED - 20090220 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18755565 <327. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18722073 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Timmermans DR AU - Ockhuysen-Vermey CF AU - Henneman L FA - Timmermans, Danielle R M FA - Ockhuysen-Vermey, Caroline F FA - Henneman, Lidewij IN - Timmermans, Danielle R M. Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Amsterdam, The Netherlands. drm.timmermans@vumc.nl TI - Presenting health risk information in different formats: the effect on participants' cognitive and emotional evaluation and decisions. SO - Patient Education & Counseling. 73(3):443-7, 2008 Dec AS - Patient Educ Couns. 73(3):443-7, 2008 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Affect MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Cognition MH - Colonic Neoplasms/ge [Genetics] MH - Colonic Neoplasms/pc [Prevention & Control] MH - *Data Interpretation, Statistical MH - *Decision Making MH - Down Syndrome/di [Diagnosis] MH - Down Syndrome/pc [Prevention & Control] MH - Female MH - Humans MH - Hyperlipoproteinemia Type II/dt [Drug Therapy] MH - Hyperlipoproteinemia Type II/ge [Genetics] MH - Male MH - Mass Screening/px [Psychology] MH - Netherlands MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Patient Selection MH - *Risk Assessment/mt [Methods] MH - Students/px [Psychology] MH - Universities AB - OBJECTIVE: Effective communication of health risks plays an important role in enabling patients to make adequate decisions. There is little--though contradictory--evidence to indicate which format is most effective for communicating risks, and which risk format is preferred by counselees. AB - METHODS: In an experiment, subjects were presented health scenarios and risk information in different formats (percentages, frequencies, and population figures) and asked to evaluate the risks and make a decision based on these. AB - RESULTS: Different risk formats had different effects on respondents' evaluation of the health risks presented. Contrary to our expectation, population figures were not evaluated as being the easiest format for all decision problems. Population figures were shown to have the biggest affective impact, and risks presented as population figures were also evaluated as significantly greater than the risks presented in other formats. The format of the presented risks influenced their decision in only one out of four decision-making situations, although in a second situation there was a similar trend. AB - CONCLUSION: This study suggests that the risk format plays a role in the decision-making process, although it remains unclear which format is the most effective in terms of understanding. AB - PRACTICE IMPLICATIONS: More experimental studies based on a theoretical analysis of the factors that promote effective risk communication are needed in the general population as well as in clinical settings with patients actually experiencing the risks and making the decisions. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(08)00348-0 DO - https://dx.doi.org/10.1016/j.pec.2008.07.013 PT - Comparative Study PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18722073 [pubmed] ID - S0738-3991(08)00348-0 [pii] ID - 10.1016/j.pec.2008.07.013 [doi] PP - ppublish PH - 2008/02/01 [received] PH - 2008/06/29 [revised] PH - 2008/07/04 [accepted] LG - English EP - 20080821 DP - 2008 Dec DC - 20081118 EZ - 2008/08/30 09:00 DA - 2009/02/21 09:00 DT - 2008/08/30 09:00 YR - 2008 ED - 20090220 RD - 20081118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18722073 <328. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19114703 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Collins ED AU - Moore CP AU - Clay KF AU - Kearing SA AU - O'Connor AM AU - Llewellyn-Thomas HA AU - Barth RJ Jr AU - Sepucha KR FA - Collins, E Dale FA - Moore, Caroline P FA - Clay, Kate F FA - Kearing, Stephen A FA - O'Connor, Annette M FA - Llewellyn-Thomas, Hilary A FA - Barth, Richard J Jr FA - Sepucha, Karen R IN - Collins, E Dale. Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA. e.dale.collins@hitchcock.org TI - Can women with early-stage breast cancer make an informed decision for mastectomy?. CM - Comment in: J Clin Oncol. 2009 Oct 20;27(30):e158-9; author reply e160-3; PMID: 19687330 CM - Comment in: J Clin Oncol. 2009 Feb 1;27(4):484-6; PMID: 19114690 SO - Journal of Clinical Oncology. 27(4):519-25, 2009 Feb 01 AS - J Clin Oncol. 27(4):519-25, 2009 Feb 01 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - Choice Behavior MH - Cohort Studies MH - *Decision Making MH - Education MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - *Mastectomy MH - *Mastectomy, Segmental MH - Middle Aged MH - Patient Education as Topic MH - *Patient Participation MH - Patient Satisfaction MH - Prospective Studies MH - Surveys and Questionnaires AB - PURPOSE: The purpose of this study was to measure the degree to which informed women chose mastectomy, and to reveal their reasons for this choice. AB - PATIENTS AND METHODS: This was a prospective cohort study of patients radiographically and pathologically eligible for either mastectomy or breast-conserving surgery (BCS; n = 125). Participants completed questionnaires at three time points: baseline, after viewing a decision aid, and after a surgical consultation. Questionnaires assessed clinical history, preference for participation in decision making, information comprehension, values, decisional conflict, and preferred treatment. AB - RESULTS: Of 125 participants, 44 (35%) chose mastectomy. Most understood that BCS and mastectomy offer an equivalent survival benefit (98%) and that BCS has a slightly higher local recurrence risk (63%); most accurately identified the magnitude of ipsilateral local recurrence risk (91%). Values assigned to three treatment attributes/outcomes ("remove breast for peace of mind," "avoid radiation," and "keep breast") clearly discriminated between patients choosing mastectomy or BCS. High decisional conflict scores improved after both the decision aid and surgical consultation. AB - CONCLUSION: Although conventional wisdom may view BCS as the preferred treatment, a notable proportion of well informed women choose mastectomy. Whereas prior studies have linked objective factors to treatment choice, this study reveals subjective preferences that underlie decision making. The systematic use of a decision aid before the surgical consultation may help women make informed, values-based decisions, while clearly reducing decisional conflict. ES - 1527-7755 IL - 0732-183X DI - JCO.2008.16.6215 DO - https://dx.doi.org/10.1200/JCO.2008.16.6215 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 19114703 [pubmed] ID - JCO.2008.16.6215 [pii] ID - 10.1200/JCO.2008.16.6215 [doi] PP - ppublish LG - English EP - 20081229 DP - 2009 Feb 01 DC - 20090202 EZ - 2008/12/31 09:00 DA - 2009/02/20 09:00 DT - 2008/12/31 09:00 YR - 2009 ED - 20090219 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19114703 <329. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 19114690 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Throckmorton AD AU - Esserman LJ FA - Throckmorton, Alyssa D FA - Esserman, Laura J TI - When informed, all women do not prefer breast conservation. CM - Comment in: J Clin Oncol. 2009 Oct 20;27(30):e158-9; author reply e160-3; PMID: 19687330 CM - Comment on: J Clin Oncol. 2009 Feb 1;27(4):519-25; PMID: 19114703 SO - Journal of Clinical Oncology. 27(4):484-6, 2009 Feb 01 AS - J Clin Oncol. 27(4):484-6, 2009 Feb 01 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - *Mastectomy, Segmental MH - Patient Education as Topic MH - *Patients/px [Psychology] ES - 1527-7755 IL - 0732-183X DI - JCO.2008.19.5057 DO - https://dx.doi.org/10.1200/JCO.2008.19.5057 PT - Comment PT - Editorial ID - 19114690 [pubmed] ID - JCO.2008.19.5057 [pii] ID - 10.1200/JCO.2008.19.5057 [doi] PP - ppublish LG - English EP - 20081229 DP - 2009 Feb 01 DC - 20090202 EZ - 2008/12/31 09:00 DA - 2009/02/20 09:00 DT - 2008/12/31 09:00 YR - 2009 ED - 20090219 RD - 20091021 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=19114690 <330. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18825616 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gravvanis A AU - Caulfield RH AU - Ramakrishnan V AU - Niranjan N FA - Gravvanis, Andreas FA - Caulfield, Robert H FA - Ramakrishnan, Venkat FA - Niranjan, Niri IN - Gravvanis, Andreas. St. Andrews Centre for Plastic Surgery, Broomfield Hospital, United Kingdom. gravvani@yahoo.com TI - Recipient vessel exposure in the axilla during microvascular breast reconstruction. SO - Journal of Reconstructive Microsurgery. 24(8):595-8, 2008 Nov AS - J Reconstr Microsurg. 24(8):595-8, 2008 Nov NJ - Journal of reconstructive microsurgery PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - jvx, 8502670 IO - J Reconstr Microsurg SB - Index Medicus CP - United States MH - *Anastomosis, Surgical MH - Axilla/su [Surgery] MH - *Axilla MH - *Breast/bs [Blood Supply] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Microsurgery/mt [Methods] MH - Middle Aged MH - Prospective Studies MH - *Surgical Flaps/bs [Blood Supply] MH - Time Factors MH - *Vascular Surgical Procedures AB - Over the years, the favored recipient vessels for microvascular breast reconstruction have changed from the thoracodorsal to the internal mammary vessels, mainly due to the deep position and poor exposure of the vessels in the axilla and all the technical difficulties this reflects. We used the simple maneuver of arm adduction during microvascular anastomoses in the axilla and compared it with the conventional method of abducted arm regarding the exposure of the vessels, the position of the operator and the assistant, and the operative time. We found that this innovation considerably improved the exposure of the vessels and the operator's position, facilitating easier and faster anastomoses. IS - 0743-684X IL - 0743-684X DO - https://dx.doi.org/10.1055/s-0028-1090605 PT - Comparative Study PT - Journal Article ID - 18825616 [pubmed] ID - 10.1055/s-0028-1090605 [doi] PP - ppublish LG - English EP - 20080929 DP - 2008 Nov DC - 20081103 EZ - 2008/10/01 09:00 DA - 2009/01/24 09:00 DT - 2008/10/01 09:00 YR - 2008 ED - 20090123 RD - 20160526 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18825616 <331. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18922644 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Munoz M AU - Estevez LG AU - Alvarez I AU - Fernandez Y AU - Margeli M AU - Tusquets I AU - Segui MA AU - Lluch A FA - Munoz, Montserrat FA - Estevez, Laura G FA - Alvarez, Isabel FA - Fernandez, Yolanda FA - Margeli, Mireia FA - Tusquets, Ignasi FA - Segui, Miguel Angel FA - Lluch, Ana IN - Munoz, Montserrat. Hospital Clinic i Provincial, Servicio de Oncologia Medica, IDIBAPS, C/Villarroel, 170, 08036 Barcelona, Spain. mmunoz@clinic.ub.es TI - Evaluation of international treatment guidelines and prognostic tests for the treatment of early breast cancer. [Review] [41 refs] SO - Cancer Treatment Reviews. 34(8):701-9, 2008 Dec AS - Cancer Treat Rev. 34(8):701-9, 2008 Dec NJ - Cancer treatment reviews PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - cnn, 7502030 IO - Cancer Treat. Rev. SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Antineoplastic Agents/ad [Administration & Dosage] MH - Biomarkers, Tumor/an [Analysis] MH - Biomarkers, Tumor/ge [Genetics] MH - Biopsy, Needle MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant MH - Combined Modality Therapy MH - Drug Therapy, Computer-Assisted MH - Female MH - Humans MH - Immunohistochemistry MH - International Cooperation MH - *Mastectomy, Segmental/mt [Methods] MH - Middle Aged MH - Neoadjuvant Therapy MH - *Neoplasm Invasiveness/pa [Pathology] MH - Neoplasm Staging MH - *Practice Guidelines as Topic MH - Prognosis MH - Risk Assessment MH - Survival Analysis MH - Treatment Outcome MH - Young Adult AB - The clinical decision to treat early-stage breast cancer with adjuvant chemotherapy is sometimes a difficult one because 70-80% of patients who receive chemotherapy would probably have survived without it. To help clinicians in this decision-making process, different tools or 'decision aids' have been developed for the treatment of early breast cancer over the years. Some of these tools include clinical treatment guidelines and computer-based programs as well as different prognostic and/or predictive tests such as those based on gene expression profiles or the presence minimum invasive disease. All of these tools try to individualize as much as possible the estimation of the risk of breast cancer relapse and death and to facilitate the clinical decision about giving additional treatment, and ultimately the most appropriate treatment to be given. Thus, it is important for clinicians to be aware of not only the existence of these tools or 'decision aids', but also to know how they have been developed, how frequently there are revised and if they have been validated. In order to address all these concerns, we have carried out a critical review of the most important prognostic tests and clinical guidelines for the treatment of early breast cancer. Information regarding their development process as well as frequency of revision, validations that have been performed and main limitations of each tool were gathered and critically analyzed. [References: 41] RN - 0 (Antineoplastic Agents) RN - 0 (Biomarkers, Tumor) ES - 1532-1967 IL - 0305-7372 DI - S0305-7372(08)00180-1 DO - https://dx.doi.org/10.1016/j.ctrv.2008.04.002 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 18922644 [pubmed] ID - S0305-7372(08)00180-1 [pii] ID - 10.1016/j.ctrv.2008.04.002 [doi] PP - ppublish PH - 2008/01/16 [received] PH - 2008/04/11 [revised] PH - 2008/04/15 [accepted] LG - English EP - 20081014 DP - 2008 Dec DC - 20081125 EZ - 2008/10/17 09:00 DA - 2008/12/30 09:00 DT - 2008/10/17 09:00 YR - 2008 ED - 20081229 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18922644 <332. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18727748 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wenzel J AU - Shaha M FA - Wenzel, Jennifer FA - Shaha, Maya IN - Wenzel, Jennifer. Johns Hopkins University School of Nursing, Baltimore, Maryland, USA. jwenzel@son.jhmi.edu TI - Experiencing cancer treatment decision-making in managed care. SO - Journal of Advanced Nursing. 63(5):455-64, 2008 Sep AS - J Adv Nurs. 63(5):455-64, 2008 Sep NJ - Journal of advanced nursing PI - Journal available in: Print PI - Citation processed from: Internet JC - 7609811, h3l IO - J Adv Nurs SB - Index Medicus SB - Nursing Journal CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - *Decision Making MH - Delivery of Health Care/og [Organization & Administration] MH - Female MH - Humans MH - *Managed Care Programs/og [Organization & Administration] MH - Middle Aged MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Surveys and Questionnaires AB - AIM: This paper is a report of a study to explore women's perceptions of and experiences with breast cancer treatment decision-making in managed care organizations (MCOs). AB - BACKGROUND: Managed care organizations are the predominant form of employer-sponsored healthcare insurance in the United States of America. These healthcare financing entities minimize cost by streamlining healthcare delivery and may impose choice restrictions. The extent of these restrictions has not previously been studied from an in-depth patient perspective. AB - METHOD: A qualitative descriptive approach was adopted using interviews with a purposive sample of 14 managed care enrollees diagnosed with breast cancer at all stages. The data were collected between 2003 and 2005. Data analysis involved a reflexive process of transcript reading, categorization, data reduction and interpretation. AB - FINDINGS: The findings are presented as a single theme: 'decisional conflict in managed care', with two distinct categories: decisions regarding (1) the MCOs and (2) treatment. MCO selection was perceived to be limited by employer constraints, cost issues or healthcare plan providers. For study participants, selecting a MCO was less difficult than issues surrounding treatment decision-making. Women reported that their most important treatment-related decisions surrounded diagnosis and involved selecting a treatment facility and provider. Once a satisfactory facility and provider were selected, these women preferred to defer treatment decisions to their healthcare providers. AB - CONCLUSION: Decision interventions should be focused on assisting women with provider and treatment facility selection early in diagnosis. Our findings might also serve as a basis for policy/practice changes to address healthcare financing limitations and to expand cancer treatment-related choices while providing desired treatment decision-making support. ES - 1365-2648 IL - 0309-2402 DI - JAN4720 DO - https://dx.doi.org/10.1111/j.1365-2648.2008.04720.x PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 18727748 [pubmed] ID - JAN4720 [pii] ID - 10.1111/j.1365-2648.2008.04720.x [doi] PP - ppublish GI - No: P30 NRO 8995 Organization: *PHS HHS* Country: United States LG - English DP - 2008 Sep DC - 20080827 EZ - 2008/08/30 09:00 DA - 2008/12/19 09:00 DT - 2008/08/30 09:00 YR - 2008 ED - 20081218 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18727748 <333. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18816317 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Entwistle V FA - Entwistle, Vikki TI - Supporting participation in clinical research: decision aids for trial recruitment?. CM - Comment on: Health Expect. 2008 Sep;11(3):220-31; PMID: 18816319 CM - Comment on: Health Expect. 2008 Sep;11(3):252-62; PMID: 18816321 SO - Health Expectations. 11(3):205-7, 2008 Sep AS - Health Expect. 11(3):205-7, 2008 Sep NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Biomedical Research MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/sc [Secondary] MH - Carcinoma in Situ/pa [Pathology] MH - Clinical Protocols MH - *Decision Support Techniques MH - Female MH - Humans MH - Patient Education as Topic MH - *Patient Selection MH - *Randomized Controlled Trials as Topic MH - *Refusal to Participate MH - Risk Assessment ES - 1369-7625 IL - 1369-6513 DI - HEX519 DO - https://dx.doi.org/10.1111/j.1369-7625.2008.00519.x PT - Comment PT - Editorial ID - 18816317 [pubmed] ID - HEX519 [pii] ID - 10.1111/j.1369-7625.2008.00519.x [doi] ID - PMC5060445 [pmc] PP - ppublish LG - English DP - 2008 Sep DC - 20080925 EZ - 2008/09/26 09:00 DA - 2008/11/11 09:00 DT - 2008/09/26 09:00 YR - 2008 ED - 20081110 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18816317 <334. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18816317 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Entwistle V FA - Entwistle, Vikki TI - Supporting participation in clinical research: decision aids for trial recruitment?. CM - Comment on: Health Expect. 2008 Sep;11(3):220-31; PMID: 18816319 CM - Comment on: Health Expect. 2008 Sep;11(3):252-62; PMID: 18816321 SO - Health Expectations. 11(3):205-7, 2008 Sep AS - Health Expect. 11(3):205-7, 2008 Sep NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Biomedical Research MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/sc [Secondary] MH - Carcinoma in Situ/pa [Pathology] MH - Clinical Protocols MH - *Decision Support Techniques MH - Female MH - Humans MH - Patient Education as Topic MH - *Patient Selection MH - *Randomized Controlled Trials as Topic MH - *Refusal to Participate MH - Risk Assessment ES - 1369-7625 IL - 1369-6513 DI - HEX519 DO - https://dx.doi.org/10.1111/j.1369-7625.2008.00519.x PT - Comment PT - Editorial ID - 18816317 [pubmed] ID - HEX519 [pii] ID - 10.1111/j.1369-7625.2008.00519.x [doi] PP - ppublish LG - English DP - 2008 Sep DC - 20080925 EZ - 2008/09/26 09:00 DA - 2008/11/11 09:00 DT - 2008/09/26 09:00 YR - 2008 ED - 20081110 RD - 20080925 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18816317 <335. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18538959 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Moumjid N AU - Nguyen F AU - Bremond A AU - Mignotte H AU - Faure C AU - Meunier A AU - Carrere MO FA - Moumjid, N FA - Nguyen, F FA - Bremond, A FA - Mignotte, H FA - Faure, C FA - Meunier, A FA - Carrere, M O IN - Moumjid, N. Centre Leon Berard, ENS-LSH, GATE (UMR 5824, CNRS), universites Lyon-1et Lyon-2, Lyon, France; Centre Leon-Berard, 28, rue Laennec, 69008 Lyon, France. ferdjaou@lyon.fnclcc.fr TI - [Patients' preferences and decision-making: state of the art and applications in cancer]. [French] OT - Preferences des patients et prise de decision : etat des lieux et retour d'experience en cancerologie. SO - Revue d Epidemiologie et de Sante Publique. 56 Suppl 3:S231-8, 2008 Jul AS - Rev Epidemiol Sante Publique. 56 Suppl 3:S231-8, 2008 Jul NJ - Revue d'epidemiologie et de sante publique PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - rst, 7608039 IO - Rev Epidemiol Sante Publique SB - Index Medicus CP - France MH - *Decision Making MH - Humans MH - *Neoplasms/th [Therapy] MH - Patient Participation MH - *Patient Satisfaction MH - Physician-Patient Relations AB - BACKGROUND: This paper deals with the physician-patient encounter. In France, the current legal framework allows patients to be informed (patients' rights to health information) and to participate to decisions regarding their own health. In such a context, this paper aims to give the reader the broad key components of the so-called 'patient treatment preferences elicitation process' in breast cancer, our research area. AB - METHODS AND RESULTS: We first present the general context, with a definition of the different physician-patient models. We then present decision aids, tools that aim to provide high-quality information to patients in the decision-making process. Finally, based on our previous studies and on examples drawn from the international literature, we present the empirical process of patients' preferences elicitation, which not only increases patients' knowledge of and satisfaction with the decision made, but also allows patients to be part of their disease management. AB - CONCLUSION: Far from being a phenomenon in the air supported by a legal system, this method developed in the 90s allows patients and more generally healthcare users to be autonomous without constraining them to a choice. IS - 0398-7620 IL - 0398-7620 DI - S0398-7620(08)00293-9 DO - https://dx.doi.org/10.1016/j.respe.2008.04.008 PT - English Abstract PT - Journal Article ID - 18538959 [pubmed] ID - S0398-7620(08)00293-9 [pii] ID - 10.1016/j.respe.2008.04.008 [doi] PP - ppublish LG - French EP - 20080606 DP - 2008 Jul DC - 20080728 EZ - 2008/06/10 09:00 DA - 2008/11/06 09:00 DT - 2008/06/10 09:00 YR - 2008 ED - 20081105 RD - 20080728 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18538959 <336. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18766034 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Heller L AU - Parker PA AU - Youssef A AU - Miller MJ FA - Heller, Lior FA - Parker, Patricia A FA - Youssef, Adel FA - Miller, Michael J IN - Heller, Lior. Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. lheller@bcm.edu TI - Interactive digital education aid in breast reconstruction. SO - Plastic & Reconstructive Surgery. 122(3):717-24, 2008 Sep AS - Plast Reconstr Surg. 122(3):717-24, 2008 Sep NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Anxiety/pc [Prevention & Control] MH - CD-I MH - Decision Making MH - Female MH - Humans MH - *Mammaplasty MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Patient Satisfaction MH - Patients/px [Psychology] MH - Prospective Studies AB - BACKGROUND: An interactive digital education aid for breast reconstruction patients was developed because of a perceived need to provide patients with more education regarding the treatment so that they can make better informed treatment decisions. A prospective randomized study was conducted to assess its effectiveness. AB - METHODS: Breast cancer patients who were candidates for breast reconstruction were recruited and randomized into a control group and a study group. Both groups received routine assessment and education in the plastic surgery clinic, but the study group also watched the interactive digital education aid. Questionnaires assessing knowledge, anxiety, and satisfaction were administered (1) before the initial plastic surgery consultation, (2) immediately before surgery, and (3) 1 month after surgery. AB - RESULTS: A total of 133 women participated, 66 in the control group and 67 in the study group. Women in both groups showed decreased anxiety, increased knowledge, and enhanced satisfaction with their decision-making ability associated with preoperative instructions about reconstructive surgery. However, the study group was significantly more satisfied than the control group with the method of receiving information and showed a less steep learning curve regarding the different techniques of breast reconstruction. They also tended to have a reduced mean level of anxiety and increased satisfaction with the treatment choice compared with the control group. AB - CONCLUSIONS: An interactive digital education aid is a beneficial educational adjunct for patients contemplating breast reconstruction. Patients who use an interactive digital education aid demonstrate greater factual knowledge, reduced anxiety, and increased postoperative satisfaction compared with patients given preoperative instructions using standard methods alone. The benefit of an interactive digital education aid is expected to be higher in a broad-based practice setting outside of a comprehensive cancer center. ES - 1529-4242 IL - 0032-1052 DI - 00006534-200809000-00006 DO - https://dx.doi.org/10.1097/PRS.0b013e318180ed06 PT - Journal Article PT - Randomized Controlled Trial ID - 18766034 [pubmed] ID - 10.1097/PRS.0b013e318180ed06 [doi] ID - 00006534-200809000-00006 [pii] PP - ppublish LG - English DP - 2008 Sep DC - 20080903 EZ - 2008/09/04 09:00 DA - 2008/09/20 09:00 DT - 2008/09/04 09:00 YR - 2008 ED - 20080919 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18766034 <337. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18539887 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee JM AU - Georgian-Smith D AU - Gazelle GS AU - Halpern EF AU - Rafferty EA AU - Moore RH AU - Yeh ED AU - D'Alessandro HA AU - Hitt RA AU - Kopans DB FA - Lee, Janie M FA - Georgian-Smith, Dianne FA - Gazelle, G Scott FA - Halpern, Elkan F FA - Rafferty, Elizabeth A FA - Moore, Richard H FA - Yeh, Eren D FA - D'Alessandro, Helen A FA - Hitt, Rachel A FA - Kopans, Daniel B IN - Lee, Janie M. Department of Radiology, Massachusetts General Hospital, 101 Merrimac St, 10th Floor, Boston, MA 02114, USA. jlee45@partners.org TI - Detecting nonpalpable recurrent breast cancer: the role of routine mammographic screening of transverse rectus abdominis myocutaneous flap reconstructions. SO - Radiology. 248(2):398-405, 2008 Aug AS - Radiology. 248(2):398-405, 2008 Aug NJ - Radiology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - qsh, 0401260 IO - Radiology SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - Female MH - Humans MH - *Mammaplasty MH - Mammography MH - Mastectomy MH - Middle Aged MH - *Neoplasm Recurrence, Local/dg [Diagnostic Imaging] MH - *Rectus Abdominis/tr [Transplantation] MH - Retrospective Studies MH - *Surgical Flaps MH - Treatment Outcome AB - PURPOSE: To perform a retrospective cohort study to determine the rates of recall and cancer detection and then to develop a decision analytic model to evaluate the effectiveness of routine screening of transverse rectus abdominis myocutaneous (TRAM) flap reconstructions. AB - MATERIALS AND METHODS: This study was approved by the institutional review board, and the methods comply with HIPAA regulations. A retrospective search of the institutional mammographic results database was done to identify bilateral screening mammographic examinations obtained from January 1, 1999, through July 15, 2005. The search included the term TRAM; the recall and cancer detetion rates were then detected. Subsequently, a decision analytic model was constructed to evaluate a hypothetical cohort of women with TRAM flap reconstructions. AB - RESULTS: Of 554 mammograms (265 TRAM flap reconstructions), 546 (98.6%) had negative results (Breast Imaging Reporting and Data System category 1 or 2). Eight (1.4%) had positive test results (Breast Imaging Reporting and Data System category 0, 3, 4, or 5). All suspicious lesions underwent biopsy and had benign pathologic results. No interval breast cancers were identified. The detection rate for nonpalpable recurrent breast cancer was 0% (exact 95% confidence interval: 0.0%, 1.4%). According to decision analysis, screening would help detect an estimated 12 additional recurrent cancers per 1000 women screened, providing an additional 1.6 days of life expectancy for the screened cohort. Under base-case conditions, screening of TRAM flap reconstructions is less effective than screening asymptomatic women in their 40s. Sensitivity analysis revealed that a benefit equivalent to that of screening asymptomatic women in their 40s was achievable under conditions related to estimates of screening effectiveness and cancer detection rate. AB - CONCLUSION: Routine screening mammography of TRAM flap reconstructions has a very low detection rate for nonpalpable recurrent breast cancer. Decision analysis indicates that screening such women is less effective than screening asymptomatic women in their 40s for primary breast cancer. ES - 1527-1315 IL - 0033-8419 DI - 2482071635 DO - https://dx.doi.org/10.1148/radiol.2482071635 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18539887 [pubmed] ID - 2482071635 [pii] ID - 10.1148/radiol.2482071635 [doi] PP - ppublish LG - English EP - 20080606 DP - 2008 Aug DC - 20080721 EZ - 2008/06/10 09:00 DA - 2008/08/13 09:00 DT - 2008/06/10 09:00 YR - 2008 ED - 20080812 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18539887 <338. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18348655 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Buyukdamgaci-Alogan G AU - Elele T AU - Hayran M AU - Erman M AU - Kilickap S FA - Buyukdamgaci-Alogan, G FA - Elele, T FA - Hayran, M FA - Erman, M FA - Kilickap, S IN - Buyukdamgaci-Alogan, G. Scientific and Technological Research Council of Turkey, Ankara, Turkey. TI - A decision-analytic model for early stage breast cancer: lumpectomy vs mastectomy. SO - Neoplasma. 55(3):222-8, 2008 AS - Neoplasma. 55(3):222-8, 2008 NJ - Neoplasma PI - Journal available in: Print PI - Citation processed from: Print JC - nvo, 0377266 IO - Neoplasma SB - Index Medicus CP - Slovakia MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Markov Chains MH - *Mastectomy MH - *Mastectomy, Segmental MH - *Models, Biological MH - Monte Carlo Method MH - Patient Satisfaction MH - Sensitivity and Specificity AB - The purpose was to construct a decision model that incorporated patient preferences over differing health state prospects and to analyze the decision context of early stage breast cancer patients in relation to two main surgical treatment options. A Markov chain was constructed to project the clinical history of breast carcinoma following surgery. A Multi Attribute Utility Model was developed for outcome evaluation. Transition probabilities were obtained by using subjective probability assessment. This study was performed on the sample population of female university students and utilities were elicited from these healthy volunteers. The results were validated by using Standard Gamble technique. Finally, Monte Carlo Simulation was utilized in Treeage-Pro 2006-Suit software program in order to calculate expected utility generated by each treatment option. The results showed that, if the subject had mastectomy, mean value for the quality adjusted life years gained was 6.42; on the other hand, if the preference was lumpectomy, it was 7.00 out of a possible 10 years. Sensitivity analysis on transition probabilities to local recurrence and salvaged states was performed and two threshold values were observed. Additionally, sensitivity analysis on utilities showed that the model was more sensitive to no evidence of disease state; however, was not sensitive to utilities of local recurrence and salvaged states. The decision model was developed with reasonable success for early stage breast cancer patients, and tested by using general public data. The results obtained from these data showed that lumpectomy was more favourable for these participants. IS - 0028-2685 IL - 0028-2685 PT - Evaluation Studies PT - Journal Article ID - 18348655 [pubmed] PP - ppublish LG - English DP - 2008 DC - 20080319 EZ - 2008/03/20 09:00 DA - 2008/08/13 09:00 DT - 2008/03/20 09:00 YR - 2008 ED - 20080812 RD - 20080319 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18348655 <339. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18469211 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kurz-Milcke E AU - Gigerenzer G AU - Martignon L FA - Kurz-Milcke, Elke FA - Gigerenzer, Gerd FA - Martignon, Laura IN - Kurz-Milcke, Elke. Institute of Mathematics and Computing, University of Education Ludwigsburg, Reuteallee 46, 71634 Ludwigsburg, Germany. kurzmilcke@ph-ludwigsburg.de TI - Transparency in risk communication: graphical and analog tools. [Review] [19 refs] SO - Annals of the New York Academy of Sciences. 1128:18-28, 2008 Apr AS - Ann N Y Acad Sci. 1128:18-28, 2008 Apr NJ - Annals of the New York Academy of Sciences PI - Journal available in: Print PI - Citation processed from: Print JC - 5nm, 7506858 IO - Ann. N. Y. Acad. Sci. SB - Index Medicus CP - United States MH - Biological Evolution MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/ep [Epidemiology] MH - Communication MH - Computer Graphics MH - *Data Interpretation, Statistical MH - Decision Making MH - Female MH - *HIV Infections/di [Diagnosis] MH - HIV Infections/ep [Epidemiology] MH - HIV Seropositivity/di [Diagnosis] MH - Humans MH - Mass Screening MH - Models, Theoretical MH - Risk MH - *Risk Assessment AB - Why is it that the public can read and write but only a few understand statistical information? Why are elementary distinctions, such as that between absolute and relative risks, not better known? In the absence of statistical literacy, key democratic ideals, such as informed consent and shared decision making in health care, will remain science fiction. In this chapter, we deal with tools for transparency in risk communication. The focus is on graphical and analog representations of risk. Analog representations use a separate icon or sign for each individual in a population. Like numerical representations, some graphical forms are transparent, whereas others indiscernibly mislead the reader. We review cases of (1) tree diagrams for representing natural versus relative frequency, (2) decision trees for the representation of fast and frugal decision making, (3) bar graphs for representing absolute versus relative risk, (4) population diagrams for the analog representation of risk, and (5) a format of representation that employs colored tinker cubes for the encoding of information about individuals in a population. Graphs have long enjoyed the status of being "worth a thousand words" and hence of being more readily accessible to human understanding than long-winded symbolic representations. This is both true and false. Graphical tools can be just as well employed for transparent and nontransparent risk communications. [References: 19] IS - 0077-8923 IL - 0077-8923 DI - 1128/1/18 DO - https://dx.doi.org/10.1196/annals.1399.004 PT - Journal Article PT - Review ID - 18469211 [pubmed] ID - 1128/1/18 [pii] ID - 10.1196/annals.1399.004 [doi] PP - ppublish LG - English DP - 2008 Apr DC - 20080512 EZ - 2008/05/13 09:00 DA - 2008/07/12 09:00 DT - 2008/05/13 09:00 YR - 2008 ED - 20080711 RD - 20101118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18469211 <340. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18242967 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jarman IH AU - Etchells TA AU - Martin JD AU - Lisboa PJ FA - Jarman, Ian H FA - Etchells, Terence A FA - Martin, Jose D FA - Lisboa, Paulo J G IN - Jarman, Ian H. School of Computing and Mathematical Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK. i.h.jarman@ljmu.ac.uk TI - An integrated framework for risk profiling of breast cancer patients following surgery. SO - Artificial Intelligence in Medicine. 42(3):165-88, 2008 Mar AS - Artif Intell Med. 42(3):165-88, 2008 Mar NJ - Artificial intelligence in medicine PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - bup, 8915031 IO - Artif Intell Med SB - Index Medicus CP - Netherlands MH - Adult MH - Algorithms MH - Artificial Intelligence MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/su [Surgery] MH - Confidence Intervals MH - *Decision Support Systems, Clinical MH - *Decision Support Techniques MH - Female MH - Health Status Indicators MH - Humans MH - Internet MH - *Mastectomy MH - Middle Aged MH - Models, Biological MH - Monte Carlo Method MH - Neural Networks (Computer) MH - *Patient Selection MH - Prognosis MH - Reproducibility of Results MH - Retrospective Studies MH - Risk Assessment MH - Treatment Outcome MH - User-Computer Interface AB - OBJECTIVE: An integrated decision support framework is proposed for clinical oncologists making prognostic assessments of patients with operable breast cancer. The framework may be delivered over a web interface. It comprises a triangulation of prognostic modelling, visualisation of historical patient data and an explanatory facility to interpret risk group assignments using empirically derived Boolean rules expressed directly in clinical terms. AB - METHODS AND MATERIALS: The prognostic inferences in the interface are validated in a multicentre longitudinal cohort study by modelling retrospective data from 917 patients recruited at Christie Hospital, Wilmslow between 1983 and 1989 and predicting for 931 patients recruited in the same centre during 1990-1993. There were also 291 patients recruited between 1984 and 1998 at the Clatterbridge Centre for Oncology and the Linda McCartney Centre, Liverpool, UK. AB - RESULTS AND CONCLUSIONS: There are three novel contributions relating this paper to breast cancer cases. First, the widely used Nottingham prognostic index (NPI) is enhanced with additional clinical features from which prognostic assessments can be made more specific for patients in need of adjuvant treatment. This is shown with a cross matching of the NPI and a new prognostic index which also provides a two-dimensional visualisation of the complete patient database by risk of negative outcome. Second, a principled rule-extraction method, orthogonal search rule extraction, generates readily interpretable explanations of risk group allocations derived from a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). Third, 95% confidence intervals for individual predictions of survival are obtained by Monte Carlo sampling from the PLANN-ARD model. IS - 0933-3657 IL - 0933-3657 DI - S0933-3657(07)00150-9 DO - https://dx.doi.org/10.1016/j.artmed.2007.11.005 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18242967 [pubmed] ID - S0933-3657(07)00150-9 [pii] ID - 10.1016/j.artmed.2007.11.005 [doi] PP - ppublish PH - 2006/11/06 [received] PH - 2007/11/29 [revised] PH - 2007/11/30 [accepted] LG - English EP - 20080201 DP - 2008 Mar DC - 20080222 EZ - 2008/02/05 09:00 DA - 2008/05/30 09:00 DT - 2008/02/05 09:00 YR - 2008 ED - 20080529 RD - 20080222 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18242967 <341. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18344816 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Spittler CA FA - Spittler, Cheryl A IN - Spittler, Cheryl A. Quinn Plastic Surgery Center, Overland Park, KS, USA. cherylaspittler@aol.com TI - Breast reconstruction using tissue expanders: assessing patients' needs utilizing a holistic approach. [Review] [20 refs] SO - Plastic Surgical Nursing. 28(1):27-32; quiz 33-4, 2008 Jan-Mar AS - Plast Surg Nurs. 28(1):27-32; quiz 33-4, 2008 Jan-Mar NJ - Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses PI - Journal available in: Print PI - Citation processed from: Print JC - 8403490, p8m IO - Plast Surg Nurs SB - Nursing Journal CP - United States MH - Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - *Holistic Health MH - Humans MH - Informed Consent MH - Mammaplasty/is [Instrumentation] MH - *Mammaplasty/nu [Nursing] MH - Mammaplasty/px [Psychology] MH - Mastectomy MH - *Needs Assessment/og [Organization & Administration] MH - Nurse's Role MH - *Nursing Assessment/og [Organization & Administration] MH - Nursing Theory MH - Patient Education as Topic MH - Perioperative Care/mt [Methods] MH - *Perioperative Care/nu [Nursing] MH - Perioperative Care/px [Psychology] MH - Self Care/mt [Methods] MH - Self Care/px [Psychology] MH - Spirituality MH - Tissue Expansion/is [Instrumentation] MH - *Tissue Expansion/nu [Nursing] MH - Tissue Expansion/px [Psychology] MH - Tissue Expansion Devices/px [Psychology] AB - Breast cancer is the most common diagnosed cancer in women. One out of 8 women is diagnosed with this disease (). Today many women are candidates for breast reconstruction and opt for reconstructive surgery at the time of mastectomy. Plastic surgical nurses provide a vital link in assessing and assisting patients to acquire and assimilate the necessary information required to make informed decisions regarding reconstruction. Although there are a variety of options in breast reconstruction, the purpose of this article is to discuss tissue expansion after mastectomy for breast restoration. The article identifies the needs women may have both preoperatively and postoperatively. Orem's self-care theory model is used to describe roles nurses may assume to assist patients in decision making and performance of self-care activities during the reconstructive process. [References: 20] IS - 0741-5206 IL - 0741-5206 DI - 00006527-200801000-00008 DO - https://dx.doi.org/10.1097/01.PSN.0000313944.82528.b8 PT - Journal Article PT - Review ID - 18344816 [pubmed] ID - 10.1097/01.PSN.0000313944.82528.b8 [doi] ID - 00006527-200801000-00008 [pii] PP - ppublish LG - English DP - 2008 Jan-Mar DC - 20080317 EZ - 2008/03/18 09:00 DA - 2008/05/09 09:00 DT - 2008/03/18 09:00 YR - 2008 ED - 20080508 RD - 20080317 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18344816 <342. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18294057 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wakefield CE AU - Kasparian NA AU - Meiser B AU - Homewood J AU - Kirk J AU - Tucker K FA - Wakefield, Claire E FA - Kasparian, Nadine A FA - Meiser, Bettina FA - Homewood, Judi FA - Kirk, Judy FA - Tucker, Kathy IN - Wakefield, Claire E. Department of Psychology, Macquarie University, NSW, Australia. c.wakefield@unsw.edu.au TI - Attitudes toward genetic testing for cancer risk after genetic counseling and decision support: a qualitative comparison between hereditary cancer types. SO - Genetic Testing. 11(4):401-11, 2007 Winter AS - Genet Test. 11(4):401-11, 2007 Winter NJ - Genetic testing PI - Journal available in: Print PI - Citation processed from: Print JC - dgt, 9802546 IO - Genet. Test. SB - Index Medicus CP - United States MH - Attitude to Health MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/px [Psychology] MH - Decision Support Systems, Clinical MH - Female MH - *Genetic Counseling MH - *Genetic Testing MH - Humans MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovarian Neoplasms/px [Psychology] MH - Risk Assessment MH - Risk Factors AB - This study aimed to qualitatively assess individuals' attitudes toward genetic testing for cancer risk after genetic counseling and decision support. As part of a larger study, 78 women considering genetic testing for hereditary breast/ovarian cancer (HBOC) risk and 22 individuals considering genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) completed an open-ended table of their perceived pros and cons of genetic testing. The most frequently reported pros were "to help manage my risk of developing cancer," "to help my family," and "to know my cancer risk." With regards to risk management, the HBOC group perceived genetic testing as most helpful in informing their general risk management practices, while the HN-PCC group focused on the potential to clarify their need for bowel cancer screening, suggesting that patients' perceptions of the benefits of genetic testing may differ across cancer syndromes. Individuals in both groups expressed concern about the potential psychological impact of genetic testing. We also found that some affected individuals may not fully comprehend the meaning of their potential test results. Eliciting patients' perceived pros and cons during genetic counseling is likely to be a valuable tool for improving patient care. This data also provides an improved evidence base for the development of patient education tools. IS - 1090-6576 IL - 1090-6576 DO - https://dx.doi.org/10.1089/gte.2007.0013 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18294057 [pubmed] ID - 10.1089/gte.2007.0013 [doi] PP - ppublish LG - English DP - 2007 Winter DC - 20080225 EZ - 2008/02/26 09:00 DA - 2008/05/08 09:00 DT - 2008/02/26 09:00 YR - 2007 ED - 20080507 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=18294057 <343. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17847124 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Husain LS AU - Collins K AU - Reed M AU - Wyld L FA - Husain, Lopa Sadia FA - Collins, Karen FA - Reed, Malcolm FA - Wyld, Lynda IN - Husain, Lopa Sadia. Academic Surgical Oncology Unit, University of Sheffield, Sheffield, UK. TI - Choices in cancer treatment: a qualitative study of the older women's (>70 years) perspective. SO - Psycho-Oncology. 17(4):410-6, 2008 Apr AS - Psychooncology. 17(4):410-6, 2008 Apr NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Aged, 80 and over MH - *Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Choice Behavior MH - Communication MH - Comorbidity MH - Decision Making MH - Humans MH - Internal-External Control MH - Interview, Psychological MH - Lymph Node Excision/px [Psychology] MH - *Mastectomy/px [Psychology] MH - Neoplasm Staging MH - Palliative Care/px [Psychology] MH - Patient Education as Topic MH - Patient Participation MH - Physician-Patient Relations MH - Prognosis MH - Sick Role MH - *Tamoxifen/tu [Therapeutic Use] AB - PURPOSE: Primary endocrine therapy (PET) is the treatment of primary, operable breast cancer with drugs, such as tamoxifen, rather than surgery. It is in widespread use in the UK with 40% of women over 70 years old being treated in this way. PET is associated with inferior rates of local control compared with the standard surgical therapies, but there is no difference in overall survival. There has been no published research regarding the attitudes of older women concerning these two alternative approaches to treatment; what may influence their treatment choice or their experience of either treatment modality. This study aimed to address these questions. AB - METHOD: In-depth qualitative interviews were undertaken to explore the views of a group of 21 purposively selected older women (>70 years old), who had been treated by PET or surgery for breast cancer. The interviews were transcribed verbatim and analysed using Framework Analysis. AB - RESULTS: Both surgery and PET were well tolerated and had high satisfaction ratings from most women. This was the case even for those who had complications following surgery or needed a change of management in the PET group. Older women expressed no age-specific fears for operative procedures. The women were passive information seekers and relied heavily on 'expert' advice in making their treatment choices. Neither social support or age were factors in their decision-making. Their main concern was to ensure that their quality of life and independence remained unaffected. AB - CONCLUSION: Older women have no strong preference for either treatment option but are concerned that the treatment is effective and causes minimal disruption to their quality of life and independence. This study suggests that medical consultations may need to be adapted to reflect the passive acceptance of 'expert' advice in the majority of women in this age group. AB - Copyright 2007 John Wiley & Sons, Ltd. RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1242 PT - Journal Article ID - 17847124 [pubmed] ID - 10.1002/pon.1242 [doi] PP - ppublish LG - English DP - 2008 Apr DC - 20080402 EZ - 2007/09/12 09:00 DA - 2008/05/06 09:00 DT - 2007/09/12 09:00 YR - 2008 ED - 20080505 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=17847124 <344. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17628037 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sheppard VB AU - Figueiredo M AU - Canar J AU - Goodman M AU - Caicedo L AU - Kaufman A AU - Norling G AU - Mandelblatt J FA - Sheppard, Vanessa B FA - Figueiredo, Melissa FA - Canar, Janet FA - Goodman, Michelle FA - Caicedo, Larisa FA - Kaufman, Adriana FA - Norling, Gretchen FA - Mandelblatt, Jeanne IN - Sheppard, Vanessa B. Cancer Control Program, Georgetown University, Washington, DC, USA. TI - Latina a Latina: developing a breast cancer decision support intervention. SO - Psycho-Oncology. 17(4):383-91, 2008 Apr AS - Psychooncology. 17(4):383-91, 2008 Apr NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Adult MH - Aged MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/px [Psychology] MH - Chemotherapy, Adjuvant/px [Psychology] MH - Communication MH - Cultural Competency MH - Culture MH - *Decision Making MH - Female MH - Health Behavior MH - *Hispanic Americans/px [Psychology] MH - Humans MH - Mentors MH - Middle Aged MH - Patient Education as Topic MH - *Peer Group MH - Pilot Projects MH - Problem Solving MH - Self Efficacy MH - *Social Support MH - Survivors/px [Psychology] AB - Latinas have the fastest rising incidence of breast cancer. Yet, little data are available about Latinas' breast cancer treatment experiences. Aims were to: (1) identify factors in Latinas' treatment decision making and (2) develop and pilot a decision support intervention. Thirty-seven Latinas diagnosed with breast cancer participated. Qualitative data were used to identify intervention messages. Most women desired help in asking questions. Women were most concerned about chemotherapy side effects. Cultural values (e.g. personalismo, familismo) helped structure intervention messages. In phase two, participants completed a face-to-face skill-building session with a trained breast cancer survivor. Women found the intervention acceptable and reported better communication and decision-making skills. Interventions that focus on cultural strengths may improve Latinas treatment experiences and informed decision making. AB - Copyright 2007 John Wiley & Sons, Ltd. ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1239 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 17628037 [pubmed] ID - 10.1002/pon.1239 [doi] PP - ppublish GI - No: U01 CA86114-04 Organization: (CA) *NCI NIH HHS* Country: United States No: U10 CA084131-03S1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2008 Apr DC - 20080402 EZ - 2007/07/14 09:00 DA - 2008/05/06 09:00 DT - 2007/07/14 09:00 YR - 2008 ED - 20080505 RD - 20080402 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=17628037 <345. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18297781 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chiew KS AU - Shepherd H AU - Vardy J AU - Tattersall MH AU - Butow PN AU - Leighl NB FA - Chiew, Kimberly S FA - Shepherd, Heather FA - Vardy, Janette FA - Tattersall, Martin H N FA - Butow, Phyllis N FA - Leighl, Natasha B IN - Chiew, Kimberly S. Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, University of Toronto, ON, Canada. TI - Development and evaluation of a decision aid for patients considering first-line chemotherapy for metastatic breast cancer. SO - Health Expectations. 11(1):35-45, 2008 Mar AS - Health Expect. 11(1):35-45, 2008 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Australia MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - Canada MH - *Choice Behavior MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - Neoplasm Metastasis MH - Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Pilot Projects MH - Quality of Life MH - Randomized Controlled Trials as Topic MH - Surveys and Questionnaires AB - OBJECTIVE: Treatment decisions in advanced breast cancer are complex, with enhanced quality of life and survival among important treatment goals. Patients with metastatic breast cancer face the decision of whether or not to have chemotherapy, and many wish to be involved in this decision. We report the development and evaluation of a decision aid (DA) designed to assist patients facing this treatment decision. AB - DESIGN AND SAMPLE: Women with metastatic breast cancer (n = 17)and medical oncologists in Australia and Canada (n = 7) were invited to evaluate the DA. AB - INTERVENTION: A DA was developed for patients with hormone resistant metastatic breast cancer considering chemotherapy. The DA presented options of supportive care, with or without chemotherapy. Potential benefits and side effects of different chemotherapy regimens, and evidence-based prognostic estimates were described,and a values clarification exercise included. AB - MAIN OUTCOME MEASURES: Patient questionnaires evaluating information and decision involvement preferences, attitudes toward the DA and oncologist feedback regarding attitudes toward the DA. AB - RESULTS: Seventeen patients participated; fifteen desired as much information about their illness as possible; sixteen wished to be actively involved in the decision-making process. The majority rated the DA as highly acceptable, clear and informative, and would recommend it to others facing this treatment decision. AB - CONCLUSION: This is the first DA for patients with advanced metastatic breast cancer considering chemotherapy. A randomized trial is underway to evaluate its role in clinical decision-making. RN - 0 (Antineoplastic Agents) ES - 1369-7625 IL - 1369-6513 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18297781 [pubmed] ID - PMC5060427 [pmc] PP - ppublish LG - English DP - 2008 Mar DC - 20080225 EZ - 2008/02/27 09:00 DA - 2008/04/16 09:00 DT - 2008/02/27 09:00 YR - 2008 ED - 20080415 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18297781 <346. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18275401 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Silvia KA AU - Ozanne EM AU - Sepucha KR FA - Silvia, Kerry A FA - Ozanne, Elissa M FA - Sepucha, Karen R IN - Silvia, Kerry A. Massachusetts General Hospital, Boston, MA 02114, USA. TI - Implementing breast cancer decision aids in community sites: barriers and resources. SO - Health Expectations. 11(1):46-53, 2008 Mar AS - Health Expect. 11(1):46-53, 2008 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Choice Behavior MH - Community Health Services MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Humans MH - Interviews as Topic MH - Massachusetts MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - *Professional-Patient Relations MH - Program Development MH - Videotape Recording AB - OBJECTIVE: To assess the feasibility of implementing four patient decision aids (PtDAs) for early stage breast cancer treatment decisions into routine clinical care in community settings. AB - BACKGROUND: There is very limited information available about implementing decision aids into routine clinical practice and most of this information is based on academic centres; more information is needed about implementing them into routine clinical practice in community settings. AB - DESIGN: Structured individual interviews. AB - SETTING AND PARTICIPANTS: Providers from 12 sites, including nine community hospitals, a community oncology centre and two academic centres. AB - MAIN OUTCOME MEASURES: Usage data, barriers to and resources for implementing the PtDAs. AB - RESULTS: Nine of the 12 sites were using the PtDAs with patients. All of the sites were lending the PtDAs to patients, usually without a formal sign-out system. The keys to successful implementation included nurses' and social workers' interest in distributing the PtDAs and the success of the lending model. Barriers that limited or prevented sites from using the PtDA included a lack of physician support, a lack of an organized system for distributing the PtDAs and nurses' perceptions about patients' attitude towards participation in decision making. AB - CONCLUSIONS: It is feasible to implement PtDAs for early stage breast cancer into routine clinical care in community settings, even with few resources available. ES - 1369-7625 IL - 1369-6513 DI - HEX477 DO - https://dx.doi.org/10.1111/j.1369-7625.2007.00477.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18275401 [pubmed] ID - HEX477 [pii] ID - 10.1111/j.1369-7625.2007.00477.x [doi] ID - PMC5060426 [pmc] PP - ppublish LG - English DP - 2008 Mar DC - 20080215 EZ - 2008/02/16 09:00 DA - 2008/04/16 09:00 DT - 2008/02/16 09:00 YR - 2008 ED - 20080415 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=18275401 <347. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18297781 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chiew KS AU - Shepherd H AU - Vardy J AU - Tattersall MH AU - Butow PN AU - Leighl NB FA - Chiew, Kimberly S FA - Shepherd, Heather FA - Vardy, Janette FA - Tattersall, Martin H N FA - Butow, Phyllis N FA - Leighl, Natasha B IN - Chiew, Kimberly S. Department of Medical Oncology and Hematology, Princess Margaret Hospital/University Health Network, University of Toronto, ON, Canada. TI - Development and evaluation of a decision aid for patients considering first-line chemotherapy for metastatic breast cancer. SO - Health Expectations. 11(1):35-45, 2008 Mar AS - Health Expect. 11(1):35-45, 2008 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Australia MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - Canada MH - *Choice Behavior MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - Neoplasm Metastasis MH - Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Pilot Projects MH - Quality of Life MH - Randomized Controlled Trials as Topic MH - Surveys and Questionnaires AB - OBJECTIVE: Treatment decisions in advanced breast cancer are complex, with enhanced quality of life and survival among important treatment goals. Patients with metastatic breast cancer face the decision of whether or not to have chemotherapy, and many wish to be involved in this decision. We report the development and evaluation of a decision aid (DA) designed to assist patients facing this treatment decision. AB - DESIGN AND SAMPLE: Women with metastatic breast cancer (n = 17)and medical oncologists in Australia and Canada (n = 7) were invited to evaluate the DA. AB - INTERVENTION: A DA was developed for patients with hormone resistant metastatic breast cancer considering chemotherapy. The DA presented options of supportive care, with or without chemotherapy. Potential benefits and side effects of different chemotherapy regimens, and evidence-based prognostic estimates were described,and a values clarification exercise included. AB - MAIN OUTCOME MEASURES: Patient questionnaires evaluating information and decision involvement preferences, attitudes toward the DA and oncologist feedback regarding attitudes toward the DA. AB - RESULTS: Seventeen patients participated; fifteen desired as much information about their illness as possible; sixteen wished to be actively involved in the decision-making process. The majority rated the DA as highly acceptable, clear and informative, and would recommend it to others facing this treatment decision. AB - CONCLUSION: This is the first DA for patients with advanced metastatic breast cancer considering chemotherapy. A randomized trial is underway to evaluate its role in clinical decision-making. RN - 0 (Antineoplastic Agents) ES - 1369-7625 IL - 1369-6513 PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18297781 [pubmed] PP - ppublish LG - English DP - 2008 Mar DC - 20080225 EZ - 2008/02/27 09:00 DA - 2008/04/16 09:00 DT - 2008/02/27 09:00 YR - 2008 ED - 20080415 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18297781 <348. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18275401 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Silvia KA AU - Ozanne EM AU - Sepucha KR FA - Silvia, Kerry A FA - Ozanne, Elissa M FA - Sepucha, Karen R IN - Silvia, Kerry A. Massachusetts General Hospital, Boston, MA 02114, USA. TI - Implementing breast cancer decision aids in community sites: barriers and resources. SO - Health Expectations. 11(1):46-53, 2008 Mar AS - Health Expect. 11(1):46-53, 2008 Mar NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Choice Behavior MH - Community Health Services MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Humans MH - Interviews as Topic MH - Massachusetts MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - *Professional-Patient Relations MH - Program Development MH - Videotape Recording AB - OBJECTIVE: To assess the feasibility of implementing four patient decision aids (PtDAs) for early stage breast cancer treatment decisions into routine clinical care in community settings. AB - BACKGROUND: There is very limited information available about implementing decision aids into routine clinical practice and most of this information is based on academic centres; more information is needed about implementing them into routine clinical practice in community settings. AB - DESIGN: Structured individual interviews. AB - SETTING AND PARTICIPANTS: Providers from 12 sites, including nine community hospitals, a community oncology centre and two academic centres. AB - MAIN OUTCOME MEASURES: Usage data, barriers to and resources for implementing the PtDAs. AB - RESULTS: Nine of the 12 sites were using the PtDAs with patients. All of the sites were lending the PtDAs to patients, usually without a formal sign-out system. The keys to successful implementation included nurses' and social workers' interest in distributing the PtDAs and the success of the lending model. Barriers that limited or prevented sites from using the PtDA included a lack of physician support, a lack of an organized system for distributing the PtDAs and nurses' perceptions about patients' attitude towards participation in decision making. AB - CONCLUSIONS: It is feasible to implement PtDAs for early stage breast cancer into routine clinical care in community settings, even with few resources available. ES - 1369-7625 IL - 1369-6513 DI - HEX477 DO - https://dx.doi.org/10.1111/j.1369-7625.2007.00477.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18275401 [pubmed] ID - HEX477 [pii] ID - 10.1111/j.1369-7625.2007.00477.x [doi] PP - ppublish LG - English DP - 2008 Mar DC - 20080215 EZ - 2008/02/16 09:00 DA - 2008/04/16 09:00 DT - 2008/02/16 09:00 YR - 2008 ED - 20080415 RD - 20080215 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18275401 <349. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18211652 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Iredale R AU - Rapport F AU - Sivell S AU - Jones W AU - Edwards A AU - Gray J AU - Elwyn G FA - Iredale, Rachel FA - Rapport, Frances FA - Sivell, Stephanie FA - Jones, Wendy FA - Edwards, Adrian FA - Gray, Jonathon FA - Elwyn, Glyn IN - Iredale, Rachel. Institute of Medical Genetics, Cardiff University School of Medicine, Cardiff, UK. Rachel.Iredale@cardiffandvale.wales.nhs.uk TI - Exploring the requirements for a decision aid on familial breast cancer in the UK context: a qualitative study with patients referred to a cancer genetics service. SO - Journal of Evaluation in Clinical Practice. 14(1):110-5, 2008 Feb AS - J Eval Clin Pract. 14(1):110-5, 2008 Feb NJ - Journal of evaluation in clinical practice PI - Journal available in: Print PI - Citation processed from: Internet JC - cwd, 9609066 IO - J Eval Clin Pract SB - Index Medicus CP - England MH - Adult MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/px [Psychology] MH - CD-ROM MH - *Decision Support Techniques MH - Female MH - Focus Groups MH - *Genetic Counseling/px [Psychology] MH - *Genetic Testing/px [Psychology] MH - Humans MH - *Patient Acceptance of Health Care MH - Pilot Projects MH - Qualitative Research MH - Referral and Consultation MH - Wales AB - RATIONALE: Patients concerned about a family history of breast cancer can face difficult decisions about screening, prophylactic surgery and genetic testing. Decision aids can facilitate patient decision making and currently include leaflets and computerized tools. These are largely aimed at the North American market. However, no decision aids concerning familial breast cancer exist in the UK. AB - METHODS: Focus groups were held with 39 women over 18 years of age referred to a cancer genetics clinic, and who had been given a risk assessment for developing breast cancer. Each focus group examined three existing North American decision aids (1 paper-based and 2 CD-ROMs) and explored what a decision aid in a UK context should look like and the information it should contain. AB - RESULTS: There was enthusiasm for the development of decision aids that suit the local context in terms of its health care policy, in paper-based and CD-ROM formats. This paper identifies areas of agreement and disagreement in terms of both content and presentation styles, and also reports some of the suggestions received about where, when and with whom decision aids should be used. Participants suggested that decision aids would be most effective when they allowed a user-selected range of formats. AB - CONCLUSION: There is still significant unmet demand for information and decision support in the context of publicly funded health care. The patient perspective provides a unique insight into issues of design, style and communication. ES - 1365-2753 IL - 1356-1294 DI - JEP811 DO - https://dx.doi.org/10.1111/j.1365-2753.2007.00811.x PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 18211652 [pubmed] ID - JEP811 [pii] ID - 10.1111/j.1365-2753.2007.00811.x [doi] PP - ppublish LG - English DP - 2008 Feb DC - 20080123 EZ - 2008/01/24 09:00 DA - 2008/03/26 09:00 DT - 2008/01/24 09:00 YR - 2008 ED - 20080325 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18211652 <350. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18211647 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Williams L AU - Jones W AU - Elwyn G AU - Edwards A FA - Williams, Lisa FA - Jones, Wendy FA - Elwyn, Glyn FA - Edwards, Adrian IN - Williams, Lisa. Department of General Practice, Centre for Health Sciences Research, School of Medicine, Cardiff University, Cardiff, UK. TI - Interactive patient decision aids for women facing genetic testing for familial breast cancer: a systematic web and literature review. [Review] [42 refs] SO - Journal of Evaluation in Clinical Practice. 14(1):70-4, 2008 Feb AS - J Eval Clin Pract. 14(1):70-4, 2008 Feb NJ - Journal of evaluation in clinical practice PI - Journal available in: Print PI - Citation processed from: Internet JC - cwd, 9609066 IO - J Eval Clin Pract SB - Index Medicus CP - England MH - *Breast Neoplasms/ge [Genetics] MH - *Decision Support Techniques MH - Female MH - *Genetic Testing/px [Psychology] MH - Humans MH - Internet MH - *Women/px [Psychology] AB - OBJECTIVE: A systematic review to identify and appraise interactive decision aids that are designed for consumer use, in the field of hereditary breast cancer and genetic testing. AB - METHODS: An Internet (Google, Alta Vista) and literature search (Medline) was conducted for suitable decision aids. The decision aid had to (inclusion criteria): be about genetic testing for familial breast cancer; fulfil the criteria of a decision aid; use multimedia IT; be interactive (user does something that influences the decision pathway); and be for patient/public use. Exclusion criteria were decision aids that: had no interactivity (e.g. leaflet, video); discussed management decisions after gene status confirmed; non-English; aids that required membership/subscription. Once aids had been selected for further appraisal they were assessed against a recognized framework for the evaluation of decision aids--the International Patient Decision Aid Standards (IPDAS) criteria. AB - RESULTS: On Google 595 web pages were assessed, as were 382 Google directory entries. Alta Vista revealed fewer results and revealed no new sites. Twenty-four web sites and four CD-ROMs with the most potential as stand alone decision aids were then selected for further assessment. On Medline 776 citations were reviewed, of these only one CD-ROM and no web sites were found. After initial appraisal only two CD-ROMs and one web site met the criteria for further consideration. Assessed against the IPDAS criteria, the decision aids scored poorly with no aid scoring more than 50%. AB - CONCLUSIONS: Although there is a significant amount of interest in genetic testing to determine whether a woman is at high risk of breast cancer, the current genetic services are having difficulty coping with the demand. Alternatives such as decision aids have been suggested. There are many sources of information available, but few are truly interactive or designed for patient use. Of the three evaluated, all were from the USA and are likely to require modification for patients elsewhere. [References: 42] ES - 1365-2753 IL - 1356-1294 DI - JEP798 DO - https://dx.doi.org/10.1111/j.1365-2753.2007.00798.x PT - Journal Article PT - Review ID - 18211647 [pubmed] ID - JEP798 [pii] ID - 10.1111/j.1365-2753.2007.00798.x [doi] PP - ppublish LG - English DP - 2008 Feb DC - 20080123 EZ - 2008/01/24 09:00 DA - 2008/03/26 09:00 DT - 2008/01/24 09:00 YR - 2008 ED - 20080325 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18211647 <351. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18165727 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Adams WP FA - Adams, William P IN - Adams, William P. University of Texas Southwestern Medical Center in Dallas, Texas, USA. BA@dr-adams.com TI - The High Five Process: tissue-based planning for breast augmentation. SO - Plastic Surgical Nursing. 27(4):197-201, 2007 Oct-Dec AS - Plast Surg Nurs. 27(4):197-201, 2007 Oct-Dec NJ - Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses PI - Journal available in: Print PI - Citation processed from: Print JC - 8403490, p8m IO - Plast Surg Nurs SB - Nursing Journal CP - United States MH - Adult MH - Anthropometry/mt [Methods] MH - *Anthropometry MH - Body Image MH - *Body Size MH - Breast Implantation/ed [Education] MH - Breast Implantation/is [Instrumentation] MH - Breast Implantation/px [Psychology] MH - *Breast Implantation MH - Breast Implants/cl [Classification] MH - Breast Implants/sd [Supply & Distribution] MH - *Breast Implants MH - Choice Behavior MH - *Decision Making, Computer-Assisted MH - Female MH - Humans MH - Patient Care Planning/og [Organization & Administration] MH - Patient Education as Topic MH - Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - Patient Selection MH - Preoperative Care/mt [Methods] MH - Preoperative Care/px [Psychology] MH - *Preoperative Care MH - Reoperation MH - Surgery, Computer-Assisted AB - Despite popularity, breast augmentation has not advanced significantly in 20 years. The re-operation data for breast augmentation has been excessive at 15% to 20% in every Federal Drug Administration pre-market approval study for the past 15 years. Recently, a more scientific approach to breast augmentation has described a true process approach to this procedure. One element, tissue-based pre-operative planning, has been shown to reduce re-operation rate to less than 3% in published peer-reviewed studies. The High Five process was published in 2005 and codifies the 5 most important pre-operative decisions made during a breast augmentation procedure. Application into clinical practice of this planning system is discussed. IS - 0741-5206 IL - 0741-5206 DI - 00006527-200710000-00007 DO - https://dx.doi.org/10.1097/01.PSN.0000306185.95812.c3 PT - Case Reports PT - Journal Article ID - 18165727 [pubmed] ID - 10.1097/01.PSN.0000306185.95812.c3 [doi] ID - 00006527-200710000-00007 [pii] PP - ppublish LG - English DP - 2007 Oct-Dec DC - 20071231 EZ - 2008/01/01 09:00 DA - 2008/03/22 09:00 DT - 2008/01/01 09:00 YR - 2007 ED - 20080321 RD - 20071231 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=18165727 <352. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 18157830 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Alderman AK AU - Hawley ST AU - Waljee J AU - Mujahid M AU - Morrow M AU - Katz SJ FA - Alderman, Amy K FA - Hawley, Sarah T FA - Waljee, Jennifer FA - Mujahid, Mahasin FA - Morrow, Monica FA - Katz, Steven J IN - Alderman, Amy K. Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0340, USA. aalder@umich.edu TI - Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer. SO - Cancer. 112(3):489-94, 2008 Feb 01 AS - Cancer. 112(3):489-94, 2008 Feb 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - California MH - *Decision Making MH - Female MH - Health Care Surveys MH - Humans MH - Logistic Models MH - *Mammaplasty MH - *Mastectomy MH - Michigan MH - Middle Aged MH - Patient Education as Topic MH - Physician-Patient Relations MH - Referral and Consultation MH - SEER Program AB - BACKGROUND: Reconstruction is rarely incorporated into the decision-making process for surgical breast cancer treatment. We examined the importance of knowing about reconstruction to patients' surgical decision-making for breast cancer. AB - METHODS: We surveyed women aged < or =79 years with breast cancer (N = 1844) who were reported to the Detroit and Los Angeles Surveillance, Epidemiology, and End Results (SEER) cancer registries (response rate, 77.4%). The dependent variables were 1) patients' report of having a discussion about breast reconstruction with their general surgeon (yes/no), 2) whether or not this discussion had an impact on their willingness to be treated with a mastectomy (yes/no), and 3) whether the patient received a mastectomy (yes/no). The independent variables included age, race, education, tumor size, tumor behavior, and presence of comorbidities. Chi-square, Student t test, and logistic regression were used for analyses. AB - RESULTS: Only 33% of patients had a general surgeon discuss breast reconstruction with them during the surgical decision-making process for their cancer. Surgeons were significantly more likely to have this discussion with younger, more educated patients with larger tumors. Knowing about reconstructive options significantly increased patients' willingness to consider a mastectomy (OR, 2.06; P <.01). In addition, this discussion influenced surgical treatment. Patients who discussed reconstruction with their general surgeon were 4 times more likely to receive a mastectomy compared with those who did not (OR, 4.48; P < .01). AB - CONCLUSIONS: Most general surgeons do not discuss reconstruction with their breast cancer patients before surgical treatment. When it occurs, this discussion significantly impacts women's treatment choice, making many more likely to choose mastectomy. This highlights the importance of multidisciplinary care models to facilitate an informed surgical treatment decision-making process. IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.23214 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 18157830 [pubmed] ID - 10.1002/cncr.23214 [doi] PP - ppublish GI - No: N01-PC-35139 Organization: (PC) *NCI NIH HHS* Country: United States No: N01-PC-65064 Organization: (PC) *NCI NIH HHS* Country: United States No: R01 CA8837-A1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2008 Feb 01 DC - 20080225 EZ - 2007/12/25 09:00 DA - 2008/03/14 09:00 DT - 2007/12/25 09:00 YR - 2008 ED - 20080313 RD - 20080225 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med6&AN=18157830 <353. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17889495 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - O'Leary KA AU - Estabrooks CA AU - Olson K AU - Cumming C FA - O'Leary, Katherine A FA - Estabrooks, Carole A FA - Olson, Karin FA - Cumming, Ceinwen IN - O'Leary, Katherine A. Knowledge Utilization Studies Program, University of Alberta, Canada. koleary@ualberta.ca TI - Information acquisition for women facing surgical treatment for breast cancer: influencing factors and selected outcomes. [Review] [71 refs] SO - Patient Education & Counseling. 69(1-3):5-19, 2007 Dec AS - Patient Educ Couns. 69(1-3):5-19, 2007 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - *Attitude to Health MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - Decision Making MH - Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Health Services Needs and Demand MH - Humans MH - Internal-External Control MH - Mastectomy/ed [Education] MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - *Mastectomy MH - Models, Educational MH - Models, Psychological MH - *Patient Education as Topic MH - Patient Participation/px [Psychology] MH - Patient Selection MH - Power (Psychology) MH - Research Design MH - Social Support MH - Women/ed [Education] MH - Women/px [Psychology] MH - *Women AB - OBJECTIVE: To examine, summarize, and critically assess the literature focusing on information use by early-stage breast cancer patients. AB - METHODS: Empirical articles reporting the information needs, sources used/preferred, and intervention-related outcomes experienced by patients in the context of making a treatment choice were chosen. Several healthcare databases were searched. Articles were limited to those published in English between January 1, 1986 and March 31, 2006. AB - RESULTS: A total of 25 articles met the inclusion criteria. Information needs were consistent, and highest rankings were for (in order): information about chances for a cure, stage of disease, and treatment options. Results were equivocal regarding the factors found to influence information need: age, time since diagnosis, and preferred role in decision-making. The highest ranked information sources accessed and preferred were physicians. Age, education, and type of treatment chosen influenced source choice. Patients using consumer decision aids (CDAs) had less decisional conflict, higher satisfaction with the decision made and the decision process, and higher knowledge levels. AB - CONCLUSION: Information needs and source use were influenced by several personal and contextual factors. AB - PRACTICE IMPLICATIONS: A better understanding of source use could provide more effective ways of disseminating information to patients. [References: 71] IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(07)00308-4 DO - https://dx.doi.org/10.1016/j.pec.2007.08.002 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 17889495 [pubmed] ID - S0738-3991(07)00308-4 [pii] ID - 10.1016/j.pec.2007.08.002 [doi] PP - ppublish PH - 2007/01/03 [received] PH - 2007/07/23 [revised] PH - 2007/08/09 [accepted] LG - English EP - 20070924 DP - 2007 Dec DC - 20071112 EZ - 2007/09/25 09:00 DA - 2008/02/20 09:00 DT - 2007/09/25 09:00 YR - 2007 ED - 20080219 RD - 20071112 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17889495 <354. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17896084 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hoeller U AU - Borgmann K AU - Feyer P AU - Souchon R AU - Organgruppe "Mammakarzinom" der DEGRO FA - Hoeller, Ulrike FA - Borgmann, Kerstin FA - Feyer, Petra FA - Souchon, Rainer FA - Organgruppe "Mammakarzinom" der DEGRO IN - Hoeller, Ulrike. Klinik fur Strahlentherapie, Radioonkologie und Nuklearmedizin, Vivantes Klinikum Neukolln, Berlin. ulrike.hoeller@vivantes.de TI - [On the interaction of adjuvant radiotherapy and tamoxifen treatment for breast cancer]. [Review] [77 refs] [German] OT - Zur Interaktion von Strahlentherapie und Tamoxifen beim Mammakarzinom. SO - Strahlentherapie und Onkologie. 183(10):535-44, 2007 Oct AS - Strahlenther Onkol. 183(10):535-44, 2007 Oct NJ - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] PI - Journal available in: Print PI - Citation processed from: Print JC - vcm, 8603469 IO - Strahlenther Onkol SB - Index Medicus CP - Germany MH - Age Factors MH - Animals MH - Antineoplastic Agents, Hormonal/ae [Adverse Effects] MH - Antineoplastic Agents, Hormonal/pd [Pharmacology] MH - *Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Clinical Trials, Phase III as Topic MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Lung/re [Radiation Effects] MH - Lung Diseases/ci [Chemically Induced] MH - Lung Diseases/et [Etiology] MH - Mastectomy MH - Middle Aged MH - Neoplasms, Experimental MH - Prospective Studies MH - Pulmonary Fibrosis/ci [Chemically Induced] MH - Pulmonary Fibrosis/et [Etiology] MH - Radiotherapy/ae [Adverse Effects] MH - Radiotherapy Dosage MH - Radiotherapy, Adjuvant MH - Randomized Controlled Trials as Topic MH - Retrospective Studies MH - Risk Factors MH - Tamoxifen/ae [Adverse Effects] MH - Tamoxifen/pd [Pharmacology] MH - *Tamoxifen/tu [Therapeutic Use] MH - Time Factors MH - Tumor Cells, Cultured/de [Drug Effects] MH - Tumor Cells, Cultured/re [Radiation Effects] AB - BACKGROUND: Tamoxifen (TAM) is well established in the adjuvant therapy of breast cancer. However, the timing of TAM therapy, concurrent or after radiotherapy, is controversial. AB - METHOD: Literature is reviewed with respect to experimental and clinical data on interaction of TAM and radiation on tumor control and radiation side effects. AB - RESULTS: In vitro data support the concept of antagonistic effects of concurrent TAM and radiation on tumor cells, but in animal models a synergistic effect was seen. Considering the modulation of TAM effects by estrogen and growth factor receptors, two-dimensional systems may not be suitable for studying the interaction of TAM and radiation. From a clinical perspective, a tumor-protective effect of TAM therapy concurrent with radiation was not evident. However, prospective studies addressing this question adequately are not available at the time. AB - CONCLUSION: Although some studies indicate an enhancement of lung and subcutaneous fibrosis after TAM therapy, the side effects are mild and at this point do not seem to warrant withholding TAM. [References: 77] RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) IS - 0179-7158 IL - 0179-7158 DO - https://dx.doi.org/10.1007/s00066-007-1710-5 PT - Comparative Study PT - English Abstract PT - Journal Article PT - Review ID - 17896084 [pubmed] ID - 10.1007/s00066-007-1710-5 [doi] PP - ppublish PH - 2007/01/08 [received] PH - 2007/07/24 [accepted] LG - German DP - 2007 Oct DC - 20070926 EZ - 2007/09/27 09:00 DA - 2008/01/31 09:00 DT - 2007/09/27 09:00 YR - 2007 ED - 20080130 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17896084 <355. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17932905 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Boughey JC AU - Cormier JN AU - Xing Y AU - Hunt KK AU - Meric-Bernstam F AU - Babiera GV AU - Ross MI AU - Kuerer HM AU - Singletary SE AU - Bedrosian I FA - Boughey, Judy C FA - Cormier, Janice N FA - Xing, Yan FA - Hunt, Kelly K FA - Meric-Bernstam, Funda FA - Babiera, Gildy V FA - Ross, Merrick I FA - Kuerer, Henry M FA - Singletary, Sonja E FA - Bedrosian, Isabelle IN - Boughey, Judy C. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77230-1402, USA. TI - Decision analysis to assess the efficacy of routine sentinel lymphadenectomy in patients undergoing prophylactic mastectomy. SO - Cancer. 110(11):2542-50, 2007 Dec 01 AS - Cancer. 110(11):2542-50, 2007 Dec 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Axilla MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - *Lymph Node Excision MH - *Mastectomy MH - Sentinel Lymph Node Biopsy AB - BACKGROUND: Patients who have invasive breast cancer identified after prophylactic mastectomy (PM) require axillary lymph node dissection (ALND) for lymph node staging (ie, directed ALND). Because the majority of these patients will be lymph node negative, sentinel lymphadenectomy (SLND) has been advocated at the time of PM to avoid the sequelae of unnecessary ALND. The objective of this study was to compare the efficacy of 2 surgical strategies, routine SLND versus directed ALND, in PM patients. AB - METHODS: A decision-analytic model was created to compare the 2 surgical strategies. Model estimates were derived from a systematic literature review. The endpoints that were examined to compare the 2 strategies were the number of SLNDs performed per breast cancer detected, the number of SLNDs attempted to avoid 1 ALND in a lymph node-negative patient with occult invasive cancer, and the number of axillary complications associated with each strategy. AB - RESULTS: The prevalence of invasive cancer in patients undergoing PM was estimated at 1.9%. At this rate, 37 SLNDs were performed per 1 breast cancer detected, and 73 SLNDs were required to avoid 1 ALND in a lymph node-negative PM patient. In 1 model scenario, the probability of complications per breast cancer detected was 9-fold greater with the SLND strategy than with the directed ALND strategy (2.7 vs 0.3). The complication rates for the 2 strategies become equivalent in the model scenario when the prevalence of occult invasive cancer was projected to 28%. AB - CONCLUSIONS: Routine SLND for patients undergoing PM is not warranted given the large number of procedures required to benefit 1 patient and the potential complications associated with performing SLND in all patients. IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.23067 PT - Comparative Study PT - Journal Article ID - 17932905 [pubmed] ID - 10.1002/cncr.23067 [doi] PP - ppublish LG - English DP - 2007 Dec 01 DC - 20071126 EZ - 2007/10/13 09:00 DA - 2008/01/10 09:00 DT - 2007/10/13 09:00 YR - 2007 ED - 20080109 RD - 20071126 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17932905 <356. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17823912 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Butow P AU - Harrison JD AU - Choy ET AU - Young JM AU - Spillane A AU - Evans A FA - Butow, Phyllis FA - Harrison, James D FA - Choy, Ellis T FA - Young, Jane M FA - Spillane, Andrew FA - Evans, Alison IN - Butow, Phyllis. School of Psychology, University of Sydney, Sydney, New South Wales, Australia. TI - Health professional and consumer views on involving breast cancer patients in the multidisciplinary discussion of their disease and treatment plan. SO - Cancer. 110(9):1937-44, 2007 Nov 01 AS - Cancer. 110(9):1937-44, 2007 Nov 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Attitude of Health Personnel MH - *Breast Neoplasms MH - Decision Making MH - Female MH - Humans MH - *Interprofessional Relations MH - Nurses MH - Patient Advocacy MH - *Patient Care Team MH - *Patient Participation/px [Psychology] MH - *Physician-Patient Relations MH - Physicians MH - Surveys and Questionnaires AB - BACKGROUND: The aim was to obtain the views of health professionals and patients about the concept of involving breast cancer patients in the multidisciplinary (MD) treatment planning meeting. AB - METHODS: Breast cancer surgeons, nurses, oncologists, and patient advocates completed a mailed questionnaire. AB - RESULTS: The majority of breast cancer health professionals and patient advocates support shared decision-making (58%-62%). However, less than a third of surgeons (32%), medical (25%), and radiation oncologists (24%) were supportive of involving women in the MD treatment planning meeting. In contrast, 93% of breast cancer advocates and 73% of breast cancer nurses were supportive of this approach. Patient advocates were significantly more in favor than all other groups (chi(2) = 148.8, df = 4, P < .001). The common reasons for supporting patient involvement included that it would lead to patients being more informed and empowered, provide them with an opportunity to ask questions, facilitate decision-making, and improve communication between the patient and the medical team. Health professionals stated that attendance would make patients anxious and that they would have to modify their medical language. Suggestions about how to manage patient involvement included the patient being supported by a breast nurse and pre-education before the meeting. Patient advocates were significantly more willing to participate in a randomized controlled trial of this process compared with all other groups. (chi(2) = 155.15, df = 4, P < .001). AB - CONCLUSIONS: Despite health professional's reservations, patient advocates were highly supportive of including women in the MD meeting. Such a high demand justifies consideration of this option. IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.23007 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17823912 [pubmed] ID - 10.1002/cncr.23007 [doi] PP - ppublish LG - English DP - 2007 Nov 01 DC - 20071025 EZ - 2007/09/08 09:00 DA - 2007/12/12 09:00 DT - 2007/09/08 09:00 YR - 2007 ED - 20071211 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17823912 <357. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17718858 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Metcalfe KA AU - Poll A AU - O'Connor A AU - Gershman S AU - Armel S AU - Finch A AU - Demsky R AU - Rosen B AU - Narod SA FA - Metcalfe, K A FA - Poll, A FA - O'Connor, A FA - Gershman, S FA - Armel, S FA - Finch, A FA - Demsky, R FA - Rosen, B FA - Narod, S A IN - Metcalfe, K A. Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada M5T 1P8. kelly.metcalfe@utoronto.ca TI - Development and testing of a decision aid for breast cancer prevention for women with a BRCA1 or BRCA2 mutation. SO - Clinical Genetics. 72(3):208-17, 2007 Sep AS - Clin Genet. 72(3):208-17, 2007 Sep NJ - Clinical genetics PI - Journal available in: Print PI - Citation processed from: Print JC - ddt, 0253664 IO - Clin. Genet. SB - Index Medicus CP - Denmark MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Counseling MH - Humans MH - Mutation MH - Pilot Projects AB - For women who carry a mutation in BRCA1 or BRCA2, the risk of breast cancer is up to 87% by the age of 70. There are options available to reduce the risk of breast cancer; however, each option has both risks and benefits, which makes decision making difficult. The objective is to develop and pilot test a decision aid for breast cancer prevention for women with a BRCA1 or BRCA2 mutation. The decision aid was developed and evaluated in three stages. In the first stage, the decision aid was developed and reviewed by cancer genetics experts. The second stage was a review of the decision aid by women with a BRCA1 or BRCA2 mutation for acceptability and feasibility. The final stage was a pre-test--post-test evaluation of the decision aid. Twenty-one women completed the pre-test questionnaire and 20 completed the post-test questionnaire. After using the decision aid, there was a significant decline in mean decisional conflict scores (p = 0.001), a significant improvement in knowledge scores (p = 0.004), and fewer women uncertain about prophylactic mastectomy (p = 0.003) and prophylactic oophorectomy (p = 0.009). Use of the decision aid decreased decisional conflict to levels suggestive of implementation of a decision. In addition, knowledge levels increased and choice predisposition changed with fewer women being uncertain about each option. This has significant clinical implications as it implies that with greater uptake of cancer prevention options by women with a BRCA1 or BRCA2 mutation, fewer women will develop and/or die of hereditary breast cancer. IS - 0009-9163 IL - 0009-9163 DI - CGE859 DO - https://dx.doi.org/10.1111/j.1399-0004.2007.00859.x PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17718858 [pubmed] ID - CGE859 [pii] ID - 10.1111/j.1399-0004.2007.00859.x [doi] PP - ppublish LG - English DP - 2007 Sep DC - 20070827 EZ - 2007/08/28 09:00 DA - 2007/12/06 09:00 DT - 2007/08/28 09:00 YR - 2007 ED - 20071203 RD - 20070827 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17718858 <358. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17874951 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Meyer BJ AU - Talbot AP AU - Ranalli C FA - Meyer, Bonnie J F FA - Talbot, Andrew P FA - Ranalli, Carlee IN - Meyer, Bonnie J F. Department of Educational and School Psychology and Special Education, University Park Campus, Pennsylvania State University, University Park, PA 16802, USA. bjm8@psu.edu TI - Why older adults make more immediate treatment decisions about cancer than younger adults. SO - Psychology & Aging. 22(3):505-24, 2007 Sep AS - Psychol Aging. 22(3):505-24, 2007 Sep NJ - Psychology and aging PI - Journal available in: Print PI - Citation processed from: Print JC - ah7, 8904079 IO - Psychol Aging SB - Index Medicus CP - United States MH - Adolescent MH - Adult MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Biopsy/px [Psychology] MH - Brachytherapy/px [Psychology] MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Decision Trees MH - Female MH - Health Knowledge, Attitudes, Practice MH - Health Surveys MH - Humans MH - Male MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Ohio MH - Patient Education as Topic MH - Patient Participation MH - Pennsylvania MH - Problem Solving MH - Prostatectomy/px [Psychology] MH - Prostatic Neoplasms/di [Diagnosis] MH - *Prostatic Neoplasms/px [Psychology] MH - Prostatic Neoplasms/th [Therapy] MH - Sex Factors AB - Literature relevant to medical decision making was reviewed, and a model was outlined for testing. Two studies examined whether older adults make more immediate decisions than younger adults about treatments for prostate or breast cancer in authentic scenarios. Findings clearly showed that older adults were more likely to make immediate decisions than younger adults. The research is important because it not only demonstrates the consistency of this age-related effect across disease domains, gender, ethnic groups, and prevalent education levels but begins to investigate a model to explain the effect. Major reasons for the effect focus on treatment knowledge, interest and engagement, and cognitive resources. Treatment knowledge, general cancer knowledge, interest, and cognitive resources relate to different ways of processing treatment information and preferences for immediate versus delayed decision making. Adults with high knowledge of treatments on a reliable test tended to make immediate treatment decisions, which supports the knowledge explanation. Adults with more cognitive resources and more interest tended to delay their treatment decisions. Little support was found for a cohort explanation for the relationship between age and preference for immediate medical decision making. AB - Copyright (PsycINFO Database Record (c) 2007 APA, all rights reserved). IS - 0882-7974 IL - 0882-7974 DI - 2007-13103-009 DO - https://dx.doi.org/10.1037/0882-7974.22.3.505 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 17874951 [pubmed] ID - 2007-13103-009 [pii] ID - 10.1037/0882-7974.22.3.505 [doi] PP - ppublish GI - No: AG 000048 Organization: (AG) *NIA NIH HHS* Country: United States No: R01 AG 09957 Organization: (AG) *NIA NIH HHS* Country: United States LG - English DP - 2007 Sep DC - 20070918 EZ - 2007/09/19 09:00 DA - 2007/12/06 09:00 DT - 2007/09/19 09:00 YR - 2007 ED - 20071130 RD - 20070918 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17874951 <359. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17911785 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Razavi AR AU - Gill H AU - Ahlfeldt H AU - Shahsavar N FA - Razavi, Amir R FA - Gill, Hans FA - Ahlfeldt, Hans FA - Shahsavar, Nosrat IN - Razavi, Amir R. Department of Biomedical Engineering, Division of Medical Informatics, Linkoping University, Sweden. amirreza.razavi@imt.liu.se TI - A data mining approach to analyze non-compliance with a guideline for the treatment of breast cancer. SO - Studies in Health Technology & Informatics. 129(Pt 1):591-5, 2007 AS - Stud Health Technol Inform. 129(Pt 1):591-5, 2007 NJ - Studies in health technology and informatics PI - Journal available in: Print PI - Citation processed from: Print JC - ck1, 9214582 IO - Stud Health Technol Inform SB - Health Technology Assessment Journals CP - Netherlands MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - *Decision Trees MH - *Guideline Adherence MH - Humans MH - Information Storage and Retrieval MH - Mastectomy MH - Practice Guidelines as Topic MH - Radiotherapy, Adjuvant/ut [Utilization] AB - Postmastectomy radiotherapy (PMRT) is prescribed in order to reduce the local recurrence of breast cancer and improve overall survival. A guideline supports the trade-off between benefits and adverse effects of PMRT. However, this guideline is not always followed in practice. This study tries to find a method for revealing patterns of non-compliance between the actual treatment and the PMRT guideline. Data from breast cancer patients admitted to Linkoping University Hospital between 1990 and 2000 were analyzed in this study. Cases that were not treated in accordance with the guideline were selected and analyzed by decision tree induction (DTI). Thereafter, four resulting rules, as representations for groups of patients, were compared to the guideline. Finding patterns of non-compliance with guidelines by means of rules can be an appropriate alternative to manual methods, i.e. a case-by-case comparison when studying very large datasets. The resulting rules can be used in a knowledge base of a guideline-based decision support system to alert when inconsistencies with the guidelines may appear. IS - 0926-9630 IL - 0926-9630 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17911785 [pubmed] PP - ppublish LG - English DP - 2007 DC - 20071003 EZ - 2007/10/04 09:00 DA - 2007/12/06 09:00 DT - 2007/10/04 09:00 YR - 2007 ED - 20071128 RD - 20080710 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17911785 <360. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17954796 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mathieu E AU - Barratt A AU - Davey HM AU - McGeechan K AU - Howard K AU - Houssami N FA - Mathieu, Erin FA - Barratt, Alexandra FA - Davey, Heather M FA - McGeechan, Kevin FA - Howard, Kirsten FA - Houssami, Nehmat IN - Mathieu, Erin. Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia. TI - Informed choice in mammography screening: a randomized trial of a decision aid for 70-year-old women. CM - Comment in: Arch Intern Med. 2007 Oct 22;167(19):2027-8; PMID: 17954794 SO - Archives of Internal Medicine. 167(19):2039-46, 2007 Oct 22 AS - Arch Intern Med. 167(19):2039-46, 2007 Oct 22 NJ - Archives of internal medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0372440, 7fs IO - Arch. Intern. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Aged MH - *Breast Neoplasms/dg [Diagnostic Imaging] MH - Choice Behavior MH - *Decision Support Techniques MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Mammography/sn [Statistics & Numerical Data] MH - *Mammography/ut [Utilization] MH - New South Wales MH - Outcome Assessment (Health Care) MH - Patient Education as Topic MH - Patient Participation MH - Patient Satisfaction AB - BACKGROUND: Many women who have participated in mammography screening are now approaching 70 years of age. These women are advised to consider both the benefits and harms of continuing to be screened. Doing so may be difficult for individual women, and there are no evaluated decision support tools to assist them. AB - METHODS: To assess the effect of a decision aid (DA) about whether to continue or stop mammography screening for women aged 70 years, a population-based, randomized controlled trial was conducted in New South Wales, Australia. Women aged 70 years who had regularly participated in mammography screening were eligible to participate in the trial. Women received a DA providing balanced, quantitative information or standard information available from the screening program. The main outcomes were the percentage of women making an informed choice about whether to continue or stop screening and the percentage of women participating in the screening. AB - RESULTS: Women who received the DA (the intervention group) were better informed than the control group (mean increase in knowledge score out of 10, 2.62 for the intervention group vs 0.68 for the control group; P < .001), and a significantly greater percentage made an informed choice (73.5% vs 48.8%; P < .001). The DA did not increase anxiety and slightly reduced decisional conflict. There was no difference in the percentage of women who participated in screening within 1 month. AB - CONCLUSIONS: This DA increased knowledge and assisted women to make an informed choice. It did not alter participation in screening. The DA is an effective way to assist women to make a decision about continuing mammography screening and seems to be a feasible intervention within a population screening program. IS - 0003-9926 IL - 0003-9926 DI - 167/19/2039 DO - https://dx.doi.org/10.1001/archinte.167.19.2039 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 17954796 [pubmed] ID - 167/19/2039 [pii] ID - 10.1001/archinte.167.19.2039 [doi] PP - ppublish LG - English DP - 2007 Oct 22 DC - 20071023 EZ - 2007/10/24 09:00 DA - 2007/12/06 09:00 DT - 2007/10/24 09:00 YR - 2007 ED - 20071120 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17954796 <361. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17909370 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Brooks JM AU - Chrischilles EA FA - Brooks, John M FA - Chrischilles, Elizabeth A IN - Brooks, John M. Program in Pharmaceutical Socioeconomics, College of Pharmacy, University of Iowa, Iowa City, Iowa, USA. john-brooks@uiowa.edu TI - Heterogeneity and the interpretation of treatment effect estimates from risk adjustment and instrumental variable methods. SO - Medical Care. 45(10 Supl 2):S123-30, 2007 Oct AS - Med Care. 45(10 Supl 2):S123-30, 2007 Oct NJ - Medical care PI - Journal available in: Print PI - Citation processed from: Print JC - 0230027, lsm IO - Med Care SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Confounding Factors (Epidemiology) MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Iowa/ep [Epidemiology] MH - Linear Models MH - *Mastectomy/mt [Methods] MH - Mastectomy, Segmental MH - Middle Aged MH - *Models, Statistical MH - *Observation/mt [Methods] MH - Radiotherapy, Adjuvant MH - Registries/sn [Statistics & Numerical Data] MH - Retrospective Studies MH - *Risk Adjustment/sn [Statistics & Numerical Data] MH - Survival Rate AB - OBJECTIVES: To contrast the interpretations of treatment effect estimates using risk adjustment and instrumental variable (IV) estimation methods using observational data when the effects of treatment are heterogeneous across patients. We demonstrate these contrasts by examining the effect of breast conserving surgery plus irradiation (BCSI) relative to mastectomy on early stage breast cancer (ESBC) survival. AB - METHODS: We estimated discrete time survival models for 6185 ESBC patients in the 1989-1994 Iowa Cancer Registry via IV estimation using 2 distinct instruments (distance of the patient's residence from the nearest radiation center, and local area BCSI rate) and controlling for cancer stage, grade, and location; age; comorbidity; hospital access; payer; diagnosis year; and area poverty level. We then estimated comparable risk adjustment survival models using linear probability methods with robust standard errors. AB - RESULTS: Risk adjustment models yielded average survival estimates similar to trial results. With favorable BCSI selection, these estimates represent an upper bound of the true effect for patients receiving BCSI. IV estimates showed a BCSI survival risk for patients whose surgery choices were affected by the instruments and these estimates varied with the instrument specification. AB - CONCLUSIONS: When treatment benefits are heterogeneous across patients, treatment effect estimates from observational data can still be useful to policymakers, but they must be interpreted correctly. Risk adjustment methods yield estimates that can assess whether the patients who received treatment benefited from the treatment, but the direction of bias must be considered. In contrast, IV estimates can assess the effect of treatment rate changes, but characteristics of patients whose choices were affected by the instruments must be considered when making such inferences. IS - 0025-7079 IL - 0025-7079 DI - 00005650-200710002-00021 DO - https://dx.doi.org/10.1097/MLR.0b013e318070c069 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 17909370 [pubmed] ID - 10.1097/MLR.0b013e318070c069 [doi] ID - 00005650-200710002-00021 [pii] PP - ppublish GI - No: N01-PC-85063-20 Organization: (PC) *NCI NIH HHS* Country: United States LG - English DP - 2007 Oct DC - 20071002 EZ - 2007/10/25 09:00 DA - 2007/12/06 09:00 DT - 2007/10/25 09:00 YR - 2007 ED - 20071120 RD - 20071002 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17909370 <362. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17896717 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Halpert J FA - Halpert, Julie TI - What do patients want?. SO - Newsweek. 141(17):63-4, 2003 Apr 28 AS - Newsweek. 141(17):63-4, 2003 Apr 28 NJ - Newsweek PI - Journal available in: Print PI - Citation processed from: Print JC - 9877127, bv8 IO - Newsweek SB - Consumer Health Journals CP - United States MH - Adult MH - Anecdotes as Topic MH - *Decision Making MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Patient Education as Topic MH - *Patient Participation MH - *Physician-Patient Relations IS - 0028-9604 IL - 0028-9604 PT - News ID - 17896717 [pubmed] PP - ppublish LG - English DP - 2003 Apr 28 DC - 20070927 EZ - 2007/09/28 09:00 DA - 2007/11/06 09:00 DT - 2007/09/28 09:00 YR - 2003 ED - 20071102 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=17896717 <363. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17278032 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Peynircioglu B AU - Arslan EB AU - Cil BE AU - Geyik S AU - Hazirolan T AU - Konan A AU - Balkanci F FA - Peynircioglu, Bora FA - Arslan, E Bengi FA - Cil, Barbaros E FA - Geyik, Serdar FA - Hazirolan, Tuncay FA - Konan, Ali FA - Balkanci, Ferhun IN - Peynircioglu, Bora. Department of Radiology, Hacettepe University, School of Medicine, Ankara, Turkey. borapeynir@gmail.com TI - Subcutaneous venous port implantation in patients with bilateral breast surgery. SO - Cardiovascular & Interventional Radiology. 30(3):405-9, 2007 May-Jun AS - Cardiovasc Intervent Radiol. 30(3):405-9, 2007 May-Jun NJ - Cardiovascular and interventional radiology PI - Journal available in: Print PI - Citation processed from: Print JC - 8003538, com IO - Cardiovasc Intervent Radiol SB - Index Medicus CP - United States MH - Adult MH - *Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/su [Surgery] MH - *Catheters, Indwelling MH - Cellulitis/dg [Diagnostic Imaging] MH - Cellulitis/et [Etiology] MH - Chemotherapy, Adjuvant MH - Combined Modality Therapy MH - Device Removal MH - Female MH - Follow-Up Studies MH - Humans MH - Infusions, Intravenous MH - Lymphedema/dg [Diagnostic Imaging] MH - Lymphedema/et [Etiology] MH - *Mastectomy, Modified Radical MH - *Mastectomy, Radical MH - *Mastectomy, Simple MH - Middle Aged MH - Neoplasms, Multiple Primary/dg [Diagnostic Imaging] MH - *Neoplasms, Multiple Primary/dt [Drug Therapy] MH - Neoplasms, Multiple Primary/su [Surgery] MH - Radiography MH - Retrospective Studies AB - The purpose of this study was to evaluate the long-term follow-up results of subcutaneous venous ports implanted in patients with bilateral mastectomies. We retrospectively reviewed the hospital charts and the electronic database of 17 patients with bilateral mastectomies whom had venous port implantation in our interventional radiology suit. A total of 17 ports were implanted to the paramedian (n = 3) and anterolateral (standard; n = 12) chest wall, on the trapezius muscle (n = 1), and to the antecubital fossa (n = 1). The mean age was 48.29 years (range: 35-60 years). The mean time interval from time of surgery to port implantation was 34 months (range: 1-84 months). The mean follow-up time was 15 months (range: 7-39 months). Follow-up parameters and classification of the complications was defined according to the SIR guidelines. No procedure-related complication occurred. A single case of mild late infection was noted and the infection rate was 0.19/1000 catheter days. Infusion chemotherapy administration was still going on in eight patients. Two patients died during the follow-up and four patients were lost after 6 months. Port removal was performed in three patients at follow-up because of the end of treatment. One trapezius port and one paramedian port weres among the removed ports without any problem. Although we have a limited number of patients, port placement to the anterior chest wall, either paramedian or anterolateral, on the trapezius muscle or to the antecubital fossa depending on the extent of the bilateral breast surgeries that can be performed with low complication rates by a careful patient and anatomical location selection by involving the patients in the decision-making process. We believe that patient education and knowledge of possible complications have high importance in follow-up. IS - 0174-1551 IL - 0174-1551 DO - https://dx.doi.org/10.1007/s00270-006-0301-7 PT - Comparative Study PT - Journal Article ID - 17278032 [pubmed] ID - 10.1007/s00270-006-0301-7 [doi] PP - ppublish LG - English DP - 2007 May-Jun DC - 20070413 EZ - 2007/02/06 09:00 DA - 2007/11/01 09:00 DT - 2007/02/06 09:00 YR - 2007 ED - 20071031 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17278032 <364. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17638637 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Yeap BH AU - Muniandy S AU - Lee SK AU - Sabaratnam S AU - Singh M FA - Yeap, Badrul H FA - Muniandy, Suseela FA - Lee, Suk-Kam FA - Sabaratnam, Subathra FA - Singh, Manjit IN - Yeap, Badrul H. Department of General Surgery, Penang General Hospital, Penang, Malaysia. drbhyeap@hotmail.com TI - Specimen shrinkage and its influence on margin assessment in breast cancer. SO - Asian Journal of Surgery. 30(3):183-7, 2007 Jul AS - ASIAN J. SURG.. 30(3):183-7, 2007 Jul NJ - Asian journal of surgery PI - Journal available in: Print PI - Citation processed from: Print JC - 8900600 IO - Asian J Surg SB - Index Medicus CP - China MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Female MH - Fixatives/pd [Pharmacology] MH - Formaldehyde/pd [Pharmacology] MH - Humans MH - Mastectomy MH - Middle Aged MH - Neoplasm, Residual MH - Tissue Culture Techniques MH - *Tissue Fixation/mt [Methods] AB - OBJECTIVE: The determination of tumour-free margin in breast cancer is crucial in deciding subsequent patient management. To exemplify the phenomenon of margin contraction during specimen preparation for histopathological analysis, we quantified the shrinkage of breast specimens as a result of formalin fixation. AB - METHODS: Fifty consecutive mastectomy and wide excision specimens were prospectively appraised. The closest free margin and maximal tumour diameter of fresh, unprepared specimens were recorded. These measurements were compared with the corresponding parameters following tissue fixation. AB - RESULTS: Following formalin fixation, the mean closest free margin of the specimens was found to have decreased from 10.28 mm to 6.78 mm (34%). The reduction of the mean diameter of the tumour itself was less significant, from 41.74 mm to 39.88 mm (4.5%). AB - CONCLUSION: Breast specimens undergo shrinkage after histological fixation, losing more than a third of their original closest free margin, whilst the tumour itself does not shrink substantially. This phenomenon has vital implications in the accuracy of margin analysis and consequent decisions on further management, including re-operation and the institution of adjuvant radiotherapy. RN - 0 (Fixatives) RN - 1HG84L3525 (Formaldehyde) IS - 1015-9584 IL - 1015-9584 DI - S1015-9584(08)60020-2 DO - https://dx.doi.org/10.1016/S1015-9584(08)60020-2 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17638637 [pubmed] ID - S1015-9584(08)60020-2 [pii] ID - 10.1016/S1015-9584(08)60020-2 [doi] PP - ppublish LG - English DP - 2007 Jul DC - 20070719 EZ - 2007/07/20 09:00 DA - 2007/10/10 09:00 DT - 2007/07/20 09:00 YR - 2007 ED - 20071009 RD - 20161021 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17638637 <365. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17666977 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rolnick SJ AU - Altschuler A AU - Nekhlyudov L AU - Elmore JG AU - Greene SM AU - Harris EL AU - Herrinton LJ AU - Barton MB AU - Geiger AM AU - Fletcher SW FA - Rolnick, Sharon J FA - Altschuler, Andrea FA - Nekhlyudov, Larissa FA - Elmore, Joann G FA - Greene, Sarah M FA - Harris, Emily L FA - Herrinton, Lisa J FA - Barton, Mary B FA - Geiger, Ann M FA - Fletcher, Suzanne W IN - Rolnick, Sharon J. HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA. Cheri.J.Rolnick@healthpartners.com TI - What women wish they knew before prophylactic mastectomy. SO - Cancer Nursing. 30(4):285-91; quiz 292-3, 2007 Jul-Aug AS - Cancer Nurs. 30(4):285-91; quiz 292-3, 2007 Jul-Aug NJ - Cancer nursing PI - Journal available in: Print PI - Citation processed from: Internet JC - 7805358, cnc IO - Cancer Nurs SB - Index Medicus SB - Nursing Journal CP - United States MH - Adaptation, Psychological MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Making MH - Female MH - Humans MH - Mammaplasty/ae [Adverse Effects] MH - Mammaplasty/px [Psychology] MH - *Mammaplasty MH - Mastectomy/ae [Adverse Effects] MH - Mastectomy/px [Psychology] MH - *Mastectomy MH - Middle Aged MH - Needs Assessment MH - *Patient Education as Topic MH - *Patient Satisfaction MH - United States AB - Although prophylactic mastectomy significantly reduces the incidence and recurrence of breast cancer, little is known about women's information needs before the procedure. We surveyed 967 women, from 6 healthcare systems, with bilateral or contralateral prophylactic mastectomy performed between 1979 and 1999. There were 2 open-ended questions: "What one thing do you wish you had known before your prophylactic mastectomy" and "Is there anything else you would like to share with us?" Three researchers categorized responses, and informational needs were ascertained. Seventy-one percent (684 women) responded, of which 81% answered one or both open-ended questions. There were 386 comments (made by 293 women) that related to information needs; 79% of women had bilateral prophylactic mastectomy and 58% had contralateral prophylactic mastectomy. Most concerns (69%) were related to reconstruction: the longevity; look and feel of implants, pain, numbness, scarring, and reconstruction options. Many women wished they had seen photographs to better prepare them for the final result. Our findings suggest that information needs of many women undergoing prophylactic mastectomy, particularly those selecting bilateral prophylactic mastectomy, have not been sufficiently addressed. Clinicians and health educators should be aware of patient needs and must counsel women accordingly. ES - 1538-9804 IL - 0162-220X DI - 00002820-200707000-00005 DO - https://dx.doi.org/10.1097/01.NCC.0000281733.40856.c4 PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural ID - 17666977 [pubmed] ID - 10.1097/01.NCC.0000281733.40856.c4 [doi] ID - 00002820-200707000-00005 [pii] PP - ppublish GI - No: U19 CA079689-01 Organization: (CA) *NCI NIH HHS* Country: United States No: R01-CA090323 Organization: (CA) *NCI NIH HHS* Country: United States No: U19 CA79689-030 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2007 Jul-Aug DC - 20070801 EZ - 2007/08/02 09:00 DA - 2007/09/19 09:00 DT - 2007/08/02 09:00 YR - 2007 ED - 20070918 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17666977 <366. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16986172 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Arora NK AU - Finney Rutten LJ AU - Gustafson DH AU - Moser R AU - Hawkins RP FA - Arora, Neeraj K FA - Finney Rutten, Lila J FA - Gustafson, David H FA - Moser, Richard FA - Hawkins, Robert P IN - Arora, Neeraj K. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892-7344, USA. aroran@mail.nih.gov TI - Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer. SO - Psycho-Oncology. 16(5):474-86, 2007 May AS - Psychooncology. 16(5):474-86, 2007 May NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Print JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Adaptation, Psychological MH - Adult MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Decision Making MH - *Family/px [Psychology] MH - Female MH - *Friends MH - Humans MH - Longitudinal Studies MH - Middle Aged MH - Patient Education as Topic MH - Patient Satisfaction MH - *Physician's Role/px [Psychology] MH - Quality of Life/px [Psychology] MH - Self Efficacy MH - Self-Help Groups MH - *Sick Role MH - *Social Support MH - Surveys and Questionnaires AB - We evaluated the helpfulness of informational, emotional, and decision-making support received by women newly diagnosed with breast cancer from their family, friends, and health care providers. Data were collected at two time points via patient surveys: baseline on an average 2 months post-diagnosis and follow-up at 5 months post-baseline. In the period closer to diagnosis, majority of the women received helpful informational support from health care providers (84.0%); helpful emotional support from family (85%), friends (80.4%), and providers (67.1%); and helpful decision-making support from providers (75.2%) and family (71.0%). Emotional support at baseline and emotional and informational support at 5-month follow-up were significantly associated with patients' health-related quality of life and self-efficacy outcomes (p<0.01). Perceived helpfulness of informational, emotional, and decision-making support provided by family, friends, and providers however significantly decreased over time (p<0.001). Cancer patients' desire significant amount of support throughout their cancer journey. Our results show that while patients receive a lot of support during the period closer to diagnosis, receipt of helpful support drops significantly within the first year itself. In order to facilitate cancer patients' adjustment to their illness, efforts need to be made to understand and address their support needs throughout the cancer experience. IS - 1057-9249 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1084 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 16986172 [pubmed] ID - 10.1002/pon.1084 [doi] PP - ppublish GI - No: 5R01HD32922 Organization: (HD) *NICHD NIH HHS* Country: United States LG - English DP - 2007 May DC - 20070507 EZ - 2006/09/21 09:00 DA - 2007/08/02 09:00 DT - 2006/09/21 09:00 YR - 2007 ED - 20070801 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16986172 <367. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17406006 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lash TL AU - Fox MP AU - Thwin SS AU - Geiger AM AU - Buist DS AU - Wei F AU - Field TS AU - Yood MU AU - Frost FJ AU - Quinn VP AU - Prout MN AU - Silliman RA FA - Lash, Timothy L FA - Fox, Matthew P FA - Thwin, Soe Soe FA - Geiger, Ann M FA - Buist, Diana S M FA - Wei, Feifei FA - Field, Terry S FA - Yood, Marianne Ulcickas FA - Frost, Floyd J FA - Quinn, Virginia P FA - Prout, Marianne N FA - Silliman, Rebecca A IN - Lash, Timothy L. Boston University School of Public Health, Boston, MA 02118, USA. tlash@bu.edu TI - Using probabilistic corrections to account for abstractor agreement in medical record reviews. SO - American Journal of Epidemiology. 165(12):1454-61, 2007 Jun 15 AS - Am J Epidemiol. 165(12):1454-61, 2007 Jun 15 NJ - American journal of epidemiology PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - 3h3, 7910653 IO - Am. J. Epidemiol. SB - Index Medicus CP - United States MH - *Abstracting and Indexing as Topic MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Comorbidity MH - *Data Interpretation, Statistical MH - Female MH - Humans MH - Mastectomy/mt [Methods] MH - *Medical Records MH - Neoplasm Recurrence, Local/ep [Epidemiology] MH - *Probability MH - United States/ep [Epidemiology] AB - The quality of medical record abstracts is often characterized in a reliability substudy. These results usually indicate agreement, but not the extent to which lack of agreement affects associations observed in the complete data. In this study, medical records were reviewed and abstracted for patients diagnosed with stage I or stage II breast cancer between 1990 and 1994 at one of six US Cancer Research Network sites. For a subsample, interrater reliability data were available. The authors calculated conventional hazard ratios and 95% confidence intervals for the association of demographic, tumor, and treatment characteristics with recurrence rate. These conventional estimates of effect were compared with three sets of estimates and 95% simulation intervals that took account of the uncertainty assessed by lack of agreement in the reliability substudy. The rate of recurrence was associated with increasing cancer stage and with treatment modality but not with demographic characteristics. The hazard ratios and simulation intervals that took account of the reliability data showed that the simulation interval grew wider as the sources of uncertainty taken into account grew more complete, but the associations expected a priori remained readily apparent. While many investigators use reliability data only as a metric for data quality, a more thorough approach can also quantitatively depict the uncertainty in the observed associations. IS - 0002-9262 IL - 0002-9262 DI - kwm034 DO - https://dx.doi.org/10.1093/aje/kwm034 PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural ID - 17406006 [pubmed] ID - kwm034 [pii] ID - 10.1093/aje/kwm034 [doi] PP - ppublish GI - No: R01 CA093772 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20070403 DP - 2007 Jun 15 DC - 20070531 EZ - 2007/04/05 09:00 DA - 2007/08/01 09:00 DT - 2007/04/05 09:00 YR - 2007 ED - 20070731 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17406006 <368. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17341306 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - McCullum M AU - Bottorff JL AU - Kelly M AU - Kieffer SA AU - Balneaves LG FA - McCullum, Mary FA - Bottorff, Joan L FA - Kelly, Mary FA - Kieffer, Stephanie A FA - Balneaves, Lynda G IN - McCullum, Mary. Hereditary Cancer Program, BC Cancer Agency, Vancouver, BC, Canada. mmccullum@bccancer.bc.ca TI - Time to decide about risk-reducing mastectomy: a case series of BRCA1/2 gene mutation carriers. SO - BMC Women's Health. 7:3, 2007 Mar 06 AS - BMC Womens Health. 7:3, 2007 Mar 06 NJ - BMC women's health PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101088690 IO - BMC Womens Health PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829393 CP - England AB - BACKGROUND: The purpose of this research was to explore women's decision-making experiences related to the option of risk-reducing mastectomy (RM), using a case series of three women who are carriers of a BRCA1/2 gene mutation. AB - METHODS: Data was collected in a pilot study that assessed the response of women to an information booklet about RM and decision-making support strategies. A detailed analysis of three women's descriptions of their decision-making processes and outcomes was conducted. AB - RESULTS: All three women were carriers of a BRCA1/2 gene mutation and, although undecided, were leaning towards RM when initially assessed. Each woman reported a different RM decision outcome at last follow-up. Case #1 decided not to have RM, stating that RM was "too radical" and early detection methods were an effective strategy for dealing with breast cancer risk. Case #2 remained undecided about RM and, over time, she became less prepared to make a decision because she felt she did not have sufficient information about surgical effects. Case #3 had undergone RM by the time of her second follow-up interview and reported that she felt "a load off (her) mind now". AB - CONCLUSION: RM decision making may shift over time and require decision support over an extended period. ES - 1472-6874 IL - 1472-6874 DI - 1472-6874-7-3 DO - https://dx.doi.org/10.1186/1472-6874-7-3 PT - Journal Article ID - 17341306 [pubmed] ID - 1472-6874-7-3 [pii] ID - 10.1186/1472-6874-7-3 [doi] ID - PMC1829393 [pmc] PP - epublish PH - 2006/07/17 [received] PH - 2007/03/06 [accepted] LG - English EP - 20070306 DP - 2007 Mar 06 DC - 20070322 EZ - 2007/03/08 09:00 DA - 2007/03/08 09:01 DT - 2007/03/08 09:00 YR - 2007 ED - 20070723 RD - 20091118 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=17341306 <369. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17371175 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jibaja-Weiss ML AU - Volk RJ AU - Granch TS AU - Nefe NE AU - Spann SJ AU - Aoki N AU - Robinson EK AU - Freidman LC AU - Beck JR FA - Jibaja-Weiss, Maria L FA - Volk, Robert J FA - Granch, Thomas S FA - Nefe, Nancy E FA - Spann, Stephen J FA - Aoki, Noriaki FA - Robinson, Emily K FA - Freidman, Lois C FA - Beck, J Robert IN - Jibaja-Weiss, Maria L. Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas 77098, USA. mariaj@bcm.edu TI - Entertainment education for informed breast cancer treatment decisions in low-literate women: development and initial evaluation of a patient decision aid. SO - Journal of Cancer Education. 21(3):133-9, 2006 Fall AS - J Cancer Educ. 21(3):133-9, 2006 Fall NJ - Journal of cancer education : the official journal of the American Association for Cancer Education PI - Journal available in: Print PI - Citation processed from: Print JC - avy, 8610343 IO - J Cancer Educ SB - Index Medicus CP - England MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/th [Therapy] MH - Continental Population Groups/ed [Education] MH - *Decision Making MH - *Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Educational Status MH - Ethnic Groups/ed [Education] MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - Neoplasm Staging MH - Patient Education as Topic/mt [Methods] MH - *Patient Education as Topic MH - Patient Satisfaction MH - *Program Development MH - *Program Evaluation MH - Research Design MH - Surveys and Questionnaires MH - Texas MH - User-Computer Interface AB - BACKGROUND: We report on the development and initial evaluation of a novel computerized decision support system (CDSS) that utilizes concepts from entertainment education (edutainment) to assist low-literate, multiethnic women in making initial surgical treatment decisions. AB - METHOD: We randomly assigned 51 patients diagnosed with early stage breast cancer to use the decision aid. AB - RESULTS: Patients who viewed the CDSS improved their knowledge of breast cancer treatment; found the application easy to use and understand, informative, and enjoyable; and were less worried about treatment. AB - CONCLUSION: The system clearly reached its intended objectives to create a usable decision aid for low-literate, novice computer users. IS - 0885-8195 IL - 0885-8195 DO - https://dx.doi.org/10.1207/s15430154jce2103_8 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 17371175 [pubmed] ID - 10.1207/s15430154jce2103_8 [doi] PP - ppublish LG - English DP - 2006 Fall DC - 20070320 EZ - 2007/03/21 09:00 DA - 2007/07/18 09:00 DT - 2007/03/21 09:00 YR - 2006 ED - 20070717 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17371175 <370. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16874745 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sheehan J AU - Sherman KA AU - Lam T AU - Boyages J FA - Sheehan, Joanne FA - Sherman, Kerry A FA - Lam, Thomas FA - Boyages, John IN - Sheehan, Joanne. Department of Psychology, Macquarie University, NSW 2109, Australia. TI - Association of information satisfaction, psychological distress and monitoring coping style with post-decision regret following breast reconstruction. SO - Psycho-Oncology. 16(4):342-51, 2007 Apr AS - Psychooncology. 16(4):342-51, 2007 Apr NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Print JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - *Adaptation, Psychological MH - Adult MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Depressive Disorder, Major/et [Etiology] MH - *Depressive Disorder, Major/th [Therapy] MH - *Disclosure MH - *Emotions MH - Female MH - Humans MH - *Mammaplasty/px [Psychology] MH - Middle Aged MH - *Patient Satisfaction MH - Social Support MH - Surveys and Questionnaires AB - Little is known of the psychosocial factors associated with decision regret in the context of breast reconstruction following mastectomy for breast cancer treatment. Moreover, there is a paucity of theoretically-based research in the area of post-decision regret. Adopting the theoretical framework of the Monitoring Process Model (Cancer 1995;76(1):167-177), the current study assessed the role of information satisfaction, current psychological distress and the moderating effect of monitoring coping style to the experience of regret over the decision to undergo reconstructive surgery. Women (N=123) diagnosed with breast cancer who had undergone immediate or delayed breast reconstruction following mastectomy participated in the study. The majority of participants (52.8%, n=65) experienced no decision regret, 27.6% experienced mild regret and 19.5% moderate to strong regret. Bivariate analyses indicated that decision regret was associated with low satisfaction with preparatory information, depression, anxiety and stress. Multinominal logistic regression analysis showed, controlling for mood state and time since last reconstructive procedure, that lower satisfaction with information and increased depression were associated with increased likelihood of experiencing regret. Monitoring coping style moderated the association between anxiety and regret (beta=-0.10, OR=0.91, p=0.01), whereby low monitors who were highly anxious had a greater likelihood of experiencing regret than highly anxious high monitors. AB - Copyright (c) 2006 John Wiley & Sons, Ltd. IS - 1057-9249 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.1067 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 16874745 [pubmed] ID - 10.1002/pon.1067 [doi] PP - ppublish LG - English DP - 2007 Apr DC - 20070402 EZ - 2006/07/29 09:00 DA - 2007/07/11 09:00 DT - 2006/07/29 09:00 YR - 2007 ED - 20070710 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16874745 <371. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17341292 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gao F AU - Tan SB AU - Machin D AU - Wong NS FA - Gao, Fei FA - Tan, Say Beng FA - Machin, David FA - Wong, Nan Soon IN - Gao, Fei. Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore. ctegfe@nccs.com.sg TI - Confirmation of double-peaked time distribution of mortality among Asian breast cancer patients in a population-based study. SO - Breast Cancer Research. 9(2):R21, 2007 AS - Breast Cancer Res. 9(2):R21, 2007 NJ - Breast cancer research : BCR PI - Journal available in: Print PI - Citation processed from: Internet JC - 100927353, dyz IO - Breast Cancer Res. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868926 SB - Index Medicus CP - England MH - Aged MH - Asian Continental Ancestry Group MH - *Breast Neoplasms/eh [Ethnology] MH - *Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/th [Therapy] MH - Cohort Studies MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - Proportional Hazards Models MH - Research Design MH - Retrospective Studies MH - Survival Analysis MH - Time Factors AB - INTRODUCTION: Double-peaked time distributions of the mortality hazard function have been reported for breast cancer patients from Western populations treated with mastectomy alone. These are thought to reflect accelerated tumour growth at micrometastatic sites mediated by angiogenesis after primary tumour removal as well as tumor dormancy. Similar data are not available for Asian populations. We sought to investigate whether differences exist in the pattern of mortality hazard function between Western breast cancer patients and their Asian counterparts in Singapore, which may suggest underlying differences in tumor biology between the two populations. AB - METHODS: We performed a retrospective cohort study of female unilateral breast cancer patients diagnosed in Singapore between October 1994 and June 1999. Data regarding patient demographics, tumour characteristics and death were available. Overall survival curves were calculated using the Kaplan-Meier method. The hazard rate was calculated as the conditional probability of dying in a time interval, given that the patient was alive at the beginning of the interval. The life table method was used to calculate the yearly hazard rates. AB - RESULTS: In the 2,105 women identified, 956 patients (45.4%) had mastectomy alone. Demographic characteristics were as follows: 86.5% were Chinese, 45.2% were postmenopausal, 38.9% were hormone receptor positive, 54.6% were node negative and 44.1% had high histological grade. We observed a double-peaked mortality hazard pattern, with a first peak in mortality achieving its maximum between years 2 and 4 after mastectomy, and a second large peak in mortality during year 9. Analyses by subgroups revealed a similar pattern regardless of T stage, or node or menopausal status. This pattern was also noted in high-grade tumors but not in those that were well to moderately differentiated. The double-peaked pattern observed in Singaporean women was quantitatively and qualitatively similar to those reported in Western series. AB - CONCLUSION: Our study confirms the existence of a double-peaked process in Asian patients, and it gives further support to the tumour dormancy hypothesis after mastectomy. ES - 1465-542X IL - 1465-5411 DI - bcr1658 DO - https://dx.doi.org/10.1186/bcr1658 PT - Journal Article ID - 17341292 [pubmed] ID - bcr1658 [pii] ID - 10.1186/bcr1658 [doi] ID - PMC1868926 [pmc] PP - ppublish PH - 2006/10/09 [received] PH - 2007/01/31 [revised] PH - 2007/03/06 [accepted] LG - English DP - 2007 DC - 20070517 EZ - 2007/03/08 09:00 DA - 2007/06/15 09:00 DT - 2007/03/08 09:00 YR - 2007 ED - 20070613 RD - 20140907 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17341292 <372. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17351025 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Johnston MF AU - Yang C AU - Hui KK AU - Xiao B AU - Li XS AU - Rusiewicz A FA - Johnston, Michael Francis FA - Yang, Changqing FA - Hui, Ka-Kit FA - Xiao, Bo FA - Li, Xiuxia Sharon FA - Rusiewicz, Anna IN - Johnston, Michael Francis. Center for East-West Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA. johnston@ucla.edu TI - Acupuncture for chemotherapy-associated cognitive dysfunction: a hypothesis-generating literature review to inform clinical advice. [Review] [70 refs] SO - Integrative Cancer Therapies. 6(1):36-41, 2007 Mar AS - Integ Cancer Ther. 6(1):36-41, 2007 Mar NJ - Integrative cancer therapies PI - Journal available in: Print PI - Citation processed from: Print JC - 101128834 IO - Integr Cancer Ther SB - Index Medicus CP - United States MH - *Acupuncture MH - *Antineoplastic Agents/ae [Adverse Effects] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/px [Psychology] MH - Chemotherapy, Adjuvant/ae [Adverse Effects] MH - Cognition Disorders/ci [Chemically Induced] MH - *Cognition Disorders/th [Therapy] MH - Humans MH - Models, Biological MH - *Neoplasms/dt [Drug Therapy] MH - Nervous System Diseases/th [Therapy] AB - There is an emerging consensus that between one fifth and one half of breast cancer patients experience chemotherapy-associated cognitive dysfunction. Research shows that patients with cancer are often interested in acupuncture for symptom relief. A clinical question thus arises: What should physicians advise their patients regarding the use of acupuncture to alleviate or ameliorate chemotherapy-associated cognitive dysfunction? The authors review and synthesize 2 bodies of relevant research literature: (1) the developing literature on the etiology and nature of chemotherapy-associated cognitive dysfunction and (2) the literature concerning acupuncture for neurological diseases and psychological issues. There is evidence that acupuncture may be effectively used to manage a range of psychoneurological issues, some of which are similar to those experienced by patients with chemotherapy-associated cognitive dysfunction. The evidence of efficacy is more promising for psychological than neurological conditions. Given evidence of possible efficacy combined with evidence of demonstrated safety, we suggest that physicians should support patient decisions to use acupuncture services for chemotherapy-associated cognitive dysfunction, especially given the lack of proven alternatives. [References: 70] RN - 0 (Antineoplastic Agents) IS - 1534-7354 IL - 1534-7354 DI - 6/1/36 DO - https://dx.doi.org/10.1177/1534735406298903 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 17351025 [pubmed] ID - 6/1/36 [pii] ID - 10.1177/1534735406298903 [doi] PP - ppublish LG - English DP - 2007 Mar DC - 20070312 EZ - 2007/03/14 09:00 DA - 2007/05/09 09:00 DT - 2007/03/14 09:00 YR - 2007 ED - 20070508 RD - 20070312 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17351025 <373. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17156967 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hawley ST AU - Lantz PM AU - Janz NK AU - Salem B AU - Morrow M AU - Schwartz K AU - Liu L AU - Katz SJ FA - Hawley, Sarah T FA - Lantz, Paula M FA - Janz, Nancy K FA - Salem, Barbara FA - Morrow, Monica FA - Schwartz, Kendra FA - Liu, Lihua FA - Katz, Steven J IN - Hawley, Sarah T. Division of General Medicine, Department of Internal Medicine, University of Michigan, United States. sarahawl@med.umich.edu TI - Factors associated with patient involvement in surgical treatment decision making for breast cancer. SO - Patient Education & Counseling. 65(3):387-95, 2007 Mar AS - Patient Educ Couns. 65(3):387-95, 2007 Mar NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839840 OI - Source: NLM. NIHMS19297 SB - Nursing Journal CP - Ireland MH - Adult MH - Age Factors MH - Aged MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - Communication MH - Cooperative Behavior MH - *Decision Making MH - Decision Support Techniques MH - Educational Status MH - Female MH - Health Services Needs and Demand MH - Humans MH - Logistic Models MH - Los Angeles MH - Mastectomy/mt [Methods] MH - *Mastectomy/px [Psychology] MH - Michigan MH - Middle Aged MH - Patient Education as Topic MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - *Physician's Role/px [Psychology] MH - Physician-Patient Relations MH - Radiotherapy, Adjuvant/px [Psychology] MH - SEER Program MH - Women/ed [Education] MH - *Women/px [Psychology] AB - OBJECTIVE: To evaluate factors associated with women's reported level of involvement in breast cancer surgical treatment decision making, and the factors associated with the match between actual and preferred involvement in this decision. AB - METHODS: Survey data from breast cancer patients in Detroit and Los Angeles was merged with surgeon data for an analytic dataset of 1101 patients and 277 surgeons. Decisional involvement and the match between actual and preferred amount of involvement were analyzed as three-level dependent variables using multinomial logistic regression controlling for clustering within surgeons. Independent variables included patient demographic and clinical factors, surgeon demographic and practice factors, cancer program designation, and two measures of patient-surgeon communication. AB - RESULTS: We found variation in women's actual decisional involvement and match between actual and preferred involvement. Women with a surgeon-based or patient-based (versus shared) decision were significantly (p < or = 0.05) younger. Women who had too little decisional involvement (versus the right amount) were younger, while women with too much involvement had less education. Patient-surgeon communication variables were significantly associated with both involvement and match, and higher surgeon volume as associated with too little involvement. AB - CONCLUSION: Patient factors and patient-surgeon communication influence women's perception of their involvement in breast cancer surgical treatment decision making. AB - PRACTICE IMPLICATIONS: Decision tools are needed across surgeons and practice settings to elicit patients' preferences for involvement in treatment decisions for breast cancer. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(06)00326-0 DO - https://dx.doi.org/10.1016/j.pec.2006.09.010 PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 17156967 [pubmed] ID - S0738-3991(06)00326-0 [pii] ID - 10.1016/j.pec.2006.09.010 [doi] ID - PMC1839840 [pmc] ID - NIHMS19297 [mid] PP - ppublish PH - 2006/03/31 [received] PH - 2006/08/23 [revised] PH - 2006/09/28 [accepted] GI - No: R01 CA088370 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA8837-A1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20061206 DP - 2007 Mar DC - 20070219 EZ - 2006/12/13 09:00 DA - 2007/05/05 09:00 DT - 2006/12/13 09:00 YR - 2007 ED - 20070504 RD - 20161019 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17156967 <374. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17023138 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sepucha K AU - Ozanne E AU - Silvia K AU - Partridge A AU - Mulley AG Jr FA - Sepucha, Karen FA - Ozanne, Elissa FA - Silvia, Kerry FA - Partridge, Ann FA - Mulley, Albert G Jr IN - Sepucha, Karen. Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. ksepucha@partners.org TI - An approach to measuring the quality of breast cancer decisions. SO - Patient Education & Counseling. 65(2):261-9, 2007 Feb AS - Patient Educ Couns. 65(2):261-9, 2007 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Breast Neoplasms MH - Conflict (Psychology) MH - *Decision Making MH - Educational Measurement MH - Female MH - Focus Groups MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Internal-External Control MH - Massachusetts MH - Mastectomy/px [Psychology] MH - Middle Aged MH - *Patient Education as Topic MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Pilot Projects MH - Practice Guidelines as Topic MH - Social Values MH - Surveys and Questionnaires MH - *Survivors/px [Psychology] MH - Treatment Outcome AB - OBJECTIVE: To explore an approach to measuring the quality of decisions made in the treatment of early stage breast cancer, focusing on patients' decision-specific knowledge and the concordance between patients' stated preferences for treatment outcomes and treatment received. AB - METHODS: Candidate knowledge and value items were identified after an extensive review of the published literature as well as reports on 27 focus groups and 46 individual interviews with breast cancer survivors. Items were subjected to cognitive interviews with six additional patients. A preliminary decision quality measure consisting of five knowledge items and four value items was pilot tested with 35 breast cancer survivors who also completed the control preferences scale and the decisional conflict scale (DCS). AB - RESULTS: Preference for control and knowledge did not vary by treatment. The mean of the participants' knowledge scores was 54%. There was no correlation between the knowledge scores and the informed subscale of the DCS (Pearson r = .152, n = 32, p = 0.408). Patients who preferred to keep their breast were over five times as likely to have breast-conserving surgery than those who did not (OR 5.33, 95% CI (1.2, 24.5), p = 0.06). Patients who wanted to avoid radiation were six times as likely to choose mastectomy than those who did not (OR 6.4, 95% CI (1.34, 30.61), p = 0.04). AB - CONCLUSION: Measuring decision quality by assessing patients' decision-specific knowledge and concordance between their values and treatment received, is feasible and important. Further work is necessary to overcome the methodological challenges identified in this pilot work. AB - PRACTICE IMPLICATIONS: Guidelines for early stage breast cancer emphasize the importance of including patients' preferences in decisions about treatment. The ability of doctors and patients to make decisions that reflect the considered preferences of well-informed patients can and should be measured. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(06)00266-7 DO - https://dx.doi.org/10.1016/j.pec.2006.08.007 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17023138 [pubmed] ID - S0738-3991(06)00266-7 [pii] ID - 10.1016/j.pec.2006.08.007 [doi] PP - ppublish PH - 2006/03/15 [received] PH - 2006/08/04 [revised] PH - 2006/08/14 [accepted] LG - English EP - 20061004 DP - 2007 Feb DC - 20070115 EZ - 2006/10/07 09:00 DA - 2007/04/21 09:00 DT - 2006/10/07 09:00 YR - 2007 ED - 20070420 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17023138 <375. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16870385 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Polacek GN AU - Ramos MC AU - Ferrer RL FA - Polacek, Georgia N L Johnston FA - Ramos, Mary Carol FA - Ferrer, Robert L IN - Polacek, Georgia N L Johnston. Department of Health and Kinesiology, University of Texas, San Antonio, 6900 N. Loop 1604 W., San Antonio, TX 78249, USA. Georgia.polacek@utsa.edu TI - Breast cancer disparities and decision-making among U.S. women. [Review] [84 refs] SO - Patient Education & Counseling. 65(2):158-65, 2007 Feb AS - Patient Educ Couns. 65(2):158-65, 2007 Feb NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - *Attitude to Health/eh [Ethnology] MH - *Breast Neoplasms/eh [Ethnology] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/th [Therapy] MH - Cause of Death MH - Chemotherapy, Adjuvant MH - *Decision Making MH - Female MH - Health Knowledge, Attitudes, Practice MH - Health Services Accessibility MH - Health Services Needs and Demand MH - Humans MH - Incidence MH - Mastectomy MH - Minority Groups/ed [Education] MH - *Minority Groups/px [Psychology] MH - Minority Groups/sn [Statistics & Numerical Data] MH - Patient Education as Topic MH - Radiotherapy, Adjuvant MH - Registries MH - Risk Factors MH - Socioeconomic Factors MH - Treatment Outcome MH - United States/ep [Epidemiology] MH - Vulnerable Populations/eh [Ethnology] MH - Vulnerable Populations/sn [Statistics & Numerical Data] MH - Women/ed [Education] MH - *Women/px [Psychology] AB - OBJECTIVE: The impact of breast cancer is immense for all women, but the literature reveals an even greater impact on women of color and among socially and economically disadvantaged populations. Persistent differences in incidence and outcome are undoubtedly due to multiple factors, but one element in poor outcome may be treatment choice. Those treatments shown to be related to best outcomes are less likely to be chosen by certain groups of women. The effects of economic and cultural factors on breast cancer treatment choice have not been thoroughly explored; these factors must be understood if health care professionals are to intervene effectively to address disparities and improve breast cancer outcomes for all women. AB - METHODS: A review of the breast cancer literature was conducted in order to: (1) describe breast cancer disparities in the United States; (2) delineate factors that might contribute to those disparities; (3) assess possible mitigating factors for predominant causes; (4) begin to decide how health care interventions might allay the factors that contribute to disparities in breast cancer incidence and mortality. AB - RESULTS: Breast cancer incidence and outcome disparities in the United States are due to multiple interacting factors. These include information about treatment, different types of treatment, the emotional context of decision-making, and patient preference for level of involvement. Treatment decision-making is complex. AB - CONCLUSION: Health literacy and level of decision-making involvement, both embedded in social and economic reality, are key components in breast cancer treatment decision-making and may contribute to breast cancer disparities in the United States. Current models of shared decision-making may not be generalizable to all breast cancer patients. AB - PRACTICE IMPLICATIONS: Optimal breast cancer outcomes for all women depend on culturally and ethnically appropriate professional support. [References: 84] IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(06)00185-6 DO - https://dx.doi.org/10.1016/j.pec.2006.06.003 PT - Journal Article PT - Review ID - 16870385 [pubmed] ID - S0738-3991(06)00185-6 [pii] ID - 10.1016/j.pec.2006.06.003 [doi] PP - ppublish PH - 2005/11/16 [received] PH - 2006/05/11 [revised] PH - 2006/06/05 [accepted] LG - English EP - 20060725 DP - 2007 Feb DC - 20070115 EZ - 2006/07/28 09:00 DA - 2007/04/21 09:00 DT - 2006/07/28 09:00 YR - 2007 ED - 20070420 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16870385 <376. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17319855 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Ozanne EM AU - Annis C AU - Adduci K AU - Showstack J AU - Esserman L FA - Ozanne, Elissa M FA - Annis, Caroline FA - Adduci, Kelly FA - Showstack, Jonathan FA - Esserman, Laura IN - Ozanne, Elissa M. Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. elissa@mgh-ita.org TI - Pilot trial of a computerized decision aid for breast cancer prevention. CM - Comment in: Breast J. 2007 Sep-Oct;13(5):539-40; author reply 540-2; PMID: 17760687 SO - Breast Journal. 13(2):147-54, 2007 Mar-Apr AS - Breast J. 13(2):147-54, 2007 Mar-Apr NJ - The breast journal PI - Journal available in: Print PI - Citation processed from: Print JC - d1h, 9505539 IO - Breast J SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Making, Computer-Assisted MH - Feasibility Studies MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Patient Satisfaction MH - Pilot Projects MH - Risk Assessment MH - San Francisco AB - This study sought to evaluate a shared decision-making aid for breast cancer prevention care designed to help women make appropriate prevention decisions by presenting information about risk in context. The decision aid was implemented in a high-risk breast cancer prevention program and pilot-tested in a randomized clinical trial comparing standard consultations to use of the decision aid. Physicians completed training with the decision aid prior to enrollment. Thirty participants enrolled (15 per group) and completed measures of clinical feasibility and effectiveness prior to, immediately after, and at 9 months after their consultations. The decision aid was feasible to use during the consultations as measured by consultation duration, user satisfaction, patient knowledge, and decisional conflict. The mean consultation duration was not significantly different between groups (24 minutes for intervention group versus 21 minutes for control group, p = 0.42). The majority found the decision aid acceptable and useful and would recommend it to others. Both groups showed an improvement in breast cancer prevention knowledge postvisit, which was significant in the intervention group (p = 0.01) but not the control group (p = 0.13). However, the knowledge scores returned to baseline at follow-up in both groups. Decision preference for patients who chose chemoprevention post consultations remained constant at follow-up for the intervention group, but not for the control group. The decision framework provides access to key information during consultations and facilitates the integration of emerging biomarkers in this setting. Initial results suggest that the decision aid is feasible for use in the consultation room. The tendency for the decision choices and knowledge scores to return to baseline at follow-up suggests the need for initial and ongoing prevention decision support. IS - 1075-122X IL - 1075-122X DI - TBJ395 DO - https://dx.doi.org/10.1111/j.1524-4741.2007.00395.x PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 17319855 [pubmed] ID - TBJ395 [pii] ID - 10.1111/j.1524-4741.2007.00395.x [doi] PP - ppublish LG - English DP - 2007 Mar-Apr DC - 20070226 EZ - 2007/02/27 09:00 DA - 2007/04/18 09:00 DT - 2007/02/27 09:00 YR - 2007 ED - 20070417 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17319855 <377. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17316413 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Millar EK AU - Tran K AU - Marr P AU - Graham PH FA - Millar, Ewan K A FA - Tran, Kayla FA - Marr, Penny FA - Graham, Peter H IN - Millar, Ewan K A. Department of Anatomical Pathology, South-Eastern Area Laboratory Service, St George Hospital, NSW, Australia. ewan.millar@sesiahs.health.nsw.gov.au TI - p27KIP-1, cyclin A and cyclin D1 protein expression in ductal carcinoma in situ of the breast: p27KIP-1 correlates with hormone receptor status but not with local recurrence. SO - Pathology International. 57(4):183-9, 2007 Apr AS - Pathol Int. 57(4):183-9, 2007 Apr NJ - Pathology international PI - Journal available in: Print PI - Citation processed from: Print JC - 9431380, BXQ IO - Pathol. Int. SB - Index Medicus CP - Australia MH - Adult MH - Aged MH - Aged, 80 and over MH - Biomarkers, Tumor/me [Metabolism] MH - *Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/pa [Pathology] MH - *Carcinoma, Intraductal, Noninfiltrating/me [Metabolism] MH - Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - Cyclin A/ge [Genetics] MH - *Cyclin A/me [Metabolism] MH - Cyclin D1/ge [Genetics] MH - *Cyclin D1/me [Metabolism] MH - Cyclin-Dependent Kinase Inhibitor p27/ge [Genetics] MH - *Cyclin-Dependent Kinase Inhibitor p27/me [Metabolism] MH - Female MH - Gene Expression Regulation, Neoplastic MH - Humans MH - Middle Aged MH - Neoplasm Recurrence, Local MH - Receptors, Estrogen/ge [Genetics] MH - *Receptors, Estrogen/me [Metabolism] MH - Receptors, Progesterone/ge [Genetics] MH - *Receptors, Progesterone/me [Metabolism] AB - Using whole sections of formalin-fixed paraffin-embedded material the expression of p27(KIP-1), cyclin A and cyclin D1 was examined in 60 cases of ductal carcinoma in situ (DCIS) using routine immunohistochemistry with a median follow up of 95 months (range 10-139 months) to identify any association with disease recurrence. Fifty-six patients were treated by local excision and radiotherapy and four by mastectomy without radiotherapy. There was a highly significant positive association between p27(KIP-1) and estrogen receptor/progesterone receptor (ER/PR) status (P = 0.002, P = 0.02) and with p27(KIP-1) and cyclin D1 expression (P = 0.002). A trend between cyclin A and PR status (P = 0.08) was also identified. These findings mirror those described in invasive ductal carcinoma, but there were no associations of any biomarker with histological parameters such as nuclear grade or with local recurrence on univariate analysis, which was present in four of the 56 locally excised group (7.1%). Further examination of a larger cohort may be worthwhile to explore the possible role as adjunctive predictive markers to aid clinical decision making. RN - 0 (Biomarkers, Tumor) RN - 0 (Cyclin A) RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) RN - 136601-57-5 (Cyclin D1) RN - 147604-94-2 (Cyclin-Dependent Kinase Inhibitor p27) IS - 1320-5463 IL - 1320-5463 DI - PIN2079 DO - https://dx.doi.org/10.1111/j.1440-1827.2007.02079.x PT - Journal Article ID - 17316413 [pubmed] ID - PIN2079 [pii] ID - 10.1111/j.1440-1827.2007.02079.x [doi] PP - ppublish LG - English DP - 2007 Apr DC - 20070223 EZ - 2007/02/24 09:00 DA - 2007/04/18 09:00 DT - 2007/02/24 09:00 YR - 2007 ED - 20070417 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17316413 <378. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17369570 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Waljee JF AU - Rogers MA AU - Alderman AK FA - Waljee, Jennifer F FA - Rogers, Mary A M FA - Alderman, Amy K IN - Waljee, Jennifer F. Section of General Surgery and Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. filip@med.umich.edu TI - Decision aids and breast cancer: do they influence choice for surgery and knowledge of treatment options?. [Review] [48 refs] SO - Journal of Clinical Oncology. 25(9):1067-73, 2007 Mar 20 AS - J Clin Oncol. 25(9):1067-73, 2007 Mar 20 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Attitude of Health Personnel MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Breast Neoplasms/th [Therapy] MH - Choice Behavior MH - Conflict (Psychology) MH - *Counseling/mt [Methods] MH - *Decision Support Techniques MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Mastectomy/mt [Methods] MH - *Mastectomy MH - Neoplasm Staging MH - Odds Ratio MH - *Patient Education as Topic MH - Patient Participation MH - Patient Satisfaction MH - Physician-Patient Relations MH - Quality of Life MH - Treatment Outcome AB - PURPOSE: To describe the effect of decision aids on the choice for surgery and knowledge of surgical therapy among women with early-stage breast cancer. AB - METHODS: A systematic review was conducted between years 1966 to 2006 of all studies designed to assess the effect of decision aids on surgical therapy. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health (CINAHL), the Cochrane Network, HAPI databases, and bibliographies were searched. Of the 123 studies screened, 11 studies met criteria. Meta-analyses were performed to assess the pooled relative risk for surgical choice and the pooled mean difference in patient knowledge. AB - RESULTS: Results from randomized controlled trials indicated that women who used a decision aid were 25% more likely to choose breast-conserving surgery over mastectomy (risk ratio, 1.25; 95% CI, 1.11 to 1.40). Decision aids significantly increased patient knowledge by 24% (P = .024). The data also suggested that decision aids decreased decisional conflict and increased satisfaction with the decision-making process. Decision aids were well received by surgeons and patients, facilitated patients' desire for shared decision making, and were feasible to implement into practice. AB - CONCLUSION: Decision aids are important adjuncts for counseling women with early-stage breast cancer. Their use increases the likelihood that women will choose breast-conserving surgery, and enhances patient knowledge of treatment options. [References: 48] ES - 1527-7755 IL - 0732-183X DI - 25/9/1067 DO - https://dx.doi.org/10.1200/JCO.2006.08.5472 PT - Journal Article PT - Meta-Analysis PT - Review ID - 17369570 [pubmed] ID - 25/9/1067 [pii] ID - 10.1200/JCO.2006.08.5472 [doi] PP - ppublish LG - English DP - 2007 Mar 20 DC - 20070319 EZ - 2007/03/21 09:00 DA - 2007/04/06 09:00 DT - 2007/03/21 09:00 YR - 2007 ED - 20070405 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17369570 <379. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17266888 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Naveiro Rilo JC AU - Peral Casado A AU - Flores Zurutuza L AU - Buron Llamazares JL FA - Naveiro Rilo, Jose Cesareo FA - Peral Casado, Alfredo FA - Flores Zurutuza, Lourdes FA - Buron Llamazares, Juan Luis IN - Naveiro Rilo, Jose Cesareo. Unidad Docente de Medicina Familiar y Comunitaria, Abad Vinayo 1, 24008 Leon, Spain. jnaveiro@gaple03.sacyl.es TI - [Breast cancer diagnosed in a screening programme. Does it differ from those diagnosed in routine practice detection?]. [Spanish] OT - Cancer de mama diagnosticado mediante un programa de deteccion precoz. ?Difiere del diagnosticado en el marco asistencial habitual? CM - Comment in: Med Clin (Barc). 2007 Jun 30;129(5):199; PMID: 17669342 SO - Medicina Clinica. 128(1):18-20, 2007 Jan 13 AS - Med Clin (Barc). 128(1):18-20, 2007 Jan 13 NJ - Medicina clinica PI - Journal available in: Print PI - Citation processed from: Print JC - ltq, 0376377 IO - Med Clin (Barc) SB - Index Medicus CP - Spain MH - Adult MH - Age Factors MH - Aged MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Early Diagnosis MH - Female MH - Humans MH - Lymphatic Metastasis/di [Diagnosis] MH - Mammography MH - *Mass Screening MH - Mastectomy MH - Middle Aged MH - Neoplasm Metastasis MH - Prognosis MH - Retrospective Studies MH - Time Factors IS - 0025-7753 IL - 0025-7753 DI - S0025-7753(07)72467-3 PT - Comparative Study PT - Evaluation Studies PT - Journal Article ID - 17266888 [pubmed] ID - S0025-7753(07)72467-3 [pii] PP - ppublish LG - Spanish DP - 2007 Jan 13 DC - 20070201 EZ - 2007/02/03 09:00 DA - 2007/03/30 09:00 DT - 2007/02/03 09:00 YR - 2007 ED - 20070329 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17266888 <380. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16860523 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fagerlin A AU - Lakhani I AU - Lantz PM AU - Janz NK AU - Morrow M AU - Schwartz K AU - Deapen D AU - Salem B AU - Liu L AU - Katz SJ FA - Fagerlin, Angela FA - Lakhani, Indu FA - Lantz, Paula M FA - Janz, Nancy K FA - Morrow, Monica FA - Schwartz, Kendra FA - Deapen, Dennis FA - Salem, Barbara FA - Liu, Lihua FA - Katz, Steven J IN - Fagerlin, Angela. VA Health Services Research & Development Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. fagerlin@umich.edu TI - An informed decision? Breast cancer patients and their knowledge about treatment. SO - Patient Education & Counseling. 64(1-3):303-12, 2006 Dec AS - Patient Educ Couns. 64(1-3):303-12, 2006 Dec NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - *Attitude to Health MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - Carcinoma, Ductal, Breast/px [Psychology] MH - Carcinoma, Intraductal, Noninfiltrating/px [Psychology] MH - Decision Making MH - Educational Measurement MH - Female MH - Health Knowledge, Attitudes, Practice MH - Health Services Needs and Demand MH - Humans MH - *Informed Consent/px [Psychology] MH - Los Angeles/ep [Epidemiology] MH - Male MH - Mastectomy/ae [Adverse Effects] MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Michigan/ep [Epidemiology] MH - Middle Aged MH - Neoplasm Recurrence, Local/ep [Epidemiology] MH - Patient Education as Topic/og [Organization & Administration] MH - *Patient Education as Topic MH - Prospective Studies MH - Surveys and Questionnaires MH - Survival Rate MH - Treatment Outcome MH - Women/ed [Education] MH - Women/px [Psychology] MH - *Women AB - OBJECTIVE: Although involving women in breast cancer treatment decisions is advocated, there is little understanding of whether women have the information they need to make informed decisions. The objective of the current study was to evaluate women's knowledge of survival and recurrence rates for mastectomy and breast conserving surgery (BCS) and the factors associated with this knowledge. AB - METHODS: We used a population-based sample of women diagnosed with breast cancer in metropolitan Los Angeles and Detroit between December 2001 and January 2003. All women with ductal carcinoma in situ and a random sample of women with invasive disease were selected (N=2382), of which 1844 participated (77.4%). All participants were mailed surveys. The main outcome measures were knowledge of survival and recurrence rates by surgical treatment type. AB - RESULTS: Only 16% of women knew that recurrence rates were different for mastectomy and BCS, and 48% knew that the survival rates were equivalent across treatment. Knowledge about survival and recurrence was improved by exposure to the Internet and health pamphlets (p<0.01). Women who had a female (versus male) surgeon, and/or a surgeon who explained both treatments (rather than just one treatment) demonstrated higher survival knowledge (p<0.01). The majority of women had inadequate knowledge with which to make informed decisions about breast cancer surgical treatment. AB - CONCLUSION: Previous explanations for poor knowledge, such as irrelevance of knowledge to decision making and lack of access to information, were not shown to be plausible explanations for the low levels of knowledge observed in this sample. AB - PRACTICE IMPLICATIONS: These results suggest a need for fundamental changes in patient education to ensure that women are able to make informed decisions about their breast cancer treatment. These changes may include an increase in the use of decision aids and in decreasing the speed at which treatment decisions are made. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(06)00092-9 DO - https://dx.doi.org/10.1016/j.pec.2006.03.010 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 16860523 [pubmed] ID - S0738-3991(06)00092-9 [pii] ID - 10.1016/j.pec.2006.03.010 [doi] PP - ppublish PH - 2005/08/11 [received] PH - 2006/03/10 [revised] PH - 2006/03/10 [accepted] GI - No: N01-PC-35139 Organization: (PC) *NCI NIH HHS* Country: United States No: N01-PC-65064 Organization: (PC) *NCI NIH HHS* Country: United States No: R01 CA8837-A1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20060724 DP - 2006 Dec DC - 20061122 EZ - 2006/07/25 09:00 DA - 2007/03/24 09:00 DT - 2006/07/25 09:00 YR - 2006 ED - 20070323 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16860523 <381. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17099197 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wilkins EG AU - Lowery JC AU - Copeland LA AU - Goldfarb SL AU - Wren PA AU - Janz NK FA - Wilkins, Edwin G FA - Lowery, Julie C FA - Copeland, Laurel A FA - Goldfarb, Sherry L FA - Wren, Patricia A FA - Janz, Nancy K IN - Wilkins, Edwin G. Section of Plastic Surgery,University of Michigan Medical School, Ann Arbor, MI 48109, USA. ewilkins@umich.edu TI - Impact of an educational video on patient decision making in early breast cancer treatment. SO - Medical Decision Making. 26(6):589-98, 2006 Nov-Dec AS - Med Decis Making. 26(6):589-98, 2006 Nov-Dec NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - Choice Behavior MH - *Decision Making MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Neoplasm Staging MH - Patient Care Team MH - *Patient Education as Topic MH - *Patient Participation MH - Patient Satisfaction MH - Personality Inventory MH - Prospective Studies MH - Quality of Life/px [Psychology] MH - *Video Recording AB - Previous research suggests that patient education programs promoting shared decision making (SDM) may improve patient satisfaction and outcomes, yet controlled clinical trials are lacking. The authors evaluate the impact of an early breast cancer treatment educational video on patients' decisional preferences and behavior. Newly diagnosed stage I/stage II breast cancer patients were assigned to SDM video program or control groups in alternating months. Surveys were administered prior to the provider visit and 1 week following the treatment decision. Variables assessed included autonomy preferences, perceived involvement in care, satisfaction, and treatment choice. There were no significant intervention effects on informational/decisional preferences, anxiety, knowledge, or satisfaction. Although 25% of SDM patients chose mastectomy compared to 14% of controls, this difference was not statistically significant. Eventhough enthusiasm for SDM programs remains high among some patients and providers, this study found only modest benefits. IS - 0272-989X IL - 0272-989X DI - 26/6/589 DO - https://dx.doi.org/10.1177/0272989X06295355 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17099197 [pubmed] ID - 26/6/589 [pii] ID - 10.1177/0272989X06295355 [doi] PP - ppublish LG - English DP - 2006 Nov-Dec DC - 20061113 EZ - 2006/11/14 09:00 DA - 2007/03/01 09:00 DT - 2006/11/14 09:00 YR - 2006 ED - 20070228 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17099197 <382. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16945498 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Molenaar S AU - Sprangers M AU - Oort F AU - Rutgers E AU - Luiten E AU - Mulder J AU - van Meeteren M AU - de Haes H FA - Molenaar, Sjaak FA - Sprangers, Mirjam FA - Oort, Frans FA - Rutgers, Emiel FA - Luiten, Ernest FA - Mulder, Jan FA - van Meeteren, Marjolijn FA - de Haes, Hanneke IN - Molenaar, Sjaak. Academic Medical Center, University of Amsterdam, Department of Medical Psychology (Room J3-401), P.O. Box 22 660, 1100 DD Amsterdam, The Netherlands. J.Molenaar@AMC.UvA.NL TI - Exploring the black box of a decision aid: what information do patients select from an interactive Cd-Rom on treatment options in breast cancer?. SO - Patient Education & Counseling. 65(1):122-30, 2007 Jan AS - Patient Educ Couns. 65(1):122-30, 2007 Jan NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adaptation, Psychological MH - Adult MH - Aged MH - Aged, 80 and over MH - Avoidance Learning MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - CD-ROM/st [Standards] MH - *CD-ROM MH - Choice Behavior MH - Communication MH - *Computer-Assisted Instruction/mt [Methods] MH - *Decision Support Techniques MH - Female MH - Health Services Needs and Demand MH - Humans MH - Informed Consent MH - Internal-External Control MH - Mastectomy/ed [Education] MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental/ed [Education] MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Netherlands MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - Surveys and Questionnaires MH - Uncertainty MH - User-Computer Interface AB - OBJECTIVE: It is thought that patients fare better when they participate in treatment decision-making, and when they have more control over the amount and type of information they receive. To facilitate informed decision-making, interactive decision aids have been introduced in health care. This article describes how much, and which information patients select from an interactive decision aid on breast cancer. To explore whether the interactive system facilitates that different patients receive different information, associations between patients' characteristics and information selection are inspected. AB - METHODS: The interactive decision aid was provided to 106 patients after an initial discussion with their surgeon about their diagnosis and treatment options. Information regarding patients' age, completed education, treatment preference, psychological functioning, decision uncertainty and decision style was collected with a written, structured questionnaire. The questionnaire was completed before patients used the interactive decision aid. To create categories, a median-split procedure was employed on the scores of the continuous background variables. The information patients selected from the interactive decision aid were registered into logfiles. Associations between patients' background variables and information selection were investigated by means of univariate statistics. AB - RESULTS: Patients (n=97; 92%) used the interactive decision aid intensively. On average, patients spent almost 70min searching for information and selected 21 information topics. Overall, treatment related information was clearly more selected than other types of information. Age, education, and decision style factors were associated with information selection. AB - CONCLUSION: The interactive breast cancer decision aid was utilized intensively. The interactive system was found to facilitate that different patients received different amounts and types of information. AB - PRACTICE IMPLICATIONS: Interactive decision aids may improve information giving to patients, and as a result, the quality of care. To safeguard informed-choice, decision aids should be used in conjunction with other communication strategies. Decision aids should be available continuously and throughout the patients' disease journey. The Internet may help to achieve broad dissemination and enduring access. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(06)00221-7 DO - https://dx.doi.org/10.1016/j.pec.2006.06.022 PT - Journal Article ID - 16945498 [pubmed] ID - S0738-3991(06)00221-7 [pii] ID - 10.1016/j.pec.2006.06.022 [doi] PP - ppublish PH - 2006/05/24 [received] PH - 2006/06/27 [accepted] LG - English EP - 20060901 DP - 2007 Jan DC - 20061204 EZ - 2006/09/02 09:00 DA - 2007/02/24 09:00 DT - 2006/09/02 09:00 YR - 2007 ED - 20070223 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16945498 <383. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16779296 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kim MS AU - Rodney WN AU - Peng J AU - Reece GP AU - Markey MK FA - Kim, Min Soon FA - Rodney, William N FA - Peng, Joshua FA - Reece, Gregory P FA - Markey, Mia K IN - Kim, Min Soon. Department of Biomedical Engineering, The University of Texas at Austin, TX, USA. TI - Towards quantifying the aesthetic outcomes of breast cancer treatment: assessment of surgical scars. SO - AMIA ... Annual Symposium Proceedings/AMIA Symposium. :1009, 2005 AS - AMIA Annu Symp Proc. :1009, 2005 NJ - AMIA ... Annual Symposium proceedings. AMIA Symposium PI - Journal available in: Print PI - Citation processed from: Internet JC - 101209213 IO - AMIA Annu Symp Proc PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560447 SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Cicatrix/cl [Classification] MH - Decision Support Techniques MH - *Esthetics MH - Female MH - Humans MH - *Image Processing, Computer-Assisted MH - *Mammaplasty MH - Mastectomy MH - Observer Variation MH - Pilot Projects AB - Our long-term goal is to develop decision aids that will improve breast cancer treatment by explicitly taking aesthetics in the consideration. Essentially all breast cancer treatment involves surgery, which inevitably leaves scars. However, the extent and type of scarring is not the same for different surgeries (e.g., different forms of reconstruction.) We present our preliminary experiences in using image processing techniques to quantify scar characteristics in clinical photographs. ES - 1942-597X IL - 1559-4076 DI - 58154 PT - Journal Article ID - 16779296 [pubmed] ID - 58154 [pii] ID - PMC1560447 [pmc] PP - ppublish GI - No: R21 CA109040 Organization: (CA) *NCI NIH HHS* Country: United States No: R21 CA109040-01A1 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2005 DC - 20060616 EZ - 2006/06/17 09:00 DA - 2007/02/16 09:00 DT - 2006/06/17 09:00 YR - 2005 ED - 20070215 RD - 20161122 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16779296 <384. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16911136 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jibaja-Weiss ML AU - Volk RJ AU - Friedman LC AU - Granchi TS AU - Neff NE AU - Spann SJ AU - Robinson EK AU - Aoki N AU - Robert Beck J FA - Jibaja-Weiss, Maria L FA - Volk, Robert J FA - Friedman, Lois C FA - Granchi, Thomas S FA - Neff, Nancy E FA - Spann, Stephen J FA - Robinson, Emily K FA - Aoki, Noriaki FA - Robert Beck, J IN - Jibaja-Weiss, Maria L. Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA. mariaj@bcm.tmc.edu TI - Preliminary testing of a just-in-time, user-defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions. SO - Health Expectations. 9(3):218-31, 2006 Sep AS - Health Expect. 9(3):218-31, 2006 Sep NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Print JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making, Computer-Assisted MH - *Educational Status MH - Humans MH - Middle Aged MH - Patient Education as Topic MH - Time Factors MH - *Women/px [Psychology] AB - OBJECTIVE: To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. AB - DESIGN: Pre-post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. AB - SAMPLE: Fifty-one female patients, who are low literate and naive computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. AB - INTERVENTION: A computerized decision aid that combines entertainment-education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. AB - OUTCOMES: Patients' use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). AB - RESULTS: Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. AB - CONCLUSIONS: A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients. IS - 1369-6513 IL - 1369-6513 DI - HEX386 DO - https://dx.doi.org/10.1111/j.1369-7625.2006.00386.x PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 16911136 [pubmed] ID - HEX386 [pii] ID - 10.1111/j.1369-7625.2006.00386.x [doi] ID - PMC5060365 [pmc] PP - ppublish LG - English DP - 2006 Sep DC - 20060816 EZ - 2006/08/17 09:00 DA - 2006/12/21 09:00 DT - 2006/08/17 09:00 YR - 2006 ED - 20061220 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=16911136 <385. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16911140 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Silvia KA AU - Sepucha KR FA - Silvia, Kerry A FA - Sepucha, Karen R IN - Silvia, Kerry A. Health Decision Research Unit, Massachusetts General Hospital, Boston, MA 02114, USA. TI - Decision aids in routine practice: lessons from the breast cancer initiative. SO - Health Expectations. 9(3):255-64, 2006 Sep AS - Health Expect. 9(3):255-64, 2006 Sep NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Print JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Academic Medical Centers MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Community Health Centers MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Humans MH - Interviews as Topic AB - BACKGROUND: Many decision aids have been developed to help patients make treatment and screening decisions; however, little is known about implementing them into routine clinical practice. AB - OBJECTIVE: To assess the feasibility of implementing a patient decision aid (PtDA) for the early stage breast cancer surgical decision into routine clinical care. AB - DESIGN: Structured individual interviews. AB - SETTING AND PARTICIPANTS: A convenience sample of providers from nine sites, including two community resource centres, a community hospital and six academic centres. AB - MAIN OUTCOME MEASURES: Usage data, barriers to and resources for implementing the PtDAs. AB - RESULTS: Six of the nine sites were using the PtDAs with patients. Two sites were primarily using a scheduling system and four sites relied on a lending system. For the academic centres, the keys to successful implementation included integrating the PtDA into the flow of patients through the centre and having physicians who recommended it to patients. At the community centres, the keys to successful implementation included an informed staff and the flexibility to get the PtDAs to patients in different ways. Barriers that limited or prevented sites from using the PtDA included a lack of clinical support, a lack of system support, competing priorities and scheduling problems. AB - CONCLUSIONS: It is feasible to implement a breast cancer PtDA into routine clinical care at academic centres and community resource centres. Future research should assess the effectiveness of PtDAs in routine clinical care as well as resources and barriers to their implementation in community hospitals. IS - 1369-6513 IL - 1369-6513 DI - HEX393 DO - https://dx.doi.org/10.1111/j.1369-7625.2006.00393.x PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 16911140 [pubmed] ID - HEX393 [pii] ID - 10.1111/j.1369-7625.2006.00393.x [doi] ID - PMC5060360 [pmc] PP - ppublish LG - English DP - 2006 Sep DC - 20060816 EZ - 2006/08/17 09:00 DA - 2006/12/21 09:00 DT - 2006/08/17 09:00 YR - 2006 ED - 20061220 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=16911140 <386. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16911140 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Silvia KA AU - Sepucha KR FA - Silvia, Kerry A FA - Sepucha, Karen R IN - Silvia, Kerry A. Health Decision Research Unit, Massachusetts General Hospital, Boston, MA 02114, USA. TI - Decision aids in routine practice: lessons from the breast cancer initiative. SO - Health Expectations. 9(3):255-64, 2006 Sep AS - Health Expect. 9(3):255-64, 2006 Sep NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Print JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Academic Medical Centers MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Community Health Centers MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Humans MH - Interviews as Topic AB - BACKGROUND: Many decision aids have been developed to help patients make treatment and screening decisions; however, little is known about implementing them into routine clinical practice. AB - OBJECTIVE: To assess the feasibility of implementing a patient decision aid (PtDA) for the early stage breast cancer surgical decision into routine clinical care. AB - DESIGN: Structured individual interviews. AB - SETTING AND PARTICIPANTS: A convenience sample of providers from nine sites, including two community resource centres, a community hospital and six academic centres. AB - MAIN OUTCOME MEASURES: Usage data, barriers to and resources for implementing the PtDAs. AB - RESULTS: Six of the nine sites were using the PtDAs with patients. Two sites were primarily using a scheduling system and four sites relied on a lending system. For the academic centres, the keys to successful implementation included integrating the PtDA into the flow of patients through the centre and having physicians who recommended it to patients. At the community centres, the keys to successful implementation included an informed staff and the flexibility to get the PtDAs to patients in different ways. Barriers that limited or prevented sites from using the PtDA included a lack of clinical support, a lack of system support, competing priorities and scheduling problems. AB - CONCLUSIONS: It is feasible to implement a breast cancer PtDA into routine clinical care at academic centres and community resource centres. Future research should assess the effectiveness of PtDAs in routine clinical care as well as resources and barriers to their implementation in community hospitals. IS - 1369-6513 IL - 1369-6513 DI - HEX393 DO - https://dx.doi.org/10.1111/j.1369-7625.2006.00393.x PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 16911140 [pubmed] ID - HEX393 [pii] ID - 10.1111/j.1369-7625.2006.00393.x [doi] PP - ppublish LG - English DP - 2006 Sep DC - 20060816 EZ - 2006/08/17 09:00 DA - 2006/12/21 09:00 DT - 2006/08/17 09:00 YR - 2006 ED - 20061220 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16911140 <387. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16911136 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jibaja-Weiss ML AU - Volk RJ AU - Friedman LC AU - Granchi TS AU - Neff NE AU - Spann SJ AU - Robinson EK AU - Aoki N AU - Robert Beck J FA - Jibaja-Weiss, Maria L FA - Volk, Robert J FA - Friedman, Lois C FA - Granchi, Thomas S FA - Neff, Nancy E FA - Spann, Stephen J FA - Robinson, Emily K FA - Aoki, Noriaki FA - Robert Beck, J IN - Jibaja-Weiss, Maria L. Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098, USA. mariaj@bcm.tmc.edu TI - Preliminary testing of a just-in-time, user-defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions. SO - Health Expectations. 9(3):218-31, 2006 Sep AS - Health Expect. 9(3):218-31, 2006 Sep NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Print JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making, Computer-Assisted MH - *Educational Status MH - Humans MH - Middle Aged MH - Patient Education as Topic MH - Time Factors MH - *Women/px [Psychology] AB - OBJECTIVE: To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. AB - DESIGN: Pre-post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. AB - SAMPLE: Fifty-one female patients, who are low literate and naive computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. AB - INTERVENTION: A computerized decision aid that combines entertainment-education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. AB - OUTCOMES: Patients' use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). AB - RESULTS: Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. AB - CONCLUSIONS: A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients. IS - 1369-6513 IL - 1369-6513 DI - HEX386 DO - https://dx.doi.org/10.1111/j.1369-7625.2006.00386.x PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 16911136 [pubmed] ID - HEX386 [pii] ID - 10.1111/j.1369-7625.2006.00386.x [doi] PP - ppublish LG - English DP - 2006 Sep DC - 20060816 EZ - 2006/08/17 09:00 DA - 2006/12/21 09:00 DT - 2006/08/17 09:00 YR - 2006 ED - 20061220 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16911136 <388. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16804803 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Vodermaier A AU - Bauerfeind I AU - Untch M AU - Nestle-Kramling C FA - Vodermaier, Andrea FA - Bauerfeind, Ingo FA - Untch, Michael FA - Nestle-Kramling, Carolin IN - Vodermaier, Andrea. Klinik und Poliklinik fur Frauenheilkunde und Geburtshilfe - Grosshadern, Ludwig-Maximilians-Universitat Munchen, Germany. Andrea.Vodermaier@med.uni-muenchen.de TI - [Prophylactic mastectomy in women at high risk for breast and ovarian cancer: qualitative analysis of the decision making process and long-term satisfaction of two women carrying a BRCA1-mutation]. [German] OT - Prophylaktische Chirurgie bei Brust- und Eierstockkrebsrisiko: qualitative Analyse des Entscheidungsprozesses und der Langzeit-zufriedenheit zweier BRCA1-Mutationstragerinnen. SO - Psychotherapie, Psychosomatik, Medizinische Psychologie. 56(9-10):351-61, 2006 Sep-Oct AS - Psychother Psychosom Med Psychol. 56(9-10):351-61, 2006 Sep-Oct NJ - Psychotherapie, Psychosomatik, medizinische Psychologie PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - qhb, 8002823 IO - Psychother Psychosom Med Psychol SB - Index Medicus CP - Germany MH - Adult MH - *BRCA1 Protein/ge [Genetics] MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Genetic Counseling MH - Germany MH - Humans MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Patient Satisfaction MH - Postoperative Complications/px [Psychology] MH - Risk AB - PURPOSE: Bilateral prophylactic mastectomy and oophorectomy are currently the most effective prevention options for female carriers of the BRCA1 or BRCA2 gene. However, especially the mastectomy procedure is very invasive and is chosen rarely among high risk women in Germany. Little is known about how women cope with this surgery and their long-term satisfaction. AB - METHODS: Face-to-face interviews were conducted with two BRCA1 mutation carriers, who had undergone prophylactic mastectomy in their twenties 9 and 16 years ago. The process of decision making and long-term satisfaction were analysed using Mayring's qualitative content analysis. AB - RESULTS: Both high risk women had a significant family history of breast and ovarian cancer. They were repeatedly confronted with uncontrollable courses of disease in their relatives who died of breast cancer between the age of 20 and 30 and left small children behind. Although both women experienced different decision making and peri- and post-operative complications, both were satisfied with the decision for prophylactic surgery and showed no regret. AB - DISCUSSION: Deciding to obtain genetic testing pushed women towards further decision making concerning prophylactic surgery in case they carry a mutation. Information about carrier status reduced uncertainty even if the result was adverse. Both high risk women experienced a decrease in cancer related anxiety which may have heightened tolerance for quality of life related impairments. Implications for counseling are described. RN - 0 (BRCA1 Protein) IS - 0937-2032 IL - 0937-2032 DO - https://dx.doi.org/10.1055/s-2006-940007 PT - Case Reports PT - English Abstract PT - Journal Article ID - 16804803 [pubmed] ID - 10.1055/s-2006-940007 [doi] PP - ppublish LG - German EP - 20060627 DP - 2006 Sep-Oct DC - 20061010 EZ - 2006/06/29 09:00 DA - 2006/12/13 09:00 DT - 2006/06/29 09:00 YR - 2006 ED - 20061212 RD - 20061010 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16804803 <389. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16962910 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Zapka JG AU - Geller BM AU - Bulliard JL AU - Fracheboud J AU - Sancho-Garnier H AU - Ballard-Barbash R AU - IBSN Communications Working Group FA - Zapka, Jane G FA - Geller, Berta M FA - Bulliard, Jean-Luc FA - Fracheboud, Jacques FA - Sancho-Garnier, Helene FA - Ballard-Barbash, Rachel FA - IBSN Communications Working Group IN - Zapka, Jane G. University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. jane.zapka@umassmed.edu TI - Print information to inform decisions about mammography screening participation in 16 countries with population-based programs. SO - Patient Education & Counseling. 63(1-2):126-37, 2006 Oct AS - Patient Educ Couns. 63(1-2):126-37, 2006 Oct NJ - Patient education and counseling PI - Journal available in: Print PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Australia MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/et [Etiology] MH - Canada MH - Community Health Planning MH - *Decision Making MH - Decision Support Techniques MH - Europe MH - Health Care Surveys MH - Humans MH - *Informed Consent/px [Psychology] MH - Informed Consent/sn [Statistics & Numerical Data] MH - Israel MH - Japan MH - Mammography/ae [Adverse Effects] MH - *Mammography/px [Psychology] MH - Mammography/sn [Statistics & Numerical Data] MH - Mass Screening/ae [Adverse Effects] MH - *Mass Screening/px [Psychology] MH - Mass Screening/sn [Statistics & Numerical Data] MH - New Zealand MH - *Patient Acceptance of Health Care/px [Psychology] MH - Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - *Patient Education as Topic/og [Organization & Administration] MH - Program Evaluation MH - Risk Assessment MH - Risk Factors MH - Teaching Materials/st [Standards] AB - OBJECTIVE: To profile and compare the content and presentation of written communications related to informed decision-making about mammography. AB - METHODS: Materials from 16 screening programs organized at the national or regional level were analyzed according to five major information domains suggested by the international literature. AB - RESULTS: A majority of countries provided information on the program (interval, cost and quality). There was considerable variability in comprehensiveness of elements in the domains, e.g., test characteristics (false positive/negative) and pros and cons of screening. The majority noted the likelihood of recall for further tests, few commented on the risks of additional tests or finding unimportant tumors. The audit also found variation in presentation (words and pictures). AB - CONCLUSIONS: Presentation of comprehensive, but balanced information on screening benefits and risks is complex and daunting. Issues such as framing effects, coupled with debate about screening efficacy are challenging to the design of effective information tools. The objective of increasing screening prevalence at the population level must be balanced with objectively presenting complete and clear information. Additional research is needed on how information (and mode of presentation) impact screening decisions. AB - PRACTICE IMPLICATIONS: Public health officials need to articulate their objectives and review written communication according to important decision-making domains. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(05)00273-9 DO - https://dx.doi.org/10.1016/j.pec.2005.09.012 PT - Comparative Study PT - Evaluation Studies PT - Journal Article PT - Research Support, N.I.H., Extramural ID - 16962910 [pubmed] ID - S0738-3991(05)00273-9 [pii] ID - 10.1016/j.pec.2005.09.012 [doi] PP - ppublish PH - 2005/02/04 [received] PH - 2005/09/09 [revised] PH - 2005/09/17 [accepted] LG - English DP - 2006 Oct DC - 20060911 EZ - 2006/09/12 09:00 DA - 2006/12/12 09:00 DT - 2006/09/12 09:00 YR - 2006 ED - 20061208 RD - 20090626 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16962910 <390. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16721068 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Knight MA AU - Nguyen DT 4th AU - Kobayashi MR AU - Evans GR FA - Knight, Mark A K FA - Nguyen, Dinh T 4th FA - Kobayashi, Mark R FA - Evans, Gregory R D IN - Knight, Mark A K. Aesthetic and Plastic Surgery Institute, The University of California, Irvine, CA, USA. TI - Institutional review of free TRAM flap breast reconstruction. SO - Annals of Plastic Surgery. 56(6):593-8, 2006 Jun AS - Ann Plast Surg. 56(6):593-8, 2006 Jun NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Print JC - 5vb, 7805336 IO - Ann Plast Surg SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Anticoagulants/tu [Therapeutic Use] MH - *Breast Neoplasms/su [Surgery] MH - Dextrans/tu [Therapeutic Use] MH - Fat Necrosis/ep [Epidemiology] MH - Female MH - Humans MH - Internship and Residency MH - Length of Stay MH - Mammaplasty/ae [Adverse Effects] MH - Mammaplasty/ed [Education] MH - Mammaplasty/mt [Methods] MH - Mammaplasty/td [Trends] MH - *Mammaplasty MH - Mastectomy MH - Middle Aged MH - Reoperation MH - Retrospective Studies MH - Surgical Flaps/td [Trends] MH - *Surgical Flaps MH - Treatment Outcome AB - INTRODUCTION: A 10-year experience with breast reconstruction in a university hospital was recently reviewed. The purpose of this study was to determine the subtypes of breast reconstructive procedures and to evaluate the frequency and change in technique over time of free TRAM (transverse rectus abdominis muscle) flap breast reconstruction performed at one institution. Trends in the development of the procedure over this period were also reviewed. AB - MATERIALS & METHODS: Between November 1994 and September 2004, a 10-year retrospective chart review was conducted. The indications for mastectomy and reconstruction were determined. The median age was 48 (range 31-66). The range of follow-up was 2 to 71 months, with a median of 19.5 months. The mean follow-up was 23.5 months. Outcome data were grouped into 2 consecutive 5-year periods (period 1: 1994-1998; period 2: 1999-2004) and evaluated for changes over time in techniques and outcome. Statistical analysis (Decision Analyst, Inc., STATS Statistics software, version 1.1, 1998) was performed using the difference between 2 proportions module to assess the probability of a significant difference in the data for period 1 and period 2 parameters. AB - RESULTS: Over a 10-year period, 117 patients underwent breast reconstruction. This consisted of 12 pedicle procedures (11.3%), including 1 bipedicle flap (0.9%) and 2 bilateral pedicle procedures (1.8%). There were 3 latissimus dorsi pedicle flaps (2.8%). Sixteen patients (15.1%) received tissue expander or implant reconstructions. Of the 117 patients, 79 underwent free flap breast reconstruction. Of the 79 free-flap patients, 22 (27.8%) had bilateral procedures, for a total of 101 free flaps performed in these 79 patients. Fifty-two patients underwent immediate reconstruction (65.8%) and 25 were delayed (31.6%) reconstructions using either deep inferior epigastric artery perforator (DIEP) flaps (4 = 3.9%) or free TRAM flaps (97 = 96.0%). A muscle-sparing technique was used in 43 of the 97 free TRAM flaps (44.3%). The preferred vascular inflow was the internal mammary artery, which was used in 66 out of 101 flaps (65.3%). The rate of anastomotic revision (arterial and venous) was 4.9%. The majority of cases used a 2.5-mm venous coupler (65.3%). In 2 of the free TRAM cases, there was insufficient volume to establish the patients preexisting volume. Therefore, at the patient's request, immediate implants were used to augment the reconstruction. The average hospital stay was 8.13 days, and the average intensive care stay was 4.59 days. When assessed for trends over time, we noted a reduction in our hospital length of stay and our ICU length of stay. AB - CONCLUSION: The experience with free tissue breast reconstruction reveals predominant use of the TRAM flap. This is justified by the reliability of this flap and the advances in achieving esthetic breast reconstruction. Additionally, we have begun performing DIEP free-flap reconstructions. Our clinical practice has evolved concurrent with standards of care, as noted by the increase in use of muscle-sparing techniques and the reduction in the use of dextran. We do not routinely use therapeutic anticoagulation in our cases. Our hospital length of stay and average intensive care length of stay have also decreased over time, consistent with a system-wide effort to increase the efficiency of healthcare delivery. RN - 0 (Anticoagulants) RN - 0 (Dextrans) IS - 0148-7043 IL - 0148-7043 DI - 00000637-200606000-00002 DO - https://dx.doi.org/10.1097/01.sap.0000202226.92967.f0 PT - Journal Article ID - 16721068 [pubmed] ID - 10.1097/01.sap.0000202226.92967.f0 [doi] ID - 00000637-200606000-00002 [pii] PP - ppublish LG - English DP - 2006 Jun DC - 20060524 EZ - 2006/05/25 09:00 DA - 2006/11/02 09:00 DT - 2006/05/25 09:00 YR - 2006 ED - 20061101 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16721068 <391. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 17051118 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tebbetts JB FA - Tebbetts, John B IN - Tebbetts, John B. johnbt@airmail.net TI - Achieving a zero percent reoperation rate at 3 years in a 50-consecutive-case augmentation mammaplasty premarket approval study. SO - Plastic & Reconstructive Surgery. 118(6):1453-7, 2006 Nov AS - Plast Reconstr Surg. 118(6):1453-7, 2006 Nov NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - *Breast Implants MH - Device Approval MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - Middle Aged MH - Patient Satisfaction MH - Prospective Studies MH - Reoperation/sn [Statistics & Numerical Data] MH - *Silicone Gels MH - United States MH - United States Food and Drug Administration AB - BACKGROUND: Excessively high reoperation rates in breast augmentation premarket approval studies are a major concern of patients and the U.S. Food and Drug Administration. Over the past two decades, reoperation rates have remained between 13 and 20 percent at 3 years in three different premarket approval studies for three different types of implant devices, indicating that high reoperation rates are not device dependent. The hypothesis of this study was that implementing specific peer-reviewed and published processes can significantly reduce reoperation rates in a premarket approval study. AB - METHODS: Fifty consecutive primary breast augmentation patients were enrolled in a premarket approval study for the Inamed Style 410 form stable, cohesive gel implant. All patients were treated specifically according to the premarket approval protocol. The series was monitored throughout the study by an independent clinical review organization and by a U.S. Food and Drug Administration inspection of the patient records on site at the author's practice. Specific content and processes were applied to patient management in patient education and informed consent, patient and surgeon decision-making processes, preoperative assessment and operative planning, implant selection based on individual patient tissue characteristics, surgical techniques, and postoperative care techniques. AB - RESULTS: Follow-up was 100 percent (50 of 50 patients) at 1 year, 98 percent (49 of 50 patients) at 2 years (one patient could not be reached), and 94 percent (47 of 50 patients) at 3 years. No reoperations were performed on any patient followed at 3 years in the 50-consecutive-patient series. AB - CONCLUSION: Implementing the peer-reviewed and published processes described in this study, no reoperations were performed in a prospective 50-consecutive-case series of primary augmentation mammaplasty patients in a premarket approval study with 94 percent follow-up at 3 years. RN - 0 (Silicone Gels) ES - 1529-4242 IL - 0032-1052 DI - 00006534-200611000-00025 DO - https://dx.doi.org/10.1097/01.prs.0000239602.99867.07 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 17051118 [pubmed] ID - 10.1097/01.prs.0000239602.99867.07 [doi] ID - 00006534-200611000-00025 [pii] PP - ppublish LG - English DP - 2006 Nov DC - 20061019 EZ - 2006/10/20 09:00 DA - 2006/11/01 09:00 DT - 2006/10/20 09:00 YR - 2006 ED - 20061031 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=17051118 <392. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16832813 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Markman M AU - Petersen J AU - Montgomery R FA - Markman, Maurie FA - Petersen, Judith FA - Montgomery, Robert IN - Markman, Maurie. University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. mmarkman@mdanderson.org TI - Influence of tumor type, disease status, and patient age on self-reported interest regarding participation in cancer clinical trials. SO - Cancer. 107(4):849-53, 2006 Aug 15 AS - Cancer. 107(4):849-53, 2006 Aug 15 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Age Distribution MH - Aged MH - Aged, 80 and over MH - *Clinical Trials as Topic/sn [Statistics & Numerical Data] MH - Clinical Trials as Topic/ut [Utilization] MH - *Decision Making MH - Female MH - Health Knowledge, Attitudes, Practice MH - Humans MH - Internet MH - Male MH - Middle Aged MH - Neoplasm Staging MH - Neoplasms/cl [Classification] MH - Neoplasms/px [Psychology] MH - *Neoplasms/th [Therapy] MH - *Patient Participation/sn [Statistics & Numerical Data] MH - Surveys and Questionnaires MH - United States/ep [Epidemiology] AB - There is limited information available regarding the reasons cancer patients decide to enter clinical trials. To explore this issue, aggregate responses to the question, "Are you interested in learning about clinical trials for your condition?" obtained from >115,000 cancer patients (or their families) who entered data into 1 of several proprietary decision-support programs embedded within approximately 100 well-established cancer-related Internet sites were analyzed. The percentage of patients (or their families) who expressed interest in learning about clinical trials ranged from as low as 21% (endometrial and cervix cancer patients >80 years of age; n=178) to as high as 85% (recurrent ovarian cancer patients, age 51-60; n=842). Patients >80 years of age, regardless of sex, tumor type, or status of disease, were considerably less likely to be interested in clinical trial information than younger individuals. Whereas there were no differences between males and females in their desire to obtain information, patients with self-declared more "serious conditions" (e.g., metastatic breast cancer, recurrent prostate cancer), and those with specific cancers having a widely recognized poor prognosis (e.g., nonsmall cell lung cancer), were more likely to request study information. In the current evaluation of a large database of individuals who elected to participate in 1 of several cancer-related decision-support programs, major differences in self-expressed interest in obtaining information regarding clinical trials was observed. Particularly notable was the reduced desire to gather such information among the very elderly, and the increased interest by patients with the most serious cancer-related conditions. IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.21997 PT - Journal Article ID - 16832813 [pubmed] ID - 10.1002/cncr.21997 [doi] PP - ppublish LG - English DP - 2006 Aug 15 DC - 20061006 EZ - 2006/07/13 09:00 DA - 2006/10/27 09:00 DT - 2006/07/13 09:00 YR - 2006 ED - 20061026 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16832813 <393. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16169221 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Osborn GD AU - Hodin M AU - Drew PJ AU - Fielder H AU - Vaughan-Williams E AU - Sweetland HM FA - Osborn, G D FA - Hodin, M FA - Drew, P J FA - Fielder, H FA - Vaughan-Williams, E FA - Sweetland, H M IN - Osborn, G D. The Cardiff Breast Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK. TI - Patient demographics and treatment for early breast cancer: an observational study. SO - Breast. 15(3):377-81, 2006 Jun AS - BREAST. 15(3):377-81, 2006 Jun NJ - Breast (Edinburgh, Scotland) PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - 9213011 IO - Breast SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Female MH - Humans MH - *Mastectomy, Modified Radical/sn [Statistics & Numerical Data] MH - Mastectomy, Modified Radical/td [Trends] MH - *Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - Mastectomy, Segmental/td [Trends] MH - Middle Aged MH - Patient Satisfaction MH - Socioeconomic Factors AB - This study aims to examine relationships between demographic factors and treatment choice for early breast cancer (T2/N<1). Two hundred and two patients were offered modified radical mastectomy (MRM), breast conserving therapy (BCT) or MRM and reconstruction and interviewed at a University Hospital and oncology centre in South Wales. Median age at treatment was 57 (32-90) years. Seventy-one patients (35%) choose MRM, 10 (5%) MRM and reconstruction and 121 (60%) BCT. Median age of women choosing MRM was 61 and 55 for BC (P<0.0001). Single women (P=0.009) and those with no family history of breast cancer (P=0.02) were more likely to choose MRM. There was no difference between treatment choice and method of cancer detection and the age at which the patient left education (P=0.065). Mean histological tumour diameter was smaller for women choosing BC (15 mm) than for women choosing mastectomy (17 mm; P=0.014). There was no association between tumour grade and treatment choice. IS - 0960-9776 IL - 0960-9776 DI - S0960-9776(05)00179-7 DO - https://dx.doi.org/10.1016/j.breast.2005.07.004 PT - Journal Article ID - 16169221 [pubmed] ID - S0960-9776(05)00179-7 [pii] ID - 10.1016/j.breast.2005.07.004 [doi] PP - ppublish PH - 2005/05/23 [received] PH - 2005/07/21 [revised] PH - 2005/07/21 [accepted] LG - English EP - 20050916 DP - 2006 Jun DC - 20060612 EZ - 2005/09/20 09:00 DA - 2006/08/23 09:00 DT - 2005/09/20 09:00 YR - 2006 ED - 20060822 RD - 20060612 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16169221 <394. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16873078 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Moumjid N AU - Bremond A FA - Moumjid, Nora FA - Bremond, Alain IN - Moumjid, Nora. Centre regional de lutte contre le cancer Leon-Berard, Lyon. TI - [Patient treatment preferences elicitation process: a French perspective]. [French] OT - Revelation des preferences des patients en matiere de decision de traitement en oncologie: un point de vue actuel. SO - Bulletin du Cancer. 93(7):691-7, 2006 Jul AS - Bull Cancer. 93(7):691-7, 2006 Jul NJ - Bulletin du cancer PI - Journal available in: Print PI - Citation processed from: Internet JC - 0072416 IO - Bull Cancer SB - Index Medicus CP - France MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - Communication MH - Decision Making MH - *Decision Support Techniques MH - Humans MH - *Patient Participation MH - *Patient Satisfaction MH - *Physician-Patient Relations AB - This paper deals with the physician-patient encounter. In France, the current legal framework allows patients to be informed (patients'rights to health information) and to participate to decisions regarding their own health. In such a context, this paper aims to give the reader the broad key components of the so-called 'patient treatment preferences elicitation process'in breast cancer, our research area. We first present the general context, with a definition of the different physician-patient models. We then present decision aids, tools that aim to provide high-quality information to patients in the decision-making process. Finally, based on our previous studies and on examples drawn from the international literature, we present the empirical process of patients'preferences elicitation which not only increases patients'knowledge of and satisfaction with the decision made, but also allows patients to be part of their disease management. Far from being a phenomenon in the air supported by a legal system, this method developed in the 90s allows patients and more generally healthcare users to be autonomous without constraining them to a choice. ES - 1769-6917 IL - 0007-4551 PT - English Abstract PT - Journal Article ID - 16873078 [pubmed] PP - ppublish PH - 2006/02/07 [received] PH - 2006/05/15 [accepted] LG - French DP - 2006 Jul DC - 20060728 EZ - 2006/07/29 09:00 DA - 2006/08/09 09:00 DT - 2006/07/29 09:00 YR - 2006 ED - 20060808 RD - 20110405 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16873078 <395. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16704673 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Laugesen MJ AU - Paul RR AU - Luft HS AU - Aubry W AU - Ganiats TG FA - Laugesen, Miriam J FA - Paul, Rebecca R FA - Luft, Harold S FA - Aubry, Wade FA - Ganiats, Theodore G IN - Laugesen, Miriam J. Department of Health Services, UCLA School of Public Health, 31-293A CHS, Box 1772, Los Angeles, CA 90095-1772, USA. TI - A comparative analysis of mandated benefit laws, 1949-2002. SO - Health Services Research. 41(3 Pt 2):1081-103, 2006 Jun AS - Health Serv Res. 41(3 Pt 2):1081-103, 2006 Jun NJ - Health services research PI - Journal available in: Print PI - Citation processed from: Print JC - g2l, 0053006 IO - Health Serv Res PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1713218 SB - Index Medicus CP - United States MH - Data Interpretation, Statistical MH - History, 20th Century MH - Humans MH - Insurance Benefits/hi [History] MH - *Insurance Benefits/lj [Legislation & Jurisprudence] MH - *Insurance Benefits/td [Trends] MH - *Insurance, Health MH - *Mandatory Programs/lj [Legislation & Jurisprudence] MH - Mandatory Programs/td [Trends] MH - United States AB - OBJECTIVE: To understand and compare the trends in mandated benefits laws in the United States. AB - DATA SOURCES/STUDY SETTING: Mandated benefit laws enacted in 50 states and the District of Columbia for the period 1949-2002 were compiled from multiple published compendia. AB - STUDY DESIGN: Laws that require private insurers and health plans to cover particular services, types of diseases, or care by specific providers in 50 states and the District of Columbia are compared for the period 1949-2002. Legislation is compared by year, by average and total frequency, by state, by type (provider, health care service, or preventive), and according to whether it requires coverage or an offer of coverage. AB - DATA COLLECTION/EXTRACTION METHOD: Data from published tables were entered into a spreadsheet and analyzed using statistical software. AB - PRINCIPAL FINDINGS: A total of 1,471 laws mandated coverage for 76 types of providers and services. The most common type of mandated coverage is for specific health care services (670 laws for 34 different services), followed by laws for services offered by specific professionals and other providers (507 mandated benefits laws for 25 types of providers), and coverage for specific preventive services (295 laws for 17 benefits). On average, a mandated benefit law has been adopted or significantly revised by 19 states, and each state has approximately 29 mandates. Only two benefits (minimum maternity stay and breast reconstruction) are mandated in all 51 jurisdictions and these were also federally mandated benefits. The mean number of total mandated benefit laws adopted or significantly revised per year was 17 per year in the 1970s, 36 per year in the 1980s, 59 per year in the 1990s, and 76 per year between 2000 and 2002. Since 1990, mandate adoption increased substantially, with around 55 percent of all mandated benefit laws enacted between 1990 and 2002. AB - CONCLUSIONS: There was a large increase in the number of mandated benefits laws during the managed care "backlash" of the 1990s. Many states now use mandated benefits to prescribe not only what services and benefits would be provided but how, where, and when services will be provided. IS - 0017-9124 IL - 0017-9124 DI - HESR521 DO - https://dx.doi.org/10.1111/j.1475-6773.2006.00521.x PT - Comparative Study PT - Historical Article PT - Journal Article ID - 16704673 [pubmed] ID - HESR521 [pii] ID - 10.1111/j.1475-6773.2006.00521.x [doi] ID - PMC1713218 [pmc] PP - ppublish LG - English DP - 2006 Jun DC - 20060517 EZ - 2006/05/18 09:00 DA - 2006/07/06 09:00 DT - 2006/05/18 09:00 YR - 2006 ED - 20060705 RD - 20140909 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16704673 <396. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16772906 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Alderman AK AU - Kuzon WM Jr AU - Wilkins EG FA - Alderman, Amy K FA - Kuzon, William M Jr FA - Wilkins, Edwin G IN - Alderman, Amy K. Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical Center, Ann Arbor, USA. aalder@umich.edu TI - A two-year prospective analysis of trunk function in TRAM breast reconstructions. SO - Plastic & Reconstructive Surgery. 117(7):2131-8, 2006 Jun AS - Plast Reconstr Surg. 117(7):2131-8, 2006 Jun NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Biomechanical Phenomena MH - *Breast Implantation/rh [Rehabilitation] MH - *Breast Neoplasms/su [Surgery] MH - Cohort Studies MH - Female MH - Humans MH - Kinetics MH - Mammaplasty/mt [Methods] MH - *Mammaplasty/rh [Rehabilitation] MH - Mastectomy/rh [Rehabilitation] MH - Middle Aged MH - Pliability MH - Prospective Studies MH - Range of Motion, Articular MH - Recovery of Function MH - Rectus Abdominis/tr [Transplantation] MH - *Surgical Flaps MH - Time Factors MH - *Tissue Expansion/rh [Rehabilitation] MH - Torque AB - BACKGROUND: Functional outcomes in breast reconstruction are important quality measures and aid in patients' decision-making process. To address the concerns of abdominal wall morbidity with transverse rectus abdominis musculocutaneous (TRAM) flap reconstructions, the authors prospectively evaluated the long-term effects of postmastectomy breast reconstruction on trunk function using objective clinical measures. AB - METHODS: Using a multicenter prospective cohort design, they recruited women undergoing first-time immediate or delayed breast reconstructions from 12 centers and 23 plastic surgeons. Trunk functional data, objectively measured with Cybex machines, for patients with an expander/implant, pedicle TRAM, and free TRAM reconstructions were evaluated preoperatively and at postoperative years 1 and 2 in 183 patients. The effects of procedure type, timing, and laterality on trunk peak torque and range of motion were analyzed using linear regression. AB - RESULTS: At 2 years postoperatively, procedure type, timing, and laterality did not significantly affect the range of motion for trunk flexion and extension. Peak torque for trunk flexion at year 2 was significantly decreased in patients with TRAM compared with expander/implant reconstructions (p < 0.05), with a 6 to 19 percent decrease in flexion peak torque. However, no significant difference in flexion peak torque was found between patients with free and pedicle TRAM reconstructions. AB - CONCLUSIONS: The authors found that (1) breast cancer patients with TRAM reconstructions had a less than 20 percent long-term deficit in trunk flexion peak torque and (2) there was no significant difference in trunk function between patients receiving pedicle and free TRAM reconstructions. ES - 1529-4242 IL - 0032-1052 DI - 00006534-200606000-00003 DO - https://dx.doi.org/10.1097/01.prs.0000218176.40705.5a PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Multicenter Study ID - 16772906 [pubmed] ID - 10.1097/01.prs.0000218176.40705.5a [doi] ID - 00006534-200606000-00003 [pii] PP - ppublish LG - English DP - 2006 Jun DC - 20060614 EZ - 2006/06/15 09:00 DA - 2006/06/29 09:00 DT - 2006/06/15 09:00 YR - 2006 ED - 20060628 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16772906 <397. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16549852 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Anderson K AU - Jacobson JS AU - Heitjan DF AU - Zivin JG AU - Hershman D AU - Neugut AI AU - Grann VR FA - Anderson, Kristin FA - Jacobson, Judith S FA - Heitjan, Daniel F FA - Zivin, Joshua Graff FA - Hershman, Dawn FA - Neugut, Alfred I FA - Grann, Victor R IN - Anderson, Kristin. Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Joseph L. Mailman School of Public Health, Columbia University, and New York Presbyterian Hospital, New York, New York 10032, USA. TI - Cost-effectiveness of preventive strategies for women with a BRCA1 or a BRCA2 mutation.[Summary for patients in Ann Intern Med. 2006 Mar 21;144(6):I40; PMID: 16549849] SO - Annals of Internal Medicine. 144(6):397-406, 2006 Mar 21 AS - Ann Intern Med. 144(6):397-406, 2006 Mar 21 NJ - Annals of internal medicine PI - Journal available in: Print PI - Citation processed from: Internet JC - 0372351 IO - Ann. Intern. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Computer Simulation MH - Cost-Benefit Analysis MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Genetic Testing/ec [Economics] MH - Heterozygote MH - Humans MH - Markov Chains MH - *Mastectomy/ec [Economics] MH - Middle Aged MH - Monte Carlo Method MH - Mutation MH - *Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy/ec [Economics] AB - BACKGROUND: For BRCA1 or BRCA2 mutation carriers, decision analysis indicates that prophylactic surgery or chemoprevention leads to better survival than surveillance alone. AB - OBJECTIVE: To evaluate the cost-effectiveness of the preventive strategies that are available to unaffected women carrying a single BRCA1 or BRCA2 mutation with high cancer penetrance. AB - DESIGN: Markov modeling with Monte Carlo simulations and probabilistic sensitivity analyses. AB - DATA SOURCES: Breast and ovarian cancer incidence and mortality rates, preference ratings, and costs derived from the literature; the Surveillance, Epidemiology, and End Results (SEER) Program; and the Health Care Financing Administration (now the Centers for Medicare & Medicaid Services). AB - TARGET POPULATION: Unaffected carriers of a single BRCA1 or BRCA2 mutation 35 to 50 years of age. AB - TIME HORIZON: Lifetime. AB - PERSPECTIVE: Health policy, societal. AB - INTERVENTIONS: Tamoxifen, oral contraceptives, bilateral salpingo-oophorectomy, mastectomy, both surgeries, or surveillance. AB - OUTCOME MEASURES: Cost-effectiveness. AB - RESULTS OF BASE-CASE ANALYSIS: For mutation carriers 35 years of age, both surgeries (prophylactic bilateral mastectomy and oophorectomy) had an incremental cost-effectiveness ratio over oophorectomy alone of 2352 dollars per life-year for BRCA1 and 100 dollars per life-year for BRCA2. With quality adjustment, oophorectomy dominated all other strategies for BRCA1 and had an incremental cost-effectiveness ratio of 2281 dollars per life-year for BRCA2. AB - RESULTS OF SENSITIVITY ANALYSIS: Older age at intervention increased the cost-effectiveness of prophylactic mastectomy for BRCA1 mutation carriers to 73,755 dollars per life-year. Varying the penetrance, mortality rates, costs, discount rates, and preferences had minimal effects on outcomes. AB - LIMITATIONS: Results are dependent on the accuracy of model assumptions. AB - CONCLUSION: On the basis of this model, the most cost-effective strategies for BRCA mutation carriers, with and without quality adjustment, were oophorectomy alone and oophorectomy and mastectomy, respectively. ES - 1539-3704 IL - 0003-4819 DI - 144/6/397 PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't ID - 16549852 [pubmed] ID - 144/6/397 [pii] PP - ppublish GI - No: K05 CA89155 Organization: (CA) *NCI NIH HHS* Country: United States No: K07 CA-95597 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2006 Mar 21 DC - 20060321 EZ - 2006/03/22 09:00 DA - 2006/04/12 09:00 DT - 2006/03/22 09:00 YR - 2006 ED - 20060411 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16549852 <398. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16327616 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tebbetts JB AU - Adams WP FA - Tebbetts, John B FA - Adams, William P IN - Tebbetts, John B. Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. jbt@plastic-surgery.com TI - Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process.[Reprint in Plast Reconstr Surg. 2006 Dec;118(7 Suppl):35S-45S; PMID: 17099482] SO - Plastic & Reconstructive Surgery. 116(7):2005-16, 2005 Dec AS - Plast Reconstr Surg. 116(7):2005-16, 2005 Dec NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Mammaplasty/mt [Methods] MH - *Mammaplasty MH - Reoperation AB - BACKGROUND: Surgeons' decisions impact patient outcomes and implant effects on tissues over time. Tissue assessment systems that provide quantitative, objective data enable objective rather than subjective decisions. First-generation dimensional systems for breast augmentation defined a desired result dimensionally and recommended an implant to force tissues to the desired result. A second-generation system, the TEPID system, defines measurements to match the implant to the patient's tissue characteristics, instead of forcing tissues to a desired result. This study defines a third-generation decision support process that prioritizes five critical decisions, identifies five key measurements, and completes all preoperative assessment and operative planning decisions in breast augmentation in 5 minutes or less. AB - METHODS: Key decision parameters and data from more than 2300 primary augmentations planned using the TEPID system were analyzed to define the five most critical decisions that affect reoperation rates and risks of uncorrectable deformities and to define a decision support process using five critical measurements. AB - RESULTS: In 1664 cases with up to 7 years of follow-up, the overall reoperation rate was 3 percent, and the reoperation rate for implant size exchange was 0.2 percent. The junior author's (Adams) clinical experience includes more than 300 augmentations with up to 6 years of follow-up using this system, with an overall reoperation rate of 2.8 percent. AB - CONCLUSION: The High Five decision support process prioritizes five critical decisions in breast augmentation and enables surgeons to address all preoperative assessment and operative planning decisions in breast augmentation in 5 minutes or less. ES - 1529-4242 IL - 0032-1052 DI - 00006534-200512000-00025 PT - Journal Article ID - 16327616 [pubmed] ID - 00006534-200512000-00025 [pii] PP - ppublish LG - English DP - 2005 Dec DC - 20051205 EZ - 2005/12/06 09:00 DA - 2006/02/24 09:00 DT - 2005/12/06 09:00 YR - 2005 ED - 20060222 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16327616 <399. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16217509 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lloyd M AU - Parikh A AU - Clarke A AU - Withey S AU - Carson E AU - Simmons J AU - McEvoy H AU - Butler PE FA - Lloyd, Mark FA - Parikh, Apul FA - Clarke, Alex FA - Withey, Simon FA - Carson, Ewart FA - Simmons, Jon FA - McEvoy, Helen FA - Butler, Peter E M TI - Formal decision trees in plastic surgery. SO - Plastic & Reconstructive Surgery. 116(5):1550-3, 2005 Oct AS - Plast Reconstr Surg. 116(5):1550-3, 2005 Oct NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Decision Support Techniques MH - *Decision Trees MH - Humans MH - Mammaplasty MH - *Outcome Assessment (Health Care) MH - Quality of Life MH - *Surgery, Plastic ES - 1529-4242 IL - 0032-1052 DI - 00006534-200510000-00060 PT - Editorial ID - 16217509 [pubmed] ID - 00006534-200510000-00060 [pii] PP - ppublish LG - English DP - 2005 Oct DC - 20051011 EZ - 2005/10/12 09:00 DA - 2006/02/24 09:00 DT - 2005/10/12 09:00 YR - 2005 ED - 20060221 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16217509 <400. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15922501 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gaston CM AU - Mitchell G FA - Gaston, Christine M FA - Mitchell, Geoffrey IN - Gaston, Christine M. Cornford House Surgery, 364 Cherry Hinton Road, Cambridge CB2 4PH, UK. christine.gaston@nhs.net TI - Information giving and decision-making in patients with advanced cancer: a systematic review. [Review] [76 refs] SO - Social Science & Medicine. 61(10):2252-64, 2005 Nov AS - Soc Sci Med. 61(10):2252-64, 2005 Nov NJ - Social science & medicine (1982) PI - Journal available in: Print PI - Citation processed from: Print JC - ut9, 8303205 IO - Soc Sci Med SB - Index Medicus CP - England MH - Age Factors MH - Clinical Trials as Topic MH - *Decision Making MH - Female MH - Humans MH - Male MH - *Neoplasms/px [Psychology] MH - *Patient Education as Topic MH - *Patient Participation/px [Psychology] MH - Sex Factors MH - Socioeconomic Factors AB - Patients with advanced, non-curable cancer face difficult decisions on further treatment, where a small increase in survival time must be balanced against the toxicity of the treatment. If patients want to be involved in these decisions, in keeping with current notions of autonomy and empowerment, they also require to be adequately informed both on the treatments proposed and on their own disease status and prognosis. A systematic review was performed on decision-making and information provision in patients with advanced cancer. Studies of interventions to improve information giving and encourage participation in decision-making were reviewed, including both randomised controlled trials and uncontrolled studies. Almost all patients expressed a desire for full information, but only about two-thirds wished to participate actively in decision-making. Higher educational level, younger age and female sex were predictive of a desire to participate in decision-making. Active decision-making was more common in patients with certain cancers (e.g. breast) than others (e.g. prostate). A number of simple interventions including question prompt sheets, audio-taping of consultations and patient decision aids have been shown to facilitate such involvement. [References: 76] IS - 0277-9536 IL - 0277-9536 DI - S0277-9536(05)00180-2 DO - https://dx.doi.org/10.1016/j.socscimed.2005.04.015 PT - Journal Article PT - Review ID - 15922501 [pubmed] ID - S0277-9536(05)00180-2 [pii] ID - 10.1016/j.socscimed.2005.04.015 [doi] PP - ppublish PH - 2004/08/11 [received] PH - 2005/04/12 [accepted] LG - English DP - 2005 Nov DC - 20050913 EZ - 2005/06/01 09:00 DA - 2006/01/25 09:00 DT - 2005/06/01 09:00 YR - 2005 ED - 20060124 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15922501 <401. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16200038 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sacco M AU - Murgante F AU - Attanasio S AU - Fossaceca R AU - Brambilla M AU - Krengli M AU - Carriero A FA - Sacco, Mariano FA - Murgante, Francesco FA - Attanasio, Silvia FA - Fossaceca, Rita FA - Brambilla, Marco FA - Krengli, Marco FA - Carriero, Alessandro IN - Sacco, Mariano. Istituto di Radiodiagnostica e Radiologia Interventistica, Ospedale Maggiore della Carita, Universita del Piemonte Orientale, Novara. TI - Breast cancer: high resolution CT in association with spirometric tests in the assessment of post-radiation pulmonary fibrosis. SO - Radiologia Medica. 110(3):156-69, 2005 Sep AS - Radiol Med (Torino). 110(3):156-69, 2005 Sep NJ - La Radiologia medica PI - Journal available in: Print PI - Citation processed from: Print JC - rbz, 0177625 IO - Radiol Med SB - Index Medicus CP - Italy MH - Adult MH - Aged MH - Breast/pa [Pathology] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/dt [Drug Therapy] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Carcinoma, Lobular/dt [Drug Therapy] MH - Carcinoma, Lobular/pa [Pathology] MH - *Carcinoma, Lobular/rt [Radiotherapy] MH - Carcinoma, Lobular/su [Surgery] MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Staging MH - *Pulmonary Fibrosis/dg [Diagnostic Imaging] MH - Pulmonary Fibrosis/et [Etiology] MH - *Radiation Pneumonitis/dg [Diagnostic Imaging] MH - *Radiography, Thoracic MH - Radiotherapy/ae [Adverse Effects] MH - Radiotherapy Dosage MH - Spirometry MH - Time Factors MH - *Tomography, X-Ray Computed/mt [Methods] IS - 0033-8362 IL - 0033-8362 PT - Comparative Study PT - Journal Article ID - 16200038 [pubmed] PP - ppublish LG - English LG - Italian DP - 2005 Sep DC - 20051003 EZ - 2005/10/04 09:00 DA - 2005/12/24 09:00 DT - 2005/10/04 09:00 YR - 2005 ED - 20051223 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16200038 <402. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16096220 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Emery J FA - Emery, J IN - Emery, J. School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Australia. jemery@cyllene.uwa.edu.au TI - The GRAIDS Trial: the development and evaluation of computer decision support for cancer genetic risk assessment in primary care. SO - Annals of Human Biology. 32(2):218-27, 2005 Mar-Apr AS - Ann Hum Biol. 32(2):218-27, 2005 Mar-Apr NJ - Annals of human biology PI - Journal available in: Print PI - Citation processed from: Print JC - 57r, 0404024 IO - Ann. Hum. Biol. SB - Index Medicus CP - England MH - Attitude of Health Personnel MH - Attitude to Computers MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Colorectal Neoplasms/ge [Genetics] MH - Colorectal Neoplasms/pc [Prevention & Control] MH - *Decision Making, Computer-Assisted MH - England MH - Female MH - Genetics/ed [Education] MH - Humans MH - Outcome Assessment (Health Care)/mt [Methods] MH - *Primary Health Care MH - *Risk Assessment/mt [Methods] AB - The development and evaluation of computer decision support for the assessment of cancer genetic risk in primary care is reported with two series of studies described: the RAGs (Risk Assessment in Genetics) studies and the GRAIDS (Genetic Risk Assessment in an Intranet and Decision Support) Trial. In the GRAIDS Trial, 45 general practices in Eastern England have been recruited and randomised. Comparison practices attend an educational session and receive clinical guidelines about familial breast and colorectal cancer. In the intervention practices a lead clinician is trained in cancer genetics and use of the GRAIDS software. The GRAIDS software is a simple pedigree-drawing program that implements clinical guidelines for familial breast and colorectal cancer and presents individualised information about breast cancer risk in a range of formats. Outcome measures of the trial include: frequency of software use, practitioners' attitudes towards the software, total number of referrals to secondary care about familial cancer and the proportion that meet regional referral criteria, and a patient-centred measure of informed decision making. The family history will become an increasingly important tool in primary care to assess genetic risk. This research evaluates an approach to support high-quality advice about cancer genetics in primary care which could be applied more broadly as our understanding of complex disease genetics increases. IS - 0301-4460 IL - 0301-4460 DI - KV54180331N067L0 DO - https://dx.doi.org/10.1080/03014460500074921 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 16096220 [pubmed] ID - KV54180331N067L0 [pii] ID - 10.1080/03014460500074921 [doi] PP - ppublish LG - English DP - 2005 Mar-Apr DC - 20050812 EZ - 2005/08/13 09:00 DA - 2005/12/13 09:00 DT - 2005/08/13 09:00 YR - 2005 ED - 20051206 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16096220 <403. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16170484 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gruber G AU - Menzi S AU - Forster A AU - Berclaz G AU - Altermatt HJ AU - Greiner RH FA - Gruber, Gunther FA - Menzi, Samuel FA - Forster, Andrea FA - Berclaz, Gilles FA - Altermatt, Hans-Jorg FA - Greiner, Richard H IN - Gruber, Gunther. Department of Radiation Oncology, Inselspital, University of Berne, Switzerland. guenther.gruber@ksa.ch TI - Sites of failure in breast cancer patients with extracapsular invasion of axillary lymph node metastases. No need for axillary irradiation?!. SO - Strahlentherapie und Onkologie. 181(9):574-9, 2005 Sep AS - Strahlenther Onkol. 181(9):574-9, 2005 Sep NJ - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] PI - Journal available in: Print PI - Citation processed from: Print JC - vcm, 8603469 IO - Strahlenther Onkol SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - Axilla/re [Radiation Effects] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Lymph Node Excision MH - *Lymph Nodes/re [Radiation Effects] MH - Lymphatic Metastasis/rt [Radiotherapy] MH - *Lymphatic Metastasis MH - Mastectomy, Modified Radical MH - Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Recurrence, Local MH - Radiotherapy Dosage MH - Receptors, Estrogen/an [Analysis] MH - Receptors, Progesterone/an [Analysis] MH - Retrospective Studies MH - Survival Analysis MH - Time Factors MH - Treatment Failure AB - BACKGROUND AND PURPOSE: Extracapsular spread (ECS) is frequent, but the specific sites of relapse are seldom given in the literature. In this study it was evaluated, if ECS might be an indicator for axillary irradiation. AB - PATIENTS AND METHODS: After a retrospective review of pathology reports, the information about ECS was available in 254 lymph node-positive patients: ECS was absent in 34% (ECS-negative; n = 87) and present in 66% (ECS-positive; n = 167). All patients were irradiated locally, 78 patients got periclavicular and 74 axillary irradiation (median total dose: 50.4 Gy). 240/254 patients (94.5%) received systemic treatment/s. Mean follow-up was 46 months. AB - RESULTS: The regional relapse rate was 4.6% without ECS versus 9.6% with ECS. The 5-year axillary relapse-free survival was 100% in ECS-negative and 90% in ECS-positive patients (p = 0.01), whereas corresponding values for periclavicular relapse-free survival (with ECS: 91% +/- 4%; without ECS: 94% +/- 3%; p = 0.77) and local relapse-free survival (with ECS: 86% +/- 4%; without ECS: 91% +/- 3%; p = 0.69) were not significantly different. chi(2)-tests revealed a high correlation of ECS with T-stage, number of positive lymph nodes and progesterone receptor status, comparisons with estrogen receptor, grade, or age were not significant. In multivariate analysis number of positive lymph nodes was solely significant for regional failure. Dividing the patients into those with one to three and those with four or more positive lymph nodes, ECS lost its significance for axillary failure. AB - CONCLUSION: ECS was accompanied by an enhanced axillary failure rate in univariate analysis, which was no longer true after adjusting for the number of positive lymph nodes. RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) IS - 0179-7158 IL - 0179-7158 DO - https://dx.doi.org/10.1007/s00066-005-1367-x PT - Comparative Study PT - Evaluation Studies PT - Journal Article ID - 16170484 [pubmed] ID - 10.1007/s00066-005-1367-x [doi] PP - ppublish PH - 2004/10/05 [received] PH - 2005/06/23 [revised] LG - English DP - 2005 Sep DC - 20050919 EZ - 2005/09/20 09:00 DA - 2005/12/13 09:00 DT - 2005/09/20 09:00 YR - 2005 ED - 20051130 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16170484 <404. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16170483 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Dorr W AU - Bertmann S AU - Herrmann T FA - Dorr, Wolfgang FA - Bertmann, Simone FA - Herrmann, Thomas IN - Dorr, Wolfgang. Department of Radiotherapy and Radiooncology, Medical Faculty Carl Gustav Carus, University of Technology, Dresden, Germany. doerr@rcs.urz.tu-dresden.de TI - Radiation induced lung reactions in breast cancer therapy. Modulating factors and consequential effects. SO - Strahlentherapie und Onkologie. 181(9):567-73, 2005 Sep AS - Strahlenther Onkol. 181(9):567-73, 2005 Sep NJ - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] PI - Journal available in: Print PI - Citation processed from: Print JC - vcm, 8603469 IO - Strahlenther Onkol SB - Index Medicus CP - Germany MH - Adult MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents, Hormonal/ad [Administration & Dosage] MH - Antineoplastic Agents, Hormonal/ae [Adverse Effects] MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant MH - Cohort Studies MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Lung/re [Radiation Effects] MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Postoperative Care MH - Pulmonary Fibrosis/dg [Diagnostic Imaging] MH - Pulmonary Fibrosis/ep [Epidemiology] MH - Pulmonary Fibrosis/et [Etiology] MH - Radiation Pneumonitis/dg [Diagnostic Imaging] MH - Radiation Pneumonitis/ep [Epidemiology] MH - *Radiation Pneumonitis/et [Etiology] MH - Radiography, Thoracic MH - Radiotherapy Dosage MH - Retrospective Studies MH - Tamoxifen/ad [Administration & Dosage] MH - Tamoxifen/ae [Adverse Effects] MH - Tamoxifen/tu [Therapeutic Use] MH - Time Factors MH - Tomography, X-Ray Computed AB - BACKGROUND AND PURPOSE: Radiologic reactions in lung, usually subclinical, are a frequent side effect of radiotherapy for breast cancer. This study was initiated to identify effects of age and tamoxifen on radiation pneumonitis and consequent fibrosis. AB - PATIENTS AND METHODS: Retrospectively, 451 patients irradiated postoperatively between 1992 and 1995 at the Department of Radiotherapy of Carl-Thiem-Klinikum (Cottbus, Germany) were analyzed. The median age was 58 years. After mastectomy (n = 296), 25 x 2.0 Gy were applied; breast-conserving surgery (n = 155) was followed by 30 x 2.0 Gy. In 221 patients, adjuvant tamoxifen was given. Follow-up included thorax radiography after 15 weeks and 1 year. In patients with reversible observations in standard chest radiography from 15 weeks to 1 year, CT or high-resolution (HR-)CT scans were analyzed after 4-7 years. AB - RESULTS: Clinical symptoms of pneumonitis were seen in 25 patients (5.5%), all with radiologic changes. Early radiologic changes were detected in 134 patients (29.7%). Age (> 58 years; p = 0.0127) and tamoxifen (p = 0.0001) were found as significant parameters of early pneumopathy. Late radiologic changes were seen in 94/425 patients (22.1%), all after a positive early reaction (p = 0.001). AB - CONCLUSION: A low incidence of clinically symptomatic pneumonitis was observed, while the vast majority of patients presented with early radiologic changes. Higher age and tamoxifen treatment significantly increased the incidence of early pneumopathy. Local fibrotic responses must be expected in all patients with early reactions, indicating a strong consequential component of the late reaction. RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) IS - 0179-7158 IL - 0179-7158 DO - https://dx.doi.org/10.1007/s00066-005-1457-9 PT - Comparative Study PT - Journal Article ID - 16170483 [pubmed] ID - 10.1007/s00066-005-1457-9 [doi] PP - ppublish PH - 2005/05/03 [received] PH - 2005/05/13 [revised] LG - English DP - 2005 Sep DC - 20050919 EZ - 2005/09/20 09:00 DA - 2005/12/13 09:00 DT - 2005/09/20 09:00 YR - 2005 ED - 20051130 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16170483 <405. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15793468 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Adams WP Jr FA - Adams, William P Jr TI - Brody's article on "the perfect breast". CM - Comment on: Plast Reconstr Surg. 2004 Apr 15;113(5):1500-3; PMID: 15060370 SO - Plastic & Reconstructive Surgery. 115(4):1204-5; author reply 1206-7, 2005 Apr AS - Plast Reconstr Surg. 115(4):1204-5; author reply 1206-7, 2005 Apr NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 1306050 IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Breast Implantation MH - *Breast Implants MH - Decision Making MH - Female MH - Humans MH - Patient Education as Topic MH - *Patient Satisfaction ES - 1529-4242 IL - 0032-1052 DI - 00006534-200504010-00036 PT - Comment PT - Letter ID - 15793468 [pubmed] ID - 00006534-200504010-00036 [pii] PP - ppublish LG - English DP - 2005 Apr DC - 20050328 EZ - 2005/03/29 09:00 DA - 2005/12/13 09:00 DT - 2005/03/29 09:00 YR - 2005 ED - 20051130 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15793468 <406. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16045423 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schwartz MD AU - Peshkin BN AU - Tercyak KP AU - Taylor KL AU - Valdimarsdottir H FA - Schwartz, Marc D FA - Peshkin, Beth N FA - Tercyak, Kenneth P FA - Taylor, Kathryn L FA - Valdimarsdottir, Heiddis IN - Schwartz, Marc D. Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA. schwartm@georgetown.edu TI - Decision making and decision support for hereditary breast-ovarian cancer susceptibility. [Review] [50 refs] SO - Health Psychology. 24(4S):S78-84, 2005 Jul AS - Health Psychol. 24(4S):S78-84, 2005 Jul NJ - Health psychology : official journal of the Division of Health Psychology, American Psychological Association PI - Journal available in: Print PI - Citation processed from: Internet JC - ejl, 8211523 IO - Health Psychol SB - Index Medicus CP - United States MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/th [Therapy] MH - DNA Mutational Analysis MH - *Decision Making MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - *Genetic Predisposition to Disease MH - Genetic Testing MH - Humans MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/th [Therapy] MH - Patient Acceptance of Health Care/px [Psychology] MH - Patient Participation/px [Psychology] MH - United States AB - Genetic testing for disease susceptibility has the potential to revolutionize health care by allowing for individually tailored disease prevention strategies. To achieve this promise, patients and physicians must use the information obtained through genetic testing to make medical decisions that are consistent with patient preferences and that lead to reduced disease morbidity and mortality. However, decisions associated with genetic testing can be complex. In this article, the authors review decision making associated with genetic testing and the medical management of hereditary breast-ovarian cancer susceptibility. They focus on decisions regarding BRCA1/2 testing and prophylactic surgery among BRCA1 and BRCA2 mutation carriers. They highlight the role of patient preferences and decision support in this population. The studies reviewed indicate that although patients' preferences do predict genetic testing and management decisions, other factors also influence their decision making. In particular, the authors discuss the role of anxiety and worry in relation to testing and surgery decisions. [References: 50] ES - 1930-7810 IL - 0278-6133 DI - 2005-08085-012 DO - https://dx.doi.org/10.1037/0278-6133.24.4.S78 PT - Journal Article PT - Review ID - 16045423 [pubmed] ID - 2005-08085-012 [pii] ID - 10.1037/0278-6133.24.4.S78 [doi] PP - ppublish GI - No: R01 CA082346 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2005 Jul DC - 20050727 EZ - 2005/07/28 09:00 DA - 2005/12/13 09:00 DT - 2005/07/28 09:00 YR - 2005 ED - 20051129 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=16045423 <407. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15951457 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Peele PB AU - Siminoff LA AU - Xu Y AU - Ravdin PM FA - Peele, Pamela B FA - Siminoff, Laura A FA - Xu, Ying FA - Ravdin, Peter M IN - Peele, Pamela B. Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA. peele@pitt.edu TI - Decreased use of adjuvant breast cancer therapy in a randomized controlled trial of a decision aid with individualized risk information. SO - Medical Decision Making. 25(3):301-7, 2005 May-Jun AS - Med Decis Making. 25(3):301-7, 2005 May-Jun NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Aged MH - Algorithms MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/cl [Classification] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/su [Surgery] MH - *Chemotherapy, Adjuvant/ut [Utilization] MH - *Decision Support Techniques MH - Female MH - Humans MH - Middle Aged MH - Models, Statistical MH - Ohio MH - *Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - *Patient Education as Topic MH - Physicians/cl [Classification] MH - Physicians/sn [Statistics & Numerical Data] MH - *Risk Assessment MH - *Severity of Illness Index MH - Socioeconomic Factors MH - Texas AB - OBJECTIVE: Oncology patients often seek involvement in their medical consultations. Such involvement is endorsed by most health care providers and mirrored in practice guidelines. However, oncologists exhibit great variation in how they provide patients with disease-relevant information, and many remain reluctant to do so at all. The authors examined the impact of a patient-specific decision aid on women's decisions about adjuvant therapy for breast cancer. AB - METHOD: 386 women with breast cancer were randomized to receive either an informational pamphlet about adjuvant therapy (usual care) or a patient-specific, evidence-based decision aid about adjuvant therapy. The authors compared rates of adjuvant therapy between the groups controlling for age, education, marital status, race, tumor severity, and practice type of their physician (university-based or community-based). AB - RESULTS: Among women with low tumor severity, only 58% (35/60) of women in the decision aid group chose adjuvant therapy, compared to 87% (33/38) of their counterparts in usual care (P<0.01). AB - CONCLUSIONS: This study illustrates the important impact of medical decision aids on treatment choices, particularly for patients for whom treatment has little benefit. In the case of adjuvant therapy for breast cancer, providing individualized, evidence-based risk information for shared decision making resulted in fewer women with low tumor severity choosing adjuvant treatment. RN - 0 (Antineoplastic Agents) IS - 0272-989X IL - 0272-989X DI - 25/3/301 DO - https://dx.doi.org/10.1177/0272989X05276851 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, P.H.S. ID - 15951457 [pubmed] ID - 25/3/301 [pii] ID - 10.1177/0272989X05276851 [doi] PP - ppublish GI - No: R01-CA711040 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2005 May-Jun DC - 20050613 EZ - 2005/06/14 09:00 DA - 2005/12/13 09:00 DT - 2005/06/14 09:00 YR - 2005 ED - 20051129 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15951457 <408. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 16161722 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Castillero C FA - Castillero, C IN - Castillero, C. Cirujano Oncologo, Instituto Omcologico Nacional. TI - [Evaluation of prognostic factors in breast cancer EC I-II and the importance of local recurrence]. [Spanish] OT - Evaluacion de factores pronosticos en cancer de mama EC I-II y la importancia de la recurrencia local. SO - Revista Medica de Panama. 26:35-9, 2001 AS - Rev Med Panama. 26:35-9, 2001 NJ - Revista medica de Panama PI - Journal available in: Print PI - Citation processed from: Print JC - rbn, 7706654 IO - Rev Med Panama SB - Index Medicus CP - Panama MH - *Adenocarcinoma/di [Diagnosis] MH - Adenocarcinoma/ge [Genetics] MH - Adenocarcinoma/me [Metabolism] MH - Adenocarcinoma/pa [Pathology] MH - Adenocarcinoma/su [Surgery] MH - Breast/pa [Pathology] MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Mastectomy, Segmental MH - *Neoplasm Recurrence, Local MH - Prognosis MH - Receptor, ErbB-2 MH - Receptors, Estrogen MH - Receptors, Progesterone MH - Risk Factors MH - Time Factors MH - Tumor Suppressor Protein p53 AB - OBJECTIVE: [corrected] We evaluated the prognostic factors in patients with breast cancer EC-I-II treated in the Instituto Nacional de Cancerologia in Mexico and compared patients with or without local or/and systemic recurrence. AB - METHOD: This is a retrospective study in patients treated with conservative surgery between 1983 and 1993 with a diagnosis of invasive breast cancer and tumors <4 cm All pathological variables were analyzed and we performed studies on c-erb.B2, P53, estrogene and progesterone receivers, cellular ploidy and cellular percentage on face "S" of the cellular cycle. All these variables were compared in two groups, one with recurrences and the other without recurrences, with the same symptoms and demographics characteristics. AB - RESULTS: From 1270 patients with breast cancer EC I-II, 139 patients were submitted to conservative surgery, 14 patients of this group recurred and were compared with 32 patients that did not, out of a total of 46 patients. We found that SBR greater than five (P = 0.046), poor differentiated tumors (P = 0.04), tumors with vascular permeability (P = 0.020) and with intraductal characteristics of a comedocarcinoma (P = 0.004) had a worse prognosis and increased the risk of local recurrences. AB - CONCLUSIONS: In patients with breast cancer the pathological variants are more important than the so called secondary prognostic variables. Besides the pathological variants, it is acceptable only the use of hormonal receptors and the presence of c-erb-b2. RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) RN - 0 (Tumor Suppressor Protein p53) RN - EC 2-7-10-1 (Receptor, ErbB-2) IS - 0379-1629 IL - 0379-1629 PT - Comparative Study PT - English Abstract PT - Evaluation Studies PT - Journal Article ID - 16161722 [pubmed] PP - ppublish LG - Spanish DP - 2001 DC - 20050915 EZ - 2005/09/16 09:00 DA - 2005/10/18 09:00 DT - 2005/09/16 09:00 YR - 2001 ED - 20051017 RD - 20141120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16161722 <409. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15386771 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tiller K AU - Meiser B AU - Gould L AU - Tucker K AU - Dudding T AU - Franklin J AU - Friedlander M AU - Andrews L FA - Tiller, K FA - Meiser, B FA - Gould, L FA - Tucker, K FA - Dudding, T FA - Franklin, J FA - Friedlander, M FA - Andrews, L IN - Tiller, K. Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia. tillerk@sesahs.nsw.gov.au TI - Knowledge of risk management strategies, and information and risk management preferences of women at increased risk for ovarian cancer. SO - Psycho-Oncology. 14(4):249-61, 2005 Apr AS - Psychooncology. 14(4):249-61, 2005 Apr NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Print JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Adult MH - Aged MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - Colorectal Neoplasms, Hereditary Nonpolyposis/ge [Genetics] MH - Colorectal Neoplasms, Hereditary Nonpolyposis/pc [Prevention & Control] MH - Colorectal Neoplasms, Hereditary Nonpolyposis/px [Psychology] MH - Contraceptives, Oral/ad [Administration & Dosage] MH - Decision Support Techniques MH - Female MH - Genes, Dominant MH - Genetic Predisposition to Disease/ge [Genetics] MH - *Genetic Predisposition to Disease/px [Psychology] MH - Health Knowledge, Attitudes, Practice MH - Heterozygote Detection MH - Humans MH - Mass Screening/px [Psychology] MH - Middle Aged MH - Neoplasms, Glandular and Epithelial/ge [Genetics] MH - Neoplasms, Glandular and Epithelial/pc [Prevention & Control] MH - *Neoplasms, Glandular and Epithelial/px [Psychology] MH - Neoplastic Syndromes, Hereditary/ge [Genetics] MH - Neoplastic Syndromes, Hereditary/pc [Prevention & Control] MH - Neoplastic Syndromes, Hereditary/px [Psychology] MH - New South Wales MH - Oncology Service, Hospital/ut [Utilization] MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovarian Neoplasms/px [Psychology] MH - Ovariectomy/px [Psychology] MH - Patient Acceptance of Health Care/px [Psychology] MH - *Patient Education as Topic MH - *Patient Participation/px [Psychology] MH - Risk Assessment MH - Risk Reduction Behavior MH - Victoria AB - Little research is available on the level of knowledge about ovarian cancer risk management options in women at increased risk for this disease. The study objectives were to evaluate this together with the information and ovarian cancer risk management preferences of high-risk women. One hundred and twenty-nine women were assessed after their attendance at one of six familial cancer clinics in relation to knowledge of surveillance and/or preventative strategies for reduction of ovarian cancer risk, preferences for particular strategies, and information preferences. Screening was selected by 57 (44%) women as the preferred risk management option. One hundred and five women (82%) indicated a wish for as much information as possible about ovarian cancer, including both good and bad outcomes and 114 (89%) reported a preference for sharing treatment decisions with their health professional. Participants' knowledge about ovarian cancer risk management options was significantly associated with educational levels (Z = -3.2, p=0.001) and whether or not ovarian cancer was included in the family history (Z = -2.3, p = 0.018). Findings from this present study indicate that women at increased risk of ovarian cancer who attend familial cancer clinics want as much information as possible about this disease and they want to be involved in the decision-making process. Women who reported a lower level of education (no post-school qualifications) may be most likely to benefit from additional educational strategies designed to supplement genetic counseling to improve their knowledge levels. AB - Copyright 2004 John Wiley & Sons, Ltd. RN - 0 (Contraceptives, Oral) IS - 1057-9249 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.840 PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 15386771 [pubmed] ID - 10.1002/pon.840 [doi] PP - ppublish LG - English DP - 2005 Apr DC - 20050411 EZ - 2004/09/24 05:00 DA - 2005/08/24 09:00 DT - 2004/09/24 05:00 YR - 2005 ED - 20050823 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15386771 <410. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15893210 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stalmeier PF AU - Roosmalen MS AU - Verhoef LC AU - Hoekstra-Weebers JE AU - Oosterwijk JC AU - Moog U AU - Hoogerbrugge N AU - van Daal WA FA - Stalmeier, Peep F M FA - Roosmalen, Marielle S FA - Verhoef, Lia C G FA - Hoekstra-Weebers, Josette E H M FA - Oosterwijk, Jan C FA - Moog, Ute FA - Hoogerbrugge, Nicoline FA - van Daal, Willem A J IN - Stalmeier, Peep F M. Medical Technology Assessment, University Medical Centre Nijmegen, Postbus 9101, 6500 HB Nijmegen, The Netherlands. p.stalmeier@mta.umcn.nl TI - The decision evaluation scales. SO - Patient Education & Counseling. 57(3):286-93, 2005 Jun AS - Patient Educ Couns. 57(3):286-93, 2005 Jun NJ - Patient education and counseling PI - Journal available in: Print PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/th [Therapy] MH - *Choice Behavior MH - *Decision Support Techniques MH - Factor Analysis, Statistical MH - Female MH - Genetic Testing/px [Psychology] MH - Hospitals, University MH - Humans MH - Informed Consent MH - Internal-External Control MH - Middle Aged MH - Negativism MH - Netherlands MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/th [Therapy] MH - Patient Education as Topic MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Patient Satisfaction MH - Psychometrics MH - Risk Assessment MH - Social Support MH - *Surveys and Questionnaires/st [Standards] MH - Uncertainty AB - There are several instruments to assess how patients evaluate their medical treatment choice. These are used to evaluate decision aids. Our objective is to investigate which psychological factors play a role when patients evaluate their medical treatment choices. A pool of 36 items was constructed, covering concepts such as uncertainty about and satisfaction with the decision, informed choice, effective decision making, responsibility for the decision, perceived riskiness of the choice, and social support regarding the decision. This pool was presented to patients at high risk for breast and ovarian cancer, awaiting a genetic test result, and facing the choice between prophylactic surgery or screening. Additional measures were assessed for validation purposes. Factor and Rasch analyses were used for factor and item selection. Construct validity of emerging scales was assessed by relating them with the additional measures. Three factors summarised the psychological factors concerning decision evaluation: Satisfaction-Uncertainty, Informed Choice, and Decision Control. Reliabilities (Cronbach's alpha) of the three scales were 0.79, 0.85, and 0.75, respectively. Construct validity hypotheses were confirmed. The first two scales were similar to previously developed scales. Of these three scales, the Decision Control scale correlated most strongly with the well-being measures, was associated with partner's agreement and physician's preferences as perceived by patients, and with a negative emotional reaction to the information material. In conclusion, the Decision Control scale is a new scale to evaluate decision aids, and it appears to be rooted in health psychological theories. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(04)00252-6 DO - https://dx.doi.org/10.1016/j.pec.2004.07.010 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Studies ID - 15893210 [pubmed] ID - S0738-3991(04)00252-6 [pii] ID - 10.1016/j.pec.2004.07.010 [doi] PP - ppublish PH - 2004/04/19 [received] PH - 2004/05/25 [revised] PH - 2004/07/27 [accepted] LG - English DP - 2005 Jun DC - 20050516 EZ - 2005/05/17 09:00 DA - 2005/08/19 09:00 DT - 2005/05/17 09:00 YR - 2005 ED - 20050818 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15893210 <411. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15657522 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Takasugi M AU - Iwamoto E AU - Akashi-Tanaka S AU - Kinoshita T AU - Fukutomi T AU - Kubouchi K FA - Takasugi, Miyuki FA - Iwamoto, Eriko FA - Akashi-Tanaka, Sadako FA - Kinoshita, Takayuki FA - Fukutomi, Takashi FA - Kubouchi, Kohichi IN - Takasugi, Miyuki. Department of Surgical Oncology Divisions, National Cancer Center Hospital, 5-1-1, Chuo-ku, Tokyo, 104-0045, Japan. TI - General aspects and specific issues of informed consent on breast cancer treatments. SO - Breast Cancer. 12(1):39-44, 2005 AS - Breast Cancer. 12(1):39-44, 2005 NJ - Breast cancer (Tokyo, Japan) PI - Journal available in: Print PI - Citation processed from: Print JC - 100888201, due IO - Breast Cancer OI - Source: KIE. 126036 OI - Source: NRCBL. VF 8.3.1 SB - Bioethics Journals SB - Index Medicus CP - Japan MH - *Breast Neoplasms/th [Therapy] MH - Clinical Trials as Topic MH - Communication MH - Genetic Testing MH - Humans MH - *Informed Consent MH - Japan MH - Patient Education as Topic MH - Physician's Role MH - *Physician-Patient Relations MH - Sentinel Lymph Node Biopsy KW - Professional Patient Relationship AB - Informed consent (IC) is the process by which a patient can make choices about his/her health care; therefore it is considered to be a voluntary authorization given by the patient to the physician. To ensure the patient's right to self-determination, what can the physicians do? When treating breast cancer, there are several specific issues that must be clarified by the IC. We have selected and evaluated the basic elements of IC and mentioned the basic concepts of IC in details. First of all, complete information must be disclosed to the patient (physician's responsibility for medical accountability). The information to be disclosed is summarized in the following three elements: 1) The nature of the treatment/procedure, 2) The relevant risks/benefits, and 3) Reasonable alternatives to the proposed intervention (alternative treatments/procedures). However, the physician is not obliged to persuade the patient to accept the proposed intervention. IC information should be documented in detail on the patient's chart without delay. These issues include IC regarding surgical procedures (mastectomy or breast conservation treatment), IC regarding clinical studies (description of randomized controlled trials), IC regarding genetic diagnosis (ethical issues), and the like. IC means informed decision-making, close relationships between physicians and patients are needed. NT - 8 refs. NT - KIE Bib: informed consent IS - 1340-6868 IL - 1340-6868 PT - Journal Article ID - 15657522 [pubmed] PP - ppublish LG - English DP - 2005 DC - 20050119 EZ - 2005/01/20 09:00 DA - 2005/07/01 09:00 DT - 2005/01/20 09:00 YR - 2005 ED - 20050630 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15657522 <412. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15755969 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Whelan TJ AU - Loprinzi C FA - Whelan, Timothy J FA - Loprinzi, Charles IN - Whelan, Timothy J. Juravinski Cancer Centre, 699 Concession St, Room 3-62, Hamilton, Ontario, L8V 5C2 Canada. tim.whelan@hrcc.on.ca TI - Physician/patient decision aids for adjuvant therapy. [Review] [23 refs] SO - Journal of Clinical Oncology. 23(8):1627-30, 2005 Mar 10 AS - J Clin Oncol. 23(8):1627-30, 2005 Mar 10 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Antineoplastic Agents/ae [Adverse Effects] MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Chemotherapy, Adjuvant MH - *Communication MH - *Decision Making MH - Female MH - Humans MH - *Patient Education as Topic/mt [Methods] MH - *Physician's Role MH - Prognosis RN - 0 (Antineoplastic Agents) IS - 0732-183X IL - 0732-183X DI - 23/8/1627 DO - https://dx.doi.org/10.1200/JCO.2005.10.072 PT - Journal Article PT - Review ID - 15755969 [pubmed] ID - 23/8/1627 [pii] ID - 10.1200/JCO.2005.10.072 [doi] PP - ppublish LG - English DP - 2005 Mar 10 DC - 20050309 EZ - 2005/03/10 09:00 DA - 2005/04/01 09:00 DT - 2005/03/10 09:00 YR - 2005 ED - 20050331 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15755969 <413. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15718344 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eisinger F AU - Huiart L AU - Sobol H FA - Eisinger, F FA - Huiart, L FA - Sobol, H TI - The choice of bilateral prophylactic mastectomy. CM - Comment on: J Clin Oncol. 2004 May 15;22(10):1823-9; PMID: 15067026 SO - Journal of Clinical Oncology. 23(6):1330-1; author reply 1331-2, 2005 Feb 20 AS - J Clin Oncol. 23(6):1330-1; author reply 1331-2, 2005 Feb 20 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/pc [Prevention & Control] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Genetic Counseling MH - Humans MH - *Mastectomy MH - Patient Education as Topic IS - 0732-183X IL - 0732-183X DI - 23/6/1330 DO - https://dx.doi.org/10.1200/JCO.2005.05.173 PT - Comment PT - Letter ID - 15718344 [pubmed] ID - 23/6/1330 [pii] ID - 10.1200/JCO.2005.05.173 [doi] PP - ppublish LG - English DP - 2005 Feb 20 DC - 20050218 EZ - 2005/02/19 09:00 DA - 2005/03/12 09:00 DT - 2005/02/19 09:00 YR - 2005 ED - 20050311 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15718344 <414. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15633083 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kiene M AU - Hoch J FA - Kiene, M FA - Hoch, J IN - Kiene, M. Klinik fur Hand-, Brust- und Plastische Chirurgie (Chefarzt: PD Dr. J. Hoch), Klinikum Neustadt, Neustadt. marekkiene@web.de TI - [Breast cancer and quality of life--improvement by contralateral breast reconstruction and symmetrical mammaplasty?]. [German] OT - Mammakarzinom und Lebensqualitat--Gewinn durch Rekonstruktion und Angleichung der Gegenseite? SO - Handchirurgie, Mikrochirurgie, Plastische Chirurgie. 36(6):384-91, 2004 Dec AS - Handchir Mikrochir Plast Chir. 36(6):384-91, 2004 Dec NJ - Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... PI - Journal available in: Print PI - Citation processed from: Print JC - fy6, 8302815 IO - Handchir Mikrochir Plast Chir SB - Index Medicus CP - Germany MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Mammaplasty/px [Psychology] MH - *Mammaplasty MH - Middle Aged MH - *Quality of Life MH - Retrospective Studies MH - Surveys and Questionnaires MH - Time Factors AB - We present the results of a retrospective study on 71 patients who underwent breast reconstruction after uni- or bilateral breast cancer. Quality of life (QoL) was evaluated dependent on whether contralateral mammaplasties to obtain symmetry had been performed or not. We used three standardized questionnaires ("SF-36" and the EORTC-questionnaires "QLQ-C30" and "QLQ-BR23") and compared four groups of patients: Group 1: no contralateral breast cancer, but contralateral symmetrical mammaplasty (n = 31). Group 2: no contralateral breast cancer, no contralateral mammaplasty (n = 22). Group 3: contralateral breast cancer, contralateral symmetrical mammaplasty (n = 9). Group 4: contralateral breast cancer, no contralateral mammaplasty (n = 9). Patients with contralateral mammaplasty for symmetry presented statistically higher levels of QoL than patients who only underwent a surgical reconstruction of the carcinomatous breast without any contralateral mammaplasty. More detailed, group 1 manifested higher levels in 17 out of 31 QoL categories than group 2. Group 3, when compared to group 4, showed higher levels in 15 QoL categories. These objective data demonstrate that the outward appearance of the female breast as a symmetrical created organ plays a pivotal role considering QoL. There is significant need to integrate breast symmetry into our preoperative plastic-surgical planning and conversations with patients. IS - 0722-1819 IL - 0722-1819 DO - https://dx.doi.org/10.1055/s-2004-817951 PT - Comparative Study PT - English Abstract PT - Journal Article ID - 15633083 [pubmed] ID - 10.1055/s-2004-817951 [doi] PP - ppublish LG - German DP - 2004 Dec DC - 20050105 EZ - 2005/01/06 09:00 DA - 2005/03/12 09:00 DT - 2005/01/06 09:00 YR - 2004 ED - 20050311 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15633083 <415. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15569200 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chung MA AU - Cady B FA - Chung, Maureen A FA - Cady, Blake TI - Surgical treatment planning in newly diagnosed breast cancer patients at high risk for BRCA-1 or BRCA-2 mutation. CM - Comment on: Breast J. 2004 Nov-Dec;10(6):475-80; PMID: 15569201 SO - Breast Journal. 10(6):473-4, 2004 Nov-Dec AS - Breast J. 10(6):473-4, 2004 Nov-Dec NJ - The breast journal PI - Journal available in: Print PI - Citation processed from: Print JC - d1h, 9505539 IO - Breast J SB - Index Medicus CP - United States MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Predisposition to Disease MH - Humans MH - *Mastectomy/mt [Methods] MH - Mutation IS - 1075-122X IL - 1075-122X DI - TBJ21666 DO - https://dx.doi.org/10.1111/j.1075-122X.2004.21666.x PT - Comment PT - Editorial ID - 15569200 [pubmed] ID - TBJ21666 [pii] ID - 10.1111/j.1075-122X.2004.21666.x [doi] PP - ppublish LG - English DP - 2004 Nov-Dec DC - 20041130 EZ - 2004/12/01 09:00 DA - 2005/02/16 09:00 DT - 2004/12/01 09:00 YR - 2004 ED - 20050214 RD - 20041130 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15569200 <416. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15304229 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wolf L FA - Wolf, Lisa IN - Wolf, Lisa. Clinical Nurse Specialist, Breast Care, Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK. Lisa.Wolf@rmh.nthames.nhs.uk TI - The information needs of women who have undergone breast reconstruction. Part I: decision-making and sources of information. SO - European Journal of Oncology Nursing. 8(3):211-23, 2004 Sep AS - EUR J ONCOL NURS. 8(3):211-23, 2004 Sep NJ - European journal of oncology nursing : the official journal of European Oncology Nursing Society PI - Journal available in: Print PI - Citation processed from: Print JC - 100885136 IO - Eur J Oncol Nurs SB - Index Medicus SB - Nursing Journal CP - Scotland MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Focus Groups MH - Humans MH - *Mammaplasty/px [Psychology] MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Needs Assessment MH - Nursing Assessment MH - *Patient Education as Topic/mt [Methods] AB - Women diagnosed with breast cancer treated by mastectomy can choose breast reconstruction. The information needs of women undergoing this procedure have only been addressed in the research literature to a limited extent. A qualitative approach was used to explore the experiences of women who had undergone breast reconstruction with a specific focus on their views on how they considered their information needs could best be met. A purposeful sample of eight women was recruited to participate in two focus groups, each lasting 2 hours. Framework analysis was used to develop an index of key themes and sub-themes which transformed the data into a structured record which facilitated systematic analysis. This paper will present the emergent key themes regarding decision-making about mastectomy and reconstructive surgery and the sources of information perceived to be relevant when preparing for breast reconstruction. Sources of information perceived by the participants as being helpful included the surgeon, the breast care clinical nurse specialist, photographs, contact with other patients, written information, the internet, a tape of the consultation and information videotapes. The breast care clinical nurse specialist played an important role in facilitating the process of receiving information. This study provides useful insight into how health care professionals can inform and prepare women for breast reconstruction. IS - 1462-3889 IL - 1462-3889 DI - S1462388904000365 DO - https://dx.doi.org/10.1016/j.ejon.2003.12.012 PT - Journal Article ID - 15304229 [pubmed] ID - 10.1016/j.ejon.2003.12.012 [doi] ID - S1462388904000365 [pii] PP - ppublish LG - English DP - 2004 Sep DC - 20040812 EZ - 2004/08/12 05:00 DA - 2004/12/16 09:00 DT - 2004/08/12 05:00 YR - 2004 ED - 20041214 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15304229 <417. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15378473 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tseng JF AU - Kronowitz SJ AU - Sun CC AU - Perry AC AU - Hunt KK AU - Babiera GV AU - Newman LA AU - Singletary SE AU - Mirza NQ AU - Ames FC AU - Meric-Bernstam F AU - Ross MI AU - Feig BW AU - Robb GL AU - Kuerer HM FA - Tseng, Jennifer F FA - Kronowitz, Steven J FA - Sun, Charlotte C FA - Perry, Allison C FA - Hunt, Kelly K FA - Babiera, Gildy V FA - Newman, Lisa A FA - Singletary, S Eva FA - Mirza, Nadeem Q FA - Ames, Frederick C FA - Meric-Bernstam, Funda FA - Ross, Merrick I FA - Feig, Barry W FA - Robb, Geoffrey L FA - Kuerer, Henry M IN - Tseng, Jennifer F. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston 77030, USA. TI - The effect of ethnicity on immediate reconstruction rates after mastectomy for breast cancer. SO - Cancer. 101(7):1514-23, 2004 Oct 01 AS - Cancer. 101(7):1514-23, 2004 Oct 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - African Americans/px [Psychology] MH - Asian Americans/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Ethnic Groups MH - European Continental Ancestry Group/px [Psychology] MH - Female MH - Hispanic Americans/px [Psychology] MH - Humans MH - *Mammaplasty/px [Psychology] MH - *Mastectomy MH - Middle Aged MH - Retrospective Studies AB - BACKGROUND: Multiple factors may influence whether patients undergo immediate breast reconstruction along with mastectomy for breast cancer. The authors investigated whether ethnicity was an independent predictor of immediate breast reconstruction. AB - METHODS: The authors identified 1004 patients who underwent mastectomy for breast cancer during the period 2001-2002. The rates of immediate reconstruction among different ethnicities were evaluated using the chi-square test. Logistic regression was used to adjust for covariates, including age and disease stage. Medical records were analyzed to identify factors that influenced each patient's decision for or against immediate breast reconstruction. AB - RESULTS: Three hundred seventy-six women (37.5%) underwent immediate breast reconstruction: This included 20.2% of African-American women, compared with 40.0% of white women, 42.0% of Hispanic women, 42.2% of Asian women, and 10.0% of Middle Eastern women (P < 0.001). The unadjusted odds ratio (OR) for immediate reconstruction for African-Americans versus whites was 0.38 (95% confidence interval [95% CI], 0.23-0.63; P < 0.001). After multivariate analysis, this disparity persisted, with an adjusted OR of 0.34 (95% CI, 0.18-0.62; P = 0.001). Asian women had lower rates of immediate reconstruction compared with white women (adjusted OR, 0.50; 95% CI, 0.24-1.04; P = 0.06). Hispanic women did not have immediate reconstruction rates that differed significantly from white women. Middle Eastern women had lower rates of immediate reconstruction compared with white women (adjusted OR, 0.08; 95% CI, 0.02-0.38; P = 0.002), but they had a corresponding increase in the rate of delayed reconstruction. In a stepwise analysis of the decision pathway to immediate reconstruction, it was found that African-American women were less likely to be offered referrals for reconstruction, were less likely to accept offered referrals, were less likely to be offered reconstruction, and were less likely to elect reconstruction if it was offered. AB - CONCLUSIONS: African-American women underwent immediate breast reconstruction at significantly lower rates compared with white women, Hispanic women, and Asian women. After adjusting for covariates, including age and disease stage, African-American women and Asian women had lower rates of reconstruction compared with white women. The factors that contribute to these differences warrant further study. AB - Copyright (c) 2004 American Cancer Society. IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.20529 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 15378473 [pubmed] ID - 10.1002/cncr.20529 [doi] PP - ppublish LG - English DP - 2004 Oct 01 DC - 20041006 EZ - 2004/09/21 05:00 DA - 2004/10/27 09:00 DT - 2004/09/21 05:00 YR - 2004 ED - 20041025 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15378473 <418. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15316908 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rimer BK AU - Briss PA AU - Zeller PK AU - Chan EC AU - Woolf SH FA - Rimer, Barbara K FA - Briss, Peter A FA - Zeller, Paula K FA - Chan, Evelyn C Y FA - Woolf, Steven H IN - Rimer, Barbara K. Department of Health Behavior and Health Education, School of Public Health, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7295, USA. brimer@email.unc.edu TI - Informed decision making: what is its role in cancer screening?. [Review] [116 refs] SO - Cancer. 101(5 Suppl):1214-28, 2004 Sep 01 AS - Cancer. 101(5 Suppl):1214-28, 2004 Sep 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer OI - Source: KIE. 127671 OI - Source: NRCBL. VF 8.1 SB - Core Clinical Journals (AIM) SB - Bioethics Journals SB - Index Medicus CP - United States MH - Community Health Services/og [Organization & Administration] MH - *Decision Making MH - *Delivery of Health Care/og [Organization & Administration] MH - Humans MH - *Informed Consent MH - *Mass Screening MH - *Neoplasms/di [Diagnosis] MH - Neoplasms/pc [Prevention & Control] KW - Health Care and Public Health; Professional Patient Relationship AB - Interest in informed decision making (IDM) has grown in recent years. Greater patient involvement in decision making is consistent with recommendations to improve health care quality. This report provides an overview of IDM; clarifies the differences between IDM, shared decision making (SDM), and informed consent; and reviews the evidence to date about IDM for cancer screening. The authors also make recommendations for research. We define IDM as occurring when an individual understands the disease or condition being addressed and comprehends what the clinical service involves, including its benefits, risks, limitations, alternatives, and uncertainties; has considered his or her preferences and makes a decision consistent with them; and believes he or she has participated in decision making at the level desired. IDM interventions are used to facilitate informed decisions. The authors reviewed the evidence to date for IDM and cancer screening based primarily on published meta-analyses and a recent report for the Centers for Disease Control and Prevention's Guide to Community Preventive Services. IDM and SDM interventions, such as decision aids, result in improved knowledge, beliefs, risk perceptions, and combinations of these. Little or no evidence exists, however, regarding whether these interventions result in 1) participation in decision making at a level consistent with patient preferences or 2) effects on patient satisfaction with the decision-making process. These variables generally either were not assessed or were not reported in the articles reviewed. Results of interventions on uptake of screening were variable. After exposure to IDM/SDM interventions, most studies showed small decreases in prostate cancer screening, whereas four studies on breast and colorectal cancer screening showed small increases. Few data are available by which to evaluate current practices in cancer screening IDM. Patient participation in IDM should be facilitated for those who prefer it. More research is needed to assess the benefits of IDM/SDM interventions and to tailor interventions to individuals who are most likely to desire and benefit from them. There are many system barriers to IDM/SDM and few tools. More work is needed in this area as well. In addition, research is needed to learn how to incorporate IDM into ongoing clinical practice and to determine whether there are unintended negative consequences of IDM. [References: 116] NT - KIE Bib: informed consent; mass screening IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.20512 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PT - Review ID - 15316908 [pubmed] ID - 10.1002/cncr.20512 [doi] PP - ppublish GI - No: 1-R01-CA105786-01 Organization: (CA) *NCI NIH HHS* Country: United States No: 5-P30-CA16086 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2004 Sep 01 DC - 20040826 EZ - 2004/08/19 05:00 DA - 2004/10/01 05:00 DT - 2004/08/19 05:00 YR - 2004 ED - 20040930 RD - 20071114 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15316908 <419. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15310772 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - van Roosmalen MS AU - Stalmeier PF AU - Verhoef LC AU - Hoekstra-Weebers JE AU - Oosterwijk JC AU - Hoogerbrugge N AU - Moog U AU - van Daal WA FA - van Roosmalen, M S FA - Stalmeier, P F M FA - Verhoef, L C G FA - Hoekstra-Weebers, J E H M FA - Oosterwijk, J C FA - Hoogerbrugge, N FA - Moog, U FA - van Daal, W A J IN - van Roosmalen, M S. Department of Radiotherapy (341), University Medical Center Nijmegen, PO Box 9101, 6500 HB Nijmegen, the Netherlands. m.vanroosmalen@rther.umcn.nl TI - Randomized trial of a shared decision-making intervention consisting of trade-offs and individualized treatment information for BRCA1/2 mutation carriers. SO - Journal of Clinical Oncology. 22(16):3293-301, 2004 Aug 15 AS - J Clin Oncol. 22(16):3293-301, 2004 Aug 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - DNA Mutational Analysis MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - *Genetic Predisposition to Disease MH - *Genetic Testing MH - Humans MH - Life Expectancy MH - Mastectomy MH - Middle Aged MH - *Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/su [Surgery] MH - Patient Education as Topic MH - *Patient Participation MH - Patient Satisfaction MH - Quality of Life AB - PURPOSE: To evaluate a shared decision-making intervention (SDMI) for BRCA1/2 mutation carriers who have to make a choice between screening and prophylactic surgery for breasts and/or ovaries. AB - PATIENTS AND METHODS: The SDMI consisted of two value assessment sessions, using the time trade-off method, followed by individualized treatment information based on (quality-adjusted) life expectancy. After the baseline assessment (2 weeks after a positive DNA test result), women were randomly assigned to the SDMI group (n = 44), receiving the SDMI 2 months after the test result, or to the control group (n = 44). The short- and long-term effects, 3 and 9 months after the test result, were assessed using questionnaires. Data were collected on well-being, treatment choice, and decision-related outcomes. AB - RESULTS: In the short term, the SDMI had no effect. In the long term, with respect to well-being, patients in the SDMI group had less intrusive thoughts (P =.05) and better general health (P =.01) and tended to be less depressed (P =.07). With respect to decision-related outcomes for the breasts, the SDMI group held stronger preferences (P =.02) and agreed more strongly to having weighed the pros and cons (P =.01). No effect was found on treatment choice. In the long term, interaction effects between the SDMI and cancer history were found. The SDMI showed an overall beneficial effect for unaffected women, whereas affected women tended to experience detrimental effects. AB - CONCLUSION: We conclude that the SDMI improved decision making in unaffected BRCA1/2 mutation carriers. Supporting decision making in a systematic way using trade-offs is beneficial for these women. IS - 0732-183X IL - 0732-183X DI - 22/16/3293 DO - https://dx.doi.org/10.1200/JCO.2004.05.066 PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 15310772 [pubmed] ID - 10.1200/JCO.2004.05.066 [doi] ID - 22/16/3293 [pii] PP - ppublish LG - English DP - 2004 Aug 15 DC - 20040816 EZ - 2004/08/18 05:00 DA - 2004/09/03 05:00 DT - 2004/08/18 05:00 YR - 2004 ED - 20040902 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15310772 <420. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15075148 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Berry D FA - Berry, Donald IN - Berry, Donald. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Box 447, Houston, TX 77030-4009, USA. dberry@mdanderson.org TI - Commentary: screening mammography: a decision analysis. CM - Comment on: Int J Epidemiol. 2004 Feb;33(1):43-55; PMID: 15075144 SO - International Journal of Epidemiology. 33(1):68; discussion 69-73, 2004 Feb AS - Int J Epidemiol. 33(1):68; discussion 69-73, 2004 Feb NJ - International journal of epidemiology PI - Journal available in: Print PI - Citation processed from: Print JC - gr6, 7802871 IO - Int J Epidemiol SB - Index Medicus CP - England MH - *Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/mo [Mortality] MH - Decision Making MH - Decision Support Techniques MH - Diagnostic Errors MH - Female MH - Humans MH - Mammography/ae [Adverse Effects] MH - *Mammography MH - Mass Screening/ae [Adverse Effects] MH - *Mass Screening/mt [Methods] MH - Patient Education as Topic MH - Randomized Controlled Trials as Topic MH - Risk Factors IS - 0300-5771 IL - 0300-5771 DI - 33/1/68 DO - https://dx.doi.org/10.1093/ije/dyh034 PT - Journal Article PT - Comment ID - 15075148 [pubmed] ID - 10.1093/ije/dyh034 [doi] ID - 33/1/68 [pii] PP - ppublish LG - English DP - 2004 Feb DC - 20040412 EZ - 2004/04/13 05:00 DA - 2004/08/17 10:00 DT - 2004/04/13 05:00 YR - 2004 ED - 20040813 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15075148 <421. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15280348 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eng C AU - Iglehart D FA - Eng, Charis FA - Iglehart, Dirk TI - Decision aids from genetics to treatment of breast cancer: long-term clinical utility or temporary solution?. CM - Comment on: JAMA. 2004 Jul 28;292(4):442-52; PMID: 15280342 CM - Comment on: JAMA. 2004 Jul 28;292(4):435-41; PMID: 15280341 SO - JAMA. 292(4):496-8, 2004 Jul 28 AS - JAMA. 292(4):496-8, 2004 Jul 28 NJ - JAMA PI - Journal available in: Print PI - Citation processed from: Internet JC - 7501160 IO - JAMA SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making, Computer-Assisted MH - *Decision Support Techniques MH - Female MH - Genetic Testing MH - Humans MH - Mastectomy MH - *Patient Education as Topic MH - Patient Participation ES - 1538-3598 IL - 0098-7484 DI - 292/4/496 DO - https://dx.doi.org/10.1001/jama.292.4.496 PT - Comment PT - Editorial PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Research Support, U.S. Gov't, P.H.S. ID - 15280348 [pubmed] ID - 10.1001/jama.292.4.496 [doi] ID - 292/4/496 [pii] PP - ppublish LG - English DP - 2004 Jul 28 DC - 20040728 EZ - 2004/07/29 05:00 DA - 2004/08/03 05:00 DT - 2004/07/29 05:00 YR - 2004 ED - 20040802 RD - 20161017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15280348 <422. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15280341 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Whelan T AU - Levine M AU - Willan A AU - Gafni A AU - Sanders K AU - Mirsky D AU - Chambers S AU - O'Brien MA AU - Reid S AU - Dubois S FA - Whelan, Timothy FA - Levine, Mark FA - Willan, Andrew FA - Gafni, Amiram FA - Sanders, Ken FA - Mirsky, Doug FA - Chambers, Shelley FA - O'Brien, Mary Ann FA - Reid, Susan FA - Dubois, Sacha IN - Whelan, Timothy. Department of Medicine, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada. tim.whelan@hrcc.on.ca TI - Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: a randomized trial. CM - Comment in: Can J Surg. 2006 Dec;49(6):431-3; PMID: 17234074 CM - Comment in: JAMA. 2004 Jul 28;292(4):496-8; PMID: 15280348 SO - JAMA. 292(4):435-41, 2004 Jul 28 AS - JAMA. 292(4):435-41, 2004 Jul 28 NJ - JAMA PI - Journal available in: Print PI - Citation processed from: Internet JC - 7501160 IO - JAMA SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Decision Support Techniques MH - Female MH - General Surgery MH - Health Knowledge, Attitudes, Practice MH - Humans MH - *Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Patient Education as Topic MH - Patient Participation MH - Patient Satisfaction MH - Physician-Patient Relations MH - Referral and Consultation AB - CONTEXT: The long-term results of randomized trials have demonstrated equivalent survival rates for mastectomy and breast-conserving therapy for the treatment of early stage breast cancer. Consequently, the choice of treatment should be based on a patient's preferences. AB - OBJECTIVE: To evaluate the impact of a decision aid regarding the different surgical treatment options on patient decision making. AB - DESIGN AND SETTING: A cluster randomized trial for which general surgeons in the communities of central-west, and eastern Ontario, Canada, were randomly assigned to use the decision aid or not in the surgical consultation. Patients received the decision aid or not based on the surgeon seen. AB - PARTICIPANTS: Twenty surgeons participated in the study. Of the 208 eligible women with newly diagnosed clinical stage I or II breast cancer seen by study surgeons, 201 agreed to be evaluated: 94 were assigned to the decision board and 107 to usual practice. Patients were recruited from November 1999 to April 2002. AB - INTERVENTION: The decision board is a decision aid designed to help physicians inform their patients about different treatment options and to enable patients to express a preference for treatment. AB - MAIN OUTCOME MEASURES: Patient knowledge about the surgical treatment of breast cancer; decisional conflict; satisfaction with decision making; and the treatment decision following the consultation. AB - RESULTS: Patients in the decision board group had higher knowledge scores about their treatment options (66.9 vs 58.7; P<.001), had less decisional conflict (1.40 vs 1.62, P =.02), and were more satisfied with decision making (4.50 vs 4.32, P =.05) following the consultation. Patients who used the decision board were more likely to choose BCT (94% vs 76%, P =.03). AB - CONCLUSIONS: The decision board was helpful in improving communication and enabling women to make a choice regarding treatment. Such instruments should be considered by surgeons when communicating the different surgical options to women with breast cancer. ES - 1538-3598 IL - 0098-7484 DI - 292/4/435 DO - https://dx.doi.org/10.1001/jama.292.4.435 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 15280341 [pubmed] ID - 10.1001/jama.292.4.435 [doi] ID - 292/4/435 [pii] PP - ppublish LG - English DP - 2004 Jul 28 DC - 20040728 EZ - 2004/07/29 05:00 DA - 2004/08/03 05:00 DT - 2004/07/29 05:00 YR - 2004 ED - 20040802 RD - 20161017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15280341 <423. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15150557 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Molenaar S AU - Oort F AU - Sprangers M AU - Rutgers E AU - Luiten E AU - Mulder J AU - de Haes H FA - Molenaar, S FA - Oort, F FA - Sprangers, M FA - Rutgers, E FA - Luiten, E FA - Mulder, J FA - de Haes, H IN - Molenaar, S. Academic Medical Center, Department of Medical Psychology (J4-401), PO Box 22 660, 1100 DD Amsterdam, The Netherlands. J.Molenaar@amc.uva.nl TI - Predictors of patients' choices for breast-conserving therapy or mastectomy: a prospective study. SO - British Journal of Cancer. 90(11):2123-30, 2004 Jun 01 AS - Br J Cancer. 90(11):2123-30, 2004 Jun 01 NJ - British journal of cancer PI - Journal available in: Print PI - Citation processed from: Print JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409497 SB - Index Medicus CP - England MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/su [Surgery] MH - Cross-Sectional Studies MH - *Decision Making MH - Decision Support Techniques MH - Demography MH - Female MH - Forecasting MH - Humans MH - *Mastectomy MH - *Mastectomy, Segmental MH - Middle Aged MH - *Patient Satisfaction MH - Physician-Patient Relations MH - Quality of Life MH - Risk Factors MH - Social Class AB - A study was undertaken to describe the treatment preferences and choices of patients with breast cancer, and to identify predictors of undergoing breast-conserving therapy (BCT) or mastectomy (MT). Consecutive patients with stage I/II breast cancer were eligible. Information about predictor variables, including socio-demographics, quality of life, patients' concerns, decision style, decisional conflict and perceived preference of the surgeon was collected at baseline, before decision making and surgery. Patients received standard information (n=88) or a decision aid (n=92) as a supplement to support decision making. A total of 180 patients participated in the study. In all, 72% decided to have BCT (n=123); 28% chose MT (n=49). Multivariate analysis showed that what patients perceived to be their surgeons' preference and the patients' concerns regarding breast loss and local tumour recurrence were the strongest predictors of treatment preference. Treatment preferences in itself were highly predictive of the treatment decision. The decision aid did not influence treatment choice. The results of this study demonstrate that patients' concerns and their perceptions of the treatment preferences of the physicians are important factors in patients' decision making. Adequate information and communication are essential to base treatment decisions on realistic concerns, and the treatment preferences of patients. IS - 0007-0920 IL - 0007-0920 DI - 6601835 DO - https://dx.doi.org/10.1038/sj.bjc.6601835 PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't ID - 15150557 [pubmed] ID - 10.1038/sj.bjc.6601835 [doi] ID - 6601835 [pii] ID - PMC2409497 [pmc] PP - ppublish LG - English DP - 2004 Jun 01 DC - 20040527 EZ - 2004/05/20 05:00 DA - 2004/07/16 05:00 DT - 2004/05/20 05:00 YR - 2004 ED - 20040715 RD - 20140609 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15150557 <424. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15106493 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Vodermaier A AU - Caspari C AU - Kohm J AU - Bauerfeind I AU - Kahlert S AU - Untch M FA - Vodermaier, Andrea FA - Caspari, Cornelia FA - Kohm, Janna FA - Bauerfeind, Ingo FA - Kahlert, Steffen FA - Untch, Michael IN - Vodermaier, Andrea. Ludwig-Maximilians-Universitat Munchen, Klinik und Poliklinik fur Frauenheilkunde und Geburtshilfe-Grosshadern, Munchen. Vodermaier@med.uni-muenchen.de TI - [Shared decision-making in primary breast cancer]. [German] OT - Partizipative Entscheidungsfindung beim primaren Mammakarzinom. SO - Zeitschrift fur Arztliche Fortbildung und Qualitatssicherung. 98(2):127-33, 2004 Mar AS - Z Arztl Fortbild Qualitatssich. 98(2):127-33, 2004 Mar NJ - Zeitschrift fur arztliche Fortbildung und Qualitatssicherung PI - Journal available in: Print PI - Citation processed from: Print JC - ct5, 9707934 IO - Z Arztl Fortbild Qualitatssich SB - Index Medicus CP - Germany MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Emotions MH - Female MH - Humans MH - *Patient Participation/px [Psychology] MH - Physician-Patient Relations MH - Truth Disclosure AB - Following an overall view of the emotional situation of primary breast cancer patients and of studies exploring shared decision making in this setting we present the results of qualitative analyses about breaking bad news situations and interviews with this group of patients and describe both methods for implementing shared decision making in the treatment of primary breast cancer and an evaluation study. The main result was that most patients showed a lack of information about breast cancer and its therapy, which led to uncertainty. Another source of uncertainty was the lack of preoperative punch biopsy. Due to the so-called "diagnostic shock" patients felt under pressure to make a quick decision over their treatment. This perceived pressure can be effectively countered by a shared decision making approach. To investigate the options in breast cancer therapy, decision aids for diagnostic and therapeutic options have been developed focusing on the following treatment modalities: 1. breast conserving therapy and radiation versus radical mastectomy 2. chemotherapy plus endocrine therapy versus endocrine therapy alone 3. preoperative versus postoperative chemotherapy. The decision instruments in question were tested in N = 35 breast cancer patients and N = 36 nurses as a control group. The results of a questionnaire survey among both these groups revealed a very positive appraisal of the decision aids. Implementation in daily routine was favoured. IS - 1431-7621 IL - 1431-7621 PT - English Abstract PT - Journal Article ID - 15106493 [pubmed] PP - ppublish LG - German DP - 2004 Mar DC - 20040426 EZ - 2004/04/27 05:00 DA - 2004/07/02 05:00 DT - 2004/04/27 05:00 YR - 2004 ED - 20040701 RD - 20081103 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15106493 <425. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15135682 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Duncan M AU - Cech A AU - Wechter D AU - Moonka R FA - Duncan, Mona FA - Cech, Amy FA - Wechter, Debra FA - Moonka, Ravi IN - Duncan, Mona. Department of General, Vascular, and Thoracic Surgery, Virginia Mason Medical Center, C6-GSUR, PO Box 900, 1100 Ninth Ave., Seattle, WA 98111, USA. TI - Criteria for establishing the adequacy of a sentinel lymphadenectomy. SO - American Journal of Surgery. 187(5):639-42; discussion 642, 2004 May AS - Am J Surg. 187(5):639-42; discussion 642, 2004 May NJ - American journal of surgery PI - Journal available in: Print PI - Citation processed from: Print JC - 3z4, 0370473 IO - Am. J. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Axilla MH - Biopsy/st [Standards] MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - Decision Support Techniques MH - Evidence-Based Medicine MH - False Negative Reactions MH - Humans MH - Mastectomy MH - Neoplasm Staging/mt [Methods] MH - Neoplasm Staging/st [Standards] MH - Neoplasm Staging/sn [Statistics & Numerical Data] MH - *Practice Guidelines as Topic/st [Standards] MH - Radionuclide Imaging MH - Radiopharmaceuticals MH - Rosaniline Dyes MH - Sensitivity and Specificity MH - Sentinel Lymph Node Biopsy/mt [Methods] MH - Sentinel Lymph Node Biopsy/st [Standards] MH - Sentinel Lymph Node Biopsy/sn [Statistics & Numerical Data] MH - *Sentinel Lymph Node Biopsy MH - Technetium Tc 99m Sulfur Colloid MH - Washington AB - BACKGROUND: Criteria are needed that could be used to terminate a sentinel lymphadenectomy for breast cancer prior to removing every sentinel lymph node, without increasing false negative rates. AB - METHODS: Quantitative information on the radioactivity and color of sentinel lymph nodes removed from 541 breast cancer patients was correlated with pathologic information to determine when a sentinel lymphadenectomy could be terminated based on characteristics of the initially removed nodes. AB - RESULTS: Tumor was found in the first two sentinel lymph nodes removed in 127 of 129 node-positive patients. In 65% of patients who were able to be evaluated, the most radioactive lymph node was a positive lymph node. When any axillary lymph node was blue, then the first tumor-containing sentinel lymph node was also blue. AB - CONCLUSIONS: Removal of the most radioactive lymph node does not insure accurate assessment of the axilla. Removal of two sentinel lymph nodes accurately staged 98.4% of node-positive patients and 99.6% of the entire study population. RN - 0 (Radiopharmaceuticals) RN - 0 (Rosaniline Dyes) RN - 39N9K8S2A4 (iso-sulfan blue) RN - 556Q0P6PB1 (Technetium Tc 99m Sulfur Colloid) IS - 0002-9610 IL - 0002-9610 DI - S0002961004000753 DO - https://dx.doi.org/10.1016/j.amjsurg.2004.01.017 PT - Comparative Study PT - Journal Article PT - Validation Studies ID - 15135682 [pubmed] ID - 10.1016/j.amjsurg.2004.01.017 [doi] ID - S0002961004000753 [pii] PP - ppublish PH - 2003/12/11 [received] PH - 2004/01/18 [revised] LG - English DP - 2004 May DC - 20040511 EZ - 2004/05/12 05:00 DA - 2004/06/21 10:00 DT - 2004/05/12 05:00 YR - 2004 ED - 20040610 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15135682 <426. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15067026 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schwartz MD AU - Lerman C AU - Brogan B AU - Peshkin BN AU - Halbert CH AU - DeMarco T AU - Lawrence W AU - Main D AU - Finch C AU - Magnant C AU - Pennanen M AU - Tsangaris T AU - Willey S AU - Isaacs C FA - Schwartz, Marc D FA - Lerman, Caryn FA - Brogan, Barbara FA - Peshkin, Beth N FA - Halbert, Chanita Hughes FA - DeMarco, Tiffani FA - Lawrence, William FA - Main, David FA - Finch, Clinton FA - Magnant, Colette FA - Pennanen, Marie FA - Tsangaris, Theodore FA - Willey, Shawna FA - Isaacs, Claudine IN - Schwartz, Marc D. Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA. schwartm@georgetown.edu TI - Impact of BRCA1/BRCA2 counseling and testing on newly diagnosed breast cancer patients. CM - Comment in: J Clin Oncol. 2005 Feb 20;23(6):1330-1; author reply 1331-2; PMID: 15718344 CM - Comment in: J Clin Oncol. 2005 May 1;23(13):3165-6; author reply 3166-7; PMID: 15860891 CM - Comment in: J Clin Oncol. 2004 May 15;22(10):1776-7; PMID: 15067025 SO - Journal of Clinical Oncology. 22(10):1823-9, 2004 May 15 AS - J Clin Oncol. 22(10):1823-9, 2004 May 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Counseling MH - *Genetic Testing MH - Humans MH - *Mastectomy/mt [Methods] MH - Middle Aged MH - Prospective Studies AB - PURPOSE: Approximately 5% to 10% of newly diagnosed breast cancer patients carry a BRCA1 or BRCA2 mutation. Given these patients' high risk for contralateral breast cancer, bilateral mastectomy is increasingly considered a treatment option for newly diagnosed BRCA1/2 carriers. In the present study, we prospectively evaluated the impact on surgical decision-making of pretreatment genetic counseling and BRCA1/BRCA2 testing among breast cancer patients at high-risk for carrying a mutation. AB - PATIENTS AND METHODS: Participants were 194 newly diagnosed breast cancer patients who had not yet received definitive surgical treatment and who had at least a 10% prior probability of carrying a BRCA1/2 mutation. Participants were offered free genetic counseling and rapid BRCA1/2 testing. Primary analyses focused on the impact of BRCA1/2 test result on subsequent breast cancer surgical treatment. AB - RESULTS: Forty-eight percent of patients who were found to carry a BRCA1/2 mutation chose bilateral mastectomy as their definitive breast cancer surgery. In contrast, 24% of patients in whom no mutation was detected and 4% of test decliners opted for bilateral mastectomy. Additional predictors of bilateral mastectomy included patients' self-reports of physician recommendations for BRCA1/2 testing and bilateral mastectomy. AB - CONCLUSION: This study highlights patient interest in and the technical feasibility of offering presurgery BRCA1/2 testing to high-risk patients. Most importantly, these results demonstrate that BRCA1/2 test results significantly affect patients' surgical decision-making. The availability of genetic counseling and testing could serve as a valuable aid to patient decision-making for newly diagnosed breast cancer patients at high-risk for carrying a mutation. IS - 0732-183X IL - 0732-183X DI - JCO.2004.04.086 DO - https://dx.doi.org/10.1200/JCO.2004.04.086 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 15067026 [pubmed] ID - 10.1200/JCO.2004.04.086 [doi] ID - JCO.2004.04.086 [pii] PP - ppublish GI - No: K07 CA65597 Organization: (CA) *NCI NIH HHS* Country: United States No: R01 CA/HG74861 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20040405 DP - 2004 May 15 DC - 20040514 EZ - 2004/04/07 05:00 DA - 2004/06/04 05:00 DT - 2004/04/07 05:00 YR - 2004 ED - 20040603 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15067026 <427. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15114125 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Thoma A AU - Veltri K AU - Khuthaila D AU - Rockwell G AU - Duku E FA - Thoma, Achilleas FA - Veltri, Karen FA - Khuthaila, Dana FA - Rockwell, Gloria FA - Duku, Eric IN - Thoma, Achilleas. Department of Surgery, Division of Plastic and Reconstructive Surgery, St. Joseph's Healthcare, Surgical Outcomes Research Centre (SOURCE), 206 James Street South, Suite 101, Hamilton, Ontario L8P 3A9, Canada. athoma@mcmaster.ca TI - Comparison of the deep inferior epigastric perforator flap and free transverse rectus abdominis myocutaneous flap in postmastectomy reconstruction: a cost-effectiveness analysis. SO - Plastic & Reconstructive Surgery. 113(6):1650-61, 2004 May AS - Plast Reconstr Surg. 113(6):1650-61, 2004 May NJ - Plastic and reconstructive surgery PI - Journal available in: Print PI - Citation processed from: Print JC - 1306050, p9s IO - Plast. Reconstr. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Abdominal Wall MH - Canada MH - Cost-Benefit Analysis MH - Epigastric Arteries MH - Female MH - Humans MH - *Mammaplasty/ec [Economics] MH - Mammaplasty/mt [Methods] MH - Mastectomy MH - Postoperative Complications/ec [Economics] MH - Probability MH - Quality-Adjusted Life Years MH - Surgical Flaps/bs [Blood Supply] MH - *Surgical Flaps/ec [Economics] AB - This study compared the deep inferior epigastric perforator (DIEP) flap and the free transverse rectus abdominis myocutaneous (TRAM) flap in postmastectomy reconstruction using a cost-effectiveness analysis. A decision analytic model was used. Medical costs associated with the two techniques were estimated from the Ontario Ministry of Health Schedule of Benefits for 2002. Hospital costs were obtained from St. Joseph's Healthcare, a university teaching hospital in Hamilton, Ontario, Canada. The utilities of clinically important health states related to breast reconstruction were obtained from 32 "experts" across Canada and converted into quality-adjusted life years. The probabilities of these various clinically important health states being associated with the DIEP and free TRAM flaps were obtained after a thorough review of the literature. The DIEP flap was more costly than the free TRAM flap ($7026.47 versus $6508.29), but it provided more quality-adjusted life years than the free TRAM flap (28.88 years versus 28.53 years). The baseline incremental cost-utility ratio was $1464.30 per quality-adjusted life year, favoring adoption of the DIEP flap. Sensitivity analyses were performed by assuming that the probabilities of occurrence of hernia, abdominal bulging, total flap loss, operating room time, and hospital stay were identical with the DIEP and free TRAM techniques. By assuming that the probability of postoperative hernia for the DIEP flap increased from 0.008 to 0.054 (same as for TRAM flap), the incremental cost-utility ratio changed to $1435.00 per quality-adjusted life year. A sensitivity analysis was performed for the complication of hernia because the DIEP flap allegedly diminishes this complication. Increasing the probability of abdominal bulge from 0.041 to 0.103 for the DIEP flap changed the ratio to $2731.78 per quality-adjusted life year. When the probability of total flap failure was increased from 0.014 to 0.016, the ratio changed to $1384.01 per quality-adjusted life year. When the time in the operating room was assumed to be the same for both flaps, the ratio changed to $4026.57 per quality-adjusted life year. If the hospital stay was assumed to be the same for both flaps, the ratio changed to $1944.30 per quality-adjusted life year. On the basis of the baseline calculation and sensitivity analyses, the DIEP flap remained a cost-effective procedure. Thus, adoption of this new technique for postmastectomy reconstruction is warranted in the Canadian health care system. IS - 0032-1052 IL - 0032-1052 DI - 00006534-200405000-00014 PT - Comparative Study PT - Journal Article ID - 15114125 [pubmed] ID - 00006534-200405000-00014 [pii] PP - ppublish LG - English DP - 2004 May DC - 20040428 EZ - 2004/04/29 05:00 DA - 2004/05/27 05:00 DT - 2004/04/29 05:00 YR - 2004 ED - 20040525 RD - 20150624 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15114125 <428. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15015707 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Esserman L AU - Sepucha K AU - Ozanne E AU - Hwang ES FA - Esserman, Laura FA - Sepucha, Karen FA - Ozanne, Elissa FA - Hwang, E Shelley IN - Esserman, Laura. Department of Surgery, University of California San Francisco Medical Center, San Francisco, California 94115, USA. laura.esserman@ucsfmedctr.org TI - Applying the neoadjuvant paradigm to ductal carcinoma in situ. SO - Annals of Surgical Oncology. 11(1 Suppl):28S-36S, 2004 Jan AS - Ann Surg Oncol. 11(1 Suppl):28S-36S, 2004 Jan NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/ep [Epidemiology] MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma, Intraductal, Noninfiltrating/ep [Epidemiology] MH - *Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - Chemotherapy, Adjuvant MH - Cyclooxygenase Inhibitors/tu [Therapeutic Use] MH - Decision Support Techniques MH - Disease Progression MH - Female MH - Humans MH - Magnetic Resonance Imaging MH - Mastectomy, Segmental MH - *Neoadjuvant Therapy MH - Radiotherapy, Adjuvant MH - Risk Assessment MH - Sensitivity and Specificity AB - Local treatment options for ductal carcinoma in situ (DCIS) are virtually identical to those for early invasive breast cancer, despite the fact that the survival from this condition is much higher. Our ability to more appropriately tailor therapy for DCIS is hampered by a lack of understanding of the natural history of DCIS, our limited ability to predict the rate of progression to invasive cancer and the response to therapy, and the absence of tools to follow patients who have not had invasive treatments. Neoadjuvant therapy, which has been proven to be both safe and effective in tailoring treatments for invasive cancer, could be ideally suited to DCIS. However, neoadjuvant therapy requires that doctors and patients delay surgical treatment that has known benefits. In order to successfully introduce this approach into clinical practice, risk assessment and decision support tools will be needed to help physicians and patients feel comfortable that they are not being exposed to unnecessary or excessive risk. In addition, we need better imaging to track extent and progression of disease. Among the possible benefits of the neoadjuvant approach, we may discover that many lesions are responsive and some even reversible, leaving us with treatments that might be tailored to biology and with important clues for breast cancer prevention in high-risk women. RN - 0 (Cyclooxygenase Inhibitors) IS - 1068-9265 IL - 1068-9265 PT - Journal Article ID - 15015707 [pubmed] PP - ppublish LG - English DP - 2004 Jan DC - 20040312 EZ - 2004/03/16 05:00 DA - 2004/04/24 05:00 DT - 2004/03/16 05:00 YR - 2004 ED - 20040423 RD - 20070718 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15015707 <429. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 15055844 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chao C AU - Abell T AU - Martin RC 2nd AU - McMasters KM FA - Chao, Celia FA - Abell, Troy FA - Martin, Robert C G 2nd FA - McMasters, Kelly M IN - Chao, Celia. Department of Surgery, University of Texas Medical Branch, Galveston 77555-0527, USA. TI - Intraoperative frozen section of sentinel nodes: a formal decision analysis. SO - American Surgeon. 70(3):215-20; discussion 220-1, 2004 Mar AS - Am Surg. 70(3):215-20; discussion 220-1, 2004 Mar NJ - The American surgeon PI - Journal available in: Print PI - Citation processed from: Print JC - 43e, 0370522 IO - Am Surg SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Biopsy, Needle MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Support Techniques MH - Disease-Free Survival MH - Female MH - *Frozen Sections MH - Humans MH - Immunohistochemistry MH - Intraoperative Care/mt [Methods] MH - *Lymph Nodes/pa [Pathology] MH - Mastectomy/mt [Methods] MH - Middle Aged MH - Neoplasm Staging MH - Probability MH - Prognosis MH - *Quality of Life MH - Retrospective Studies MH - Risk Assessment MH - Sampling Studies MH - Sensitivity and Specificity MH - *Sentinel Lymph Node Biopsy MH - Survival Analysis MH - Treatment Outcome AB - In the absence of data from randomized trials, a formal decision analysis was undertaken to quantify the relative value of the patients' quality of life with regard to performing intraoperative frozen section (FS) versus permanent section (PS) analysis of the sentinel lymph node (SLN) for breast cancer. Assumptions for this analysis were based on data from 203 nodal basins where the prevalence of nodal metastasis was 26.1 per cent; the FS sensitivity was 68 per cent and FS false-positive rate was 0.7 per cent. DATA 4.0 was used to model the decision analysis. The two branches of the tree represent the two surgical options of either FS analysis intraoperatively, accompanied by immediate axillary dissection for positive nodes versus PS analysis followed by reoperative axillary dissection. The expected utility (EU) with the FS strategy is 0.9736; the EU for PS is 0.9732, suggesting no definite preference for either procedure. Overall, the toss-up is very robust. The decision to choose FS versus PS should be based on individual patient risk and preference because the decision analysis indicated that these two options are equivalent with respect to patient quality of life. IS - 0003-1348 IL - 0003-1348 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 15055844 [pubmed] PP - ppublish LG - English DP - 2004 Mar DC - 20040401 EZ - 2004/04/02 05:00 DA - 2004/04/17 05:00 DT - 2004/04/02 05:00 YR - 2004 ED - 20040416 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=15055844 <430. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 14981106 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Armstrong K AU - Schwartz JS AU - Randall T AU - Rubin SC AU - Weber B FA - Armstrong, Katrina FA - Schwartz, J Sanford FA - Randall, Thomas FA - Rubin, Stephen C FA - Weber, Barbara IN - Armstrong, Katrina. Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. karmstro@mail.med.upenn.edu TI - Hormone replacement therapy and life expectancy after prophylactic oophorectomy in women with BRCA1/2 mutations: a decision analysis. CM - Comment in: J Clin Oncol. 2004 Mar 15;22(6):978-80; PMID: 14981100 SO - Journal of Clinical Oncology. 22(6):1045-54, 2004 Mar 15 AS - J Clin Oncol. 22(6):1045-54, 2004 Mar 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Cohort Studies MH - *Decision Support Techniques MH - Estrogen Replacement Therapy/ae [Adverse Effects] MH - *Estrogen Replacement Therapy MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Predisposition to Disease MH - Humans MH - *Life Expectancy MH - Markov Chains MH - Middle Aged MH - Mutation MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - *Postoperative Care MH - Risk MH - Treatment Outcome AB - PURPOSE: The decision about prophylactic oophorectomy is difficult for many premenopausal women with BRCA1/2 mutations because of concerns and controversy about the use of hormone replacement therapy (HRT) after oophorectomy. AB - PATIENTS AND METHODS: A Markov decision analytic model used the most current epidemiologic data to assess the expected outcomes of prophylactic oophorectomy with or without HRT (to age 50 years or for life) in cohorts of women with BRCA1/2 mutations. Sensitivity analyses were conducted to assess the impact of alternative assumptions about effects of HRT, effects of prophylactic oophorectomy, and risks of cancer associated with BRCA1/2 mutations. AB - RESULTS: In our model, prophylactic oophorectomy lengthened life expectancy in women with BRCA1/2 mutations, irrespective of whether HRT was used after oophorectomy. This gain ranged from 3.34 to 4.65 years, depending on age at oophorectomy. Use of HRT after oophorectomy was associated with relatively small changes in life expectancy (+0.17 to -0.34 years) when HRT was stopped at age 50, but larger decrements in life expectancy if HRT was continued for life (-0.79 to -1.09 years). HRT was associated with a gain in life expectancy of between 0.39 and 0.79 years for mutation carriers undergoing both prophylactic mastectomy and oophorectomy. AB - CONCLUSION: On the basis of the results of this decision analysis, we recommend that women with BRCA1/2 mutations undergo prophylactic oophorectomy after completion of childbearing, decide about short-term HRT after oophorectomy based largely on quality-of-life issues rather than life expectancy, and, if using HRT, consider discontinuing treatment at the time of expected natural menopause, approximately age 50 years. IS - 0732-183X IL - 0732-183X DI - JCO.2004.06.090 DO - https://dx.doi.org/10.1200/JCO.2004.06.090 PT - Journal Article ID - 14981106 [pubmed] ID - 10.1200/JCO.2004.06.090 [doi] ID - JCO.2004.06.090 [pii] PP - ppublish LG - English EP - 20040223 DP - 2004 Mar 15 DC - 20040315 EZ - 2004/02/26 05:00 DA - 2004/04/09 05:00 DT - 2004/02/26 05:00 YR - 2004 ED - 20040408 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=14981106 <431. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 14735173 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - van Roosmalen MS AU - Stalmeier PF AU - Verhoef LC AU - Hoekstra-Weebers JE AU - Oosterwijk JC AU - Hoogerbrugge N AU - Moog U AU - van Daal WA FA - van Roosmalen, M S FA - Stalmeier, P F M FA - Verhoef, L C G FA - Hoekstra-Weebers, J E H M FA - Oosterwijk, J C FA - Hoogerbrugge, N FA - Moog, U FA - van Daal, W A J IN - van Roosmalen, M S. Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN), University Medical Center Nijmegen, Nijmegen, The Netherlands. m.vanroosmalen@rther.umcn.nl TI - Randomised trial of a decision aid and its timing for women being tested for a BRCA1/2 mutation. SO - British Journal of Cancer. 90(2):333-42, 2004 Jan 26 AS - Br J Cancer. 90(2):333-42, 2004 Jan 26 NJ - British journal of cancer PI - Journal available in: Print PI - Citation processed from: Print JC - av4, 0370635 IO - Br. J. Cancer PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410151 SB - Index Medicus CP - England MH - Adult MH - Attitude to Health MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - DNA Mutational Analysis MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - *Genetic Counseling MH - *Genetic Predisposition to Disease MH - *Genetic Testing MH - Humans MH - Mastectomy MH - Middle Aged MH - Pamphlets MH - *Patient Education as Topic MH - Prognosis MH - Risk Factors MH - Time Factors MH - Video Recording AB - The aim of the study was to evaluate the impact of a decision aid (DA) and its timing in women being tested for a BRCA1/2 mutation. Women with and without a previous history of cancer were included after blood sampling for genetic testing. The DA consisted of a brochure and video providing information on screening and prophylactic surgery. To evaluate the impact of the DA, women were randomised to the DA group (n=184), receiving the DA 2 weeks after blood sampling, or to the control group (n=184). To evaluate the impact of timing, mutation carriers who had received the DA before the test result (n=47) were compared to mutation carriers who received the DA after the test result (n=42). Data were collected on well-being, treatment choice, decision and information related outcomes. The impact of the DA was measured 4 weeks after blood sampling. The impact of timing was measured 2 weeks after a positive test result. The DA had no impact on well-being. Regarding decision related outcomes, the DA group more frequently considered prophylactic surgery (P=0.02) corroborated with higher valuations (P=0.04). No differences were found for the other decision related outcomes. Regarding information related outcomes, the DA group felt better informed (P=0.00), was more satisfied with the information (P=0.00), and showed more accurate risk perceptions. Timing of the DA had no effect on any of the outcomes. No interactions were found between the DA and history of cancer. In conclusion, women being tested for a BRCA1/2 mutation benefit from the DA on information related outcomes. Because timing had no effect, the DA is considered useful either before or after the test result. IS - 0007-0920 IL - 0007-0920 DI - 6601525 DO - https://dx.doi.org/10.1038/sj.bjc.6601525 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial ID - 14735173 [pubmed] ID - 10.1038/sj.bjc.6601525 [doi] ID - 6601525 [pii] ID - PMC2410151 [pmc] PP - ppublish LG - English DP - 2004 Jan 26 DC - 20040121 EZ - 2004/01/22 05:00 DA - 2004/03/05 05:00 DT - 2004/01/22 05:00 YR - 2004 ED - 20040304 RD - 20140610 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med5&AN=14735173 <432. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 14725910 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Racadot S AU - Marchal C AU - Charra-Brunaud C AU - Verhaeghe JL AU - Peiffert D AU - Bey P FA - Racadot, S FA - Marchal, C FA - Charra-Brunaud, C FA - Verhaeghe, J-L FA - Peiffert, D FA - Bey, P IN - Racadot, S. Service de radiotherapie, centre Alexis-Vautrin, avenue de Bourgogne, 54511 Vandoeuvre-les-Nancy, France. sracadot@wanadoo.fr TI - [Re-irradiation after salvage mastectomy for local recurrence after a conservative treatment: a retrospective analysis of twenty patients (Nancy: 1988-2001)]. [French] OT - Re-irradiation parietale apres mastectomie de rattrapage pour recidive d'un cancer du sein apres traitement conservateur : etude retrospective sur 20 patientes (Nancy : 1988-2001). SO - Cancer Radiotherapie. 7(6):369-79, 2003 Dec AS - Cancer Radiother. 7(6):369-79, 2003 Dec NJ - Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique PI - Journal available in: Print PI - Citation processed from: Print JC - cqv, 9711272 IO - Cancer Radiother SB - Index Medicus CP - France MH - Adult MH - Aged MH - Brachytherapy MH - Breast/pa [Pathology] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/dt [Drug Therapy] MH - Carcinoma, Ductal, Breast/mo [Mortality] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - *Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - Carcinoma, Lobular/dt [Drug Therapy] MH - Carcinoma, Lobular/mo [Mortality] MH - Carcinoma, Lobular/pa [Pathology] MH - *Carcinoma, Lobular/rt [Radiotherapy] MH - Carcinoma, Lobular/su [Surgery] MH - Chemotherapy, Adjuvant MH - Chi-Square Distribution MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Lymphatic Metastasis MH - *Mastectomy MH - Middle Aged MH - Neoplasm Metastasis MH - Neoplasm Recurrence, Local/dt [Drug Therapy] MH - Neoplasm Recurrence, Local/mo [Mortality] MH - Neoplasm Recurrence, Local/pa [Pathology] MH - *Neoplasm Recurrence, Local/rt [Radiotherapy] MH - Neoplasm Recurrence, Local/su [Surgery] MH - Radiotherapy/ae [Adverse Effects] MH - Radiotherapy Dosage MH - Retrospective Studies MH - *Salvage Therapy MH - Time Factors AB - PURPOSE: To retrospectively assess the efficacy of post-mastectomy re-irradiation for local relapse of breast cancer. AB - PATIENTS AND METHODS: Twenty patients, initially treated by conservative surgery and radiotherapy (50 Gy in 25 fractions over 5 weeks) were treated from 1998 to 2001 for a local relapse by salvage mastectomy and re-irradiation (either electron or photon beams). Mean age was 53 years (31-71). Reasons for re-irradiation were that the local relapses were inflammatory (4 pts), multifocal (5 pts), cutaneous (5 pts), involved the nipple (3 pts) or because the surgical margins (either muscle or skin) were involved (3 pts). The median dose of re-irradiation was 45 Gy (33-65) in 15 fractions over 33 days. Mean follow-up was 48 months (5-97). AB - RESULTS: Fifteen patients remained free of a second local recurrence and 10 were still alive, without metastasis. Neither the dose of re-irradiation nor the irradiated surfaces were prognostic factors of local control (P = 0.877 and P = 0.424). Five patients developed radiation-induced pneumonitis without functional respiratory impairment. The incidence of pneumonitis seemed to be related to the biological dose of re-irradiation (P = 0.037). Other late complications occurred such as pigmentation changes (12 pts), telangiectasia (8 pts), chondritis (2 pts), parietal fibrosis (7 pts), rib fractures (4 pts), severe pain (11 pts) and lymphedema (2 pts). The increase in biological equivalent dose was highly statistically linked with the occurrence of disabling pain (P = 0.0123). AB - CONCLUSION: Parietal re-irradiation achieves good and lasting local control with an acceptable rate of acute complications but with a risk of disabling late sequelae such as severe pain. IS - 1278-3218 IL - 1278-3218 DI - S1278321803001161 PT - Comparative Study PT - English Abstract PT - Journal Article ID - 14725910 [pubmed] ID - S1278321803001161 [pii] PP - ppublish LG - French DP - 2003 Dec DC - 20040116 EZ - 2004/01/17 05:00 DA - 2004/02/28 05:00 DT - 2004/01/17 05:00 YR - 2003 ED - 20040227 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14725910 <433. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12942517 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Thoma A AU - Khuthaila D AU - Rockwell G AU - Veltri K FA - Thoma, Achilleas FA - Khuthaila, Dana FA - Rockwell, Gloria FA - Veltri, Karen IN - Thoma, Achilleas. Division of Plastic and Reconstructive Surgery, Department of Surgery, St. Joseph's Healthcare, Surgical Outcomes Research Centre and McMaster University, Hamilton, Ontario, Canada. athoma@mcmaster.ca TI - Cost-utility analysis comparing free and pedicled TRAM flap for breast reconstruction. SO - Microsurgery. 23(4):287-95, 2003 AS - Microsurgery. 23(4):287-95, 2003 NJ - Microsurgery PI - Journal available in: Print PI - Citation processed from: Print JC - mis, 8309230 IO - Microsurgery SB - Index Medicus CP - United States MH - Cost-Benefit Analysis MH - Costs and Cost Analysis MH - *Decision Support Techniques MH - Female MH - Hospital Costs/sn [Statistics & Numerical Data] MH - Humans MH - *Mammaplasty/ec [Economics] MH - Mammaplasty/mt [Methods] MH - National Health Programs/ec [Economics] MH - Ontario MH - Quality-Adjusted Life Years MH - Surgical Flaps/ec [Economics] MH - *Surgical Flaps AB - The purpose of this study was to compare the free TRAM to the unipedicled TRAM flap in postmastectomy reconstruction, using a cost-utility analysis. A decision analytic model was used for this study. Medical costs associated with the two techniques were estimated from the Ontario Ministry of Health Schedule of Benefits (1998). Hospital costs were obtained from St. Joseph's Healthcare, a university hospital in Hamilton, Ontario. Utilities were obtained from 33 "experts" across Canada and then converted into quality-adjusted life-years (QALYs). The probabilities of various health states associated with unipedicled and free TRAM flaps were obtained by reviewing several key articles. The free TRAM flap was more costly than the unipedicled TRAM flap, but it provided more QALYs. The baseline incremental cost-utility ratio (ICUR) was $5,113.73/QALY, favoring adoption of the free TRAM flap. This study showed that the free TRAM flap is a cost-effective procedure for postmastectomy reconstruction in the Canadian healthcare system. AB - Copyright 2003 Wiley-Liss, Inc. MICROSURGERY 23:287-295 2003 IS - 0738-1085 IL - 0738-1085 DO - https://dx.doi.org/10.1002/micr.10138 PT - Comparative Study PT - Journal Article ID - 12942517 [pubmed] ID - 10.1002/micr.10138 [doi] PP - ppublish LG - English DP - 2003 DC - 20030827 EZ - 2003/08/28 05:00 DA - 2004/01/09 05:00 DT - 2003/08/28 05:00 YR - 2003 ED - 20040108 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12942517 <434. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 14581440 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chao C AU - Studts JL AU - Abell T AU - Hadley T AU - Roetzer L AU - Dineen S AU - Lorenz D AU - YoussefAgha A AU - McMasters KM FA - Chao, Celia FA - Studts, Jamie L FA - Abell, Troy FA - Hadley, Terence FA - Roetzer, Lynne FA - Dineen, Sean FA - Lorenz, Doug FA - YoussefAgha, Ahmed FA - McMasters, Kelly M IN - Chao, Celia. Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Route 0527, Galveston, TX 77555-0527, USA. cechao@utmb.edu TI - Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making. CM - Comment in: J Clin Oncol. 2003 Dec 1;21(23):4263-4; PMID: 14581445 SO - Journal of Clinical Oncology. 21(23):4299-305, 2003 Dec 01 AS - J Clin Oncol. 21(23):4299-305, 2003 Dec 01 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/mo [Mortality] MH - Chemotherapy, Adjuvant MH - *Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Lymph Nodes/pa [Pathology] MH - Male MH - Mastectomy/mt [Methods] MH - Middle Aged MH - Neoplasm Invasiveness MH - *Neoplasm Recurrence, Local/dt [Drug Therapy] MH - Prognosis MH - Receptors, Estrogen/an [Analysis] MH - Risk Assessment MH - Risk Factors MH - *Risk Reduction Behavior MH - Surveys and Questionnaires MH - Survival Rate MH - Tamoxifen/tu [Therapeutic Use] MH - Treatment Outcome AB - PURPOSE: The purpose of this study was to examine the impact of four methods of communicating survival benefits on chemotherapy decisions. We hypothesized that the four methods of communicating mathematically equivalent risk information would lead to different chemotherapy decisions. AB - METHODS: Each participant received two hypothetical scenarios regarding their mother (a postmenopausal woman with an invasive, lymph node-negative, hormone receptor-positive breast cancer) and was asked to decide whether they would encourage their mother to take chemotherapy in addition to surgery and tamoxifen. In the part 1, participants received one of four methods of describing the chemotherapy survival benefit: (1) relative risk reduction, (2) absolute risk reduction, (3) absolute survival benefit, or (4) number needed to treat. In part 2, each participant received all four methods. Following each decision, participants were asked to rate their confidence and confusion regarding their decision. AB - RESULTS: Participants included 203 preclinical medical students. In part 1, participants who received relative risk reduction information were significantly more likely to endorse chemotherapy. In part 2, there were no treatment decision differences when participants received all four methods of communicating survival benefits of chemotherapy. However, receiving all four methods led to significantly higher ratings of confusion. In deciding on endorsing chemotherapy, participants understood the information best when presented with data in the absolute survival benefit format. AB - CONCLUSION: These results support the hypothesis that the method used to present information about chemotherapy influences treatment decisions. Absolute survival benefit is the most easily understood method of conveying the information regarding benefit of treatment. RN - 0 (Antineoplastic Agents) RN - 0 (Receptors, Estrogen) RN - 094ZI81Y45 (Tamoxifen) IS - 0732-183X IL - 0732-183X DI - JCO.2003.06.025 DO - https://dx.doi.org/10.1200/JCO.2003.06.025 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 14581440 [pubmed] ID - 10.1200/JCO.2003.06.025 [doi] ID - JCO.2003.06.025 [pii] PP - ppublish LG - English EP - 20031027 DP - 2003 Dec 01 DC - 20031203 EZ - 2003/10/29 05:00 DA - 2004/01/06 05:00 DT - 2003/10/29 05:00 YR - 2003 ED - 20040105 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14581440 <435. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12825857 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Keating NL AU - Weeks JC AU - Borbas C AU - Guadagnoli E FA - Keating, Nancy L FA - Weeks, Jane C FA - Borbas, Catherine FA - Guadagnoli, Edward IN - Keating, Nancy L. Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. keating@hcp.med.harvard.edu TI - Treatment of early stage breast cancer: do surgeons and patients agree regarding whether treatment alternatives were discussed?. SO - Breast Cancer Research & Treatment. 79(2):225-31, 2003 May AS - Breast Cancer Res Treat. 79(2):225-31, 2003 May NJ - Breast cancer research and treatment PI - Journal available in: Print PI - Citation processed from: Print JC - a8x, 8111104 IO - Breast Cancer Res. Treat. SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Communication MH - Data Collection MH - *Decision Making MH - Female MH - Humans MH - Logistic Models MH - Middle Aged MH - Neoplasm Staging MH - Patient Education as Topic MH - *Patient Participation/sn [Statistics & Numerical Data] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - *Physician-Patient Relations AB - BACKGROUND: Informing patients of available treatment alternatives is an important element of informed consent. We examined and compared patients' and their surgeons' reports of discussing treatment alternatives for early stage breast cancer. AB - METHODS: We surveyed early stage breast cancer patients in two states (Minnesota and Massachusetts) about discussions of breast cancer treatments. We also surveyed their surgeons. We compared how often patients' and surgeons' reports about discussions of treatment alternatives agreed, and we used generalized estimating equations to identify factors related to patients' reports that alternatives were not discussed when their surgeons reported that they were discussed. AB - RESULTS: Among 1154 women eligible for both breast-conserving surgery and mastectomy, only 71% reported that their surgeon discussed both treatments. Surgeons of 730 women returned surveys and reported discussing both treatments with 82% of the patients. One-third of the time, patients and surgeons disagreed about whether both treatments were discussed; with patients more often reporting that both treatments were not discussed when surgeons reported they were. In adjusted analyses, compared to better-educated patients, less-educated patients more often reported that their surgeons did not discuss both treatments when their surgeons reported that they did (compared to non-high school graduates, odds ratio (OR) 0.44, 95% confidence interval (CI) 0.22-0.87 for high school graduates; OR 0.51; 95% CI 0.27-0.96 for women with at least some college education; and OR 0.50; 95% CI 0.20-1.24 for women with any post-graduate work). AB - CONCLUSION: Patients' and surgeons' reports of treatments discussed often disagree. Interventions to assure that surgeons present and patients fully comprehend treatment options may help to improve the decision-making process, particularly for less well-educated women. IS - 0167-6806 IL - 0167-6806 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. ID - 12825857 [pubmed] PP - ppublish GI - No: CA57755 Organization: (CA) *NCI NIH HHS* Country: United States No: CA59408 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2003 May DC - 20030626 EZ - 2003/06/27 05:00 DA - 2003/11/05 05:00 DT - 2003/06/27 05:00 YR - 2003 ED - 20031104 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12825857 <436. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12865955 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Leinung S AU - Schonfelder M AU - Winzer KJ AU - Schuster E AU - Gastinger I AU - Lippert H AU - Wurl P AU - Studiengruppe "Mammakarzinom" der Ostdeutschen Arbeitsgruppe fur Leistungserfassung und Qualitatssicherung und das An-Institut fur Qualitatssicherung in der operativen Medizin der Otto-von-Guericke-Universitat Magdeburg FA - Leinung, S FA - Schonfelder, M FA - Winzer, K-J FA - Schuster, E FA - Gastinger, I FA - Lippert, H FA - Wurl, P FA - Studiengruppe "Mammakarzinom" der Ostdeutschen Arbeitsgruppe fur Leistungserfassung und Qualitatssicherung und das An-Institut fur Qualitatssicherung in der operativen Medizin der Otto-von-Guericke-Universitat Magdeburg IN - Leinung, S. Chirurgische Klinik II der Universitat Leipzig. leinungs@medizin.uni-leipzig.de TI - [Prospective multicenter study for quality management of breast cancer surgery]. [German] OT - Prospektive Multizenterstudie zur Qualitatssicherung der Chirurgie des Mammakarzinoms. SO - Zentralblatt fur Chirurgie. 128(6):493-9, 2003 Jun AS - Zentralbl Chir. 128(6):493-9, 2003 Jun NJ - Zentralblatt fur Chirurgie PI - Journal available in: Print PI - Citation processed from: Print JC - y5i, 0413645 IO - Zentralbl Chir SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - *Breast Neoplasms/su [Surgery] MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Lymph Node Excision MH - Mammography MH - Mastectomy MH - Middle Aged MH - Neoadjuvant Therapy MH - Neoplasm Metastasis MH - Postoperative Care MH - Prospective Studies MH - *Quality Assurance, Health Care MH - Risk Factors MH - Time Factors MH - Tomography, X-Ray Computed MH - Ultrasonography, Mammary AB - Over the last 10 years a dramatic decrease became apparent in primary treatment of breast cancer in general surgical departments. A prospective 1-year observational study involving 84 surgical departments was carried out to describe the current therapeutic situation. A total of 1,416 patients undergoing primary surgical treatment for mammary carcinoma were recorded, and their data evaluated. 68.9% of the carcinomas were treated in departments with an annual case load for this disease of more than 20 operations, with 50% of them being operated on in 8 departments with a case load of 40-100 procedures per year. 94.4% of the carcinomas were confirmed histologically, and in 91% of the patients surgery was performed in curative intention. The rate of breast-preserving procedures was 40%, and breast amputations accounted for 60%. An analysis of the data allowed an evaluation of this specific patient group in the surgical departments. Deficits in terms of management quality are identified. IS - 0044-409X IL - 0044-409X DO - https://dx.doi.org/10.1055/s-2003-40623 PT - Comparative Study PT - Journal Article PT - Multicenter Study ID - 12865955 [pubmed] ID - 10.1055/s-2003-40623 [doi] PP - ppublish LG - German DP - 2003 Jun DC - 20030716 EZ - 2003/07/17 05:00 DA - 2003/10/31 05:00 DT - 2003/07/17 05:00 YR - 2003 ED - 20031030 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12865955 <437. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 14528705 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Truant T AU - Bottorff JL FA - Truant, T FA - Bottorff, J L IN - Truant, T. Vancouver Cancer Centre, British Columbia Cancer Agency, 600 West 10th Avenue, Vancouver, BC, Canada V5Z 4E6. ttruant@bccancer.bc.ca TI - Decision making related to complementary therapies: a process of regaining control. SO - Patient Education & Counseling. 38(2):131-42, 1999 Oct AS - Patient Educ Couns. 38(2):131-42, 1999 Oct NJ - Patient education and counseling PI - Journal available in: Print PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adaptation, Psychological MH - Adult MH - Aged MH - *Attitude to Health MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Choice Behavior MH - Complementary Therapies/mt [Methods] MH - *Complementary Therapies/px [Psychology] MH - Health Knowledge, Attitudes, Practice MH - Holistic Health MH - Humans MH - *Internal-External Control MH - Middle Aged MH - Morale MH - Nursing Methodology Research MH - Patient Selection MH - Patient-Centered Care MH - Sick Role MH - Social Support MH - Surveys and Questionnaires MH - Uncertainty MH - Women/ed [Education] MH - *Women/px [Psychology] AB - The process by which women with breast cancer make decisions related to using complementary therapies was investigated using grounded theory. Open-ended interviews were conducted with 16 women receiving orthodox treatment from across the breast cancer trajectory and who used a wide range of complementary therapies. Constant comparative analysis revealed that decision making regarding complementary therapies involved three interconnected sequential phases: (1) Getting something in place: covering all the bases, (2) hand-picking complementary therapies that fit: getting a personalized regimen in place and (3) living with the security of complementary therapies: fine-tuning a regimen to live with. Factors that influenced the decision-making process, both positively and negatively, were identified. Decision making related to the use of complementary therapies was perceived as a means of regaining control during experiences of uncertainty associated with breast cancer; the outcome of which was the maintenance of hope. Implications for supporting women's decision-making efforts regarding complementary therapies are presented. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(99)00060-9 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 14528705 [pubmed] ID - S0738-3991(99)00060-9 [pii] PP - ppublish LG - English DP - 1999 Oct DC - 20031007 EZ - 2003/10/08 05:00 DA - 2003/10/28 05:00 DT - 2003/10/08 05:00 YR - 1999 ED - 20031027 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14528705 <438. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 14528554 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Irwin E AU - Arnold A AU - Whelan TJ AU - Reyno LM AU - Cranton P FA - Irwin, E FA - Arnold, A FA - Whelan, T J FA - Reyno, L M FA - Cranton, P IN - Irwin, E. McMaster University, School of Nursing, OCTRF Hamilton Regional Cancer Centre, Hamilton, Ontario, Canada. TI - Offering a choice between two adjuvant chemotherapy regimens: a pilot study to develop a decision aid for women with breast cancer. SO - Patient Education & Counseling. 37(3):283-91, 1999 Jul AS - Patient Educ Couns. 37(3):283-91, 1999 Jul NJ - Patient education and counseling PI - Journal available in: Print PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - Attitude to Health MH - Audiovisual Aids/st [Standards] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/px [Psychology] MH - Chemotherapy, Adjuvant/ae [Adverse Effects] MH - *Chemotherapy, Adjuvant/px [Psychology] MH - *Choice Behavior MH - *Decision Support Techniques MH - Female MH - Humans MH - Male MH - Mastectomy MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Pilot Projects MH - Premenopause/px [Psychology] MH - Quality of Life MH - Surveys and Questionnaires MH - Treatment Outcome MH - *Women/ed [Education] MH - *Women/px [Psychology] AB - BACKGROUND: The primary objective of this study was to develop a decision aid which would encourage and assist patients to become involved in treatment decision making, and help clinicians to objectively educate patients about the benefits and risks of adjuvant chemotherapy for breast cancer. A secondary objective was to investigate the factors influencing this treatment decision-making process for women when choosing between adriamycin and cyclophosphamide (AC) versus cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy. AB - METHODS: An educational visual instrument called a Decision Board was developed consisting of written and graphical material. The Decision Board displays general information about chemotherapy and detailed information about each chemotherapy regimen, including the schedule and side effects, and was presented to patients with a scripted standardized oral explanation. The instrument was evaluated in 46 premenopausal women newly diagnosed with node-positive breast cancer. Following presentation of the board, the patients were given a take home version to review and asked to return 1-2 weeks later with a decision. During the second visit each patient was asked to complete a questionnaire regarding demographics, learning and comprehension, treatment preference, and factors influencing their decision. AB - RESULTS: Recall of information was acceptable (> or = 80%). The Decision Board was found helpful by all, but the level of difficulty with decision making was variable. Out of 46 women, 23 women chose AC, 21 chose CMF, and two chose no treatment. The major factors affecting treatment preference were related to the impact on quality of life, the length of therapy, and the side effects, in particular, vomiting and alopecia. AB - CONCLUSIONS: The Decision Board appears to be a valuable educational tool that enables patients to become well-informed and directly involved in their treatment decisions. IS - 0738-3991 IL - 0738-3991 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 14528554 [pubmed] PP - ppublish LG - English DP - 1999 Jul DC - 20031007 EZ - 2003/10/08 05:00 DA - 2003/10/28 05:00 DT - 2003/10/08 05:00 YR - 1999 ED - 20031027 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=14528554 <439. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12919237 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Goodwin JS AU - Satish S AU - Anderson ET AU - Nattinger AB AU - Freeman JL FA - Goodwin, James S FA - Satish, Shiva FA - Anderson, Elizabeth T FA - Nattinger, Ann B FA - Freeman, Jean L IN - Goodwin, James S. Department of Internal Medicine, School of Medicine, The University of Texas Medical Branch, Galveston, Texas 77555, USA. jsgoodwi@utmb.edu TI - Effect of nurse case management on the treatment of older women with breast cancer. CM - Comment in: Evid Based Nurs. 2004 Apr;7(2):58; PMID: 15106640 SO - Journal of the American Geriatrics Society. 51(9):1252-9, 2003 Sep AS - J Am Geriatr Soc. 51(9):1252-9, 2003 Sep NJ - Journal of the American Geriatrics Society PI - Journal available in: Print PI - Citation processed from: Print JC - 7503062, h6v IO - J Am Geriatr Soc SB - Index Medicus CP - United States MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - *Case Management MH - Data Interpretation, Statistical MH - Female MH - Geriatric Assessment MH - *Health Services Accessibility MH - Humans MH - Male MH - Middle Aged MH - *Nurse's Role MH - Patient Satisfaction MH - Physician's Role MH - Prospective Studies MH - Psychiatric Status Rating Scales MH - *Social Support MH - Socioeconomic Factors MH - Time Factors MH - Treatment Outcome AB - OBJECTIVES: To evaluate the effect of nurse case management on the treatment of older women with breast cancer. AB - DESIGN: Randomized prospective trial. AB - SETTING: Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. AB - PARTICIPANTS: Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. AB - INTERVENTION: Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. AB - MEASUREMENTS: The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. AB - RESULTS: More women in the intervention group received breast-conserving surgery (28.6% vs 18.7%; P=.031) and radiation therapy (36.0% vs 19.0%; P=.003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3% vs 44.8%; P=.001) and axillary dissection (71.4% vs 44.8%; P=.057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3% vs 2.6%, P=.054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7% vs 30.0%, P=.057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93% vs 84%; P=.037) and were more likely to state that they had a real choice in their treatment (82.2% vs 69.9%, P=.020). Women with indicators of poor social support were more likely to benefit from nurse case management. AB - CONCLUSION: Nurse case management results in more appropriate management of older women with breast cancer. IS - 0002-8614 IL - 0002-8614 DI - 51409 PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial ID - 12919237 [pubmed] ID - 51409 [pii] PP - ppublish GI - No: P30 AG024832 Organization: (AG) *NIA NIH HHS* Country: United States LG - English DP - 2003 Sep DC - 20030815 EZ - 2003/08/16 05:00 DA - 2003/10/21 05:00 DT - 2003/08/16 05:00 YR - 2003 ED - 20031020 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12919237 <440. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12690474 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Taucher S AU - Gnant M AU - Jakesz R FA - Taucher, Susanne FA - Gnant, Michael FA - Jakesz, Raimund IN - Taucher, Susanne. Department of Surgery, Medical School, Vienna University, Waehringer Guertel 18-20, 1090 Vienna, Austria. susanne.taucher@univie.ac.at TI - Preventive mastectomy in patients at breast cancer risk due to genetic alterations in the BRCA1 and BRCA2 gene. SO - Langenbecks Archives of Surgery. 388(1):3-8, 2003 Mar AS - Langenbecks Arch Surg. 388(1):3-8, 2003 Mar NJ - Langenbeck's archives of surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - cw4, 9808285 IO - Langenbecks Arch Surg SB - Index Medicus CP - Germany MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Humans MH - *Mastectomy MH - Ovariectomy AB - BACKGROUND: The availability of genetic testing for inherited mutations in the BRCA1 and BRCA2 gene provides potentially valuable information to women at high risk of breast and ovarian cancer. AB - METHODS AND FOCUS: We review the literature on the value of prophylactic surgical strategies in patients with hereditary predisposition to develop breast cancer and discuss the surgical options available in high-risk cancer patients, decision analyses, and possible complications. AB - RESULTS: Preventive surgical interventions to reduce cancer risk in high-risk patients are often strongly recommended. A patient's life-time risk to develop breast cancer in the presence of BRCA1 and BRCA2 mutations is 50-90%. Despite the reduction in the risk of developing breast cancer, prophylactic mastectomy often leads to significant physical and psychological sequelae. IS - 1435-2443 IL - 1435-2443 DO - https://dx.doi.org/10.1007/s00423-003-0355-9 PT - Journal Article ID - 12690474 [pubmed] ID - 10.1007/s00423-003-0355-9 [doi] PP - ppublish PH - 2002/11/04 [received] PH - 2003/01/17 [accepted] LG - English EP - 20030221 DP - 2003 Mar DC - 20030411 EZ - 2003/04/12 05:00 DA - 2003/09/17 05:00 DT - 2003/04/12 05:00 YR - 2003 ED - 20030916 RD - 20161020 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12690474 <441. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12880217 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Budden LM AU - Pierce PF AU - Hayes BA AU - Buettner PG FA - Budden, Lea M FA - Pierce, Penny F FA - Hayes, Barbara A FA - Buettner, Petra G IN - Budden, Lea M. School of Nursing Sciences, James Cook University Townsville, Queensland, Australia. Lea.Budden@jcu.edu.au TI - Australian women's prediagnostic decision-making styles, relating to treatment choices for early breast cancer treatment. SO - Research & Theory for Nursing Practice. 17(2):117-36, 2003 Summer AS - Res Theory Nurs Pract. 17(2):117-36, 2003 Summer NJ - Research and theory for nursing practice PI - Journal available in: Print PI - Citation processed from: Print JC - 101146940 IO - Res Theory Nurs Pract SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Age Factors MH - Aged MH - Avoidance Learning MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Choice Behavior MH - *Decision Making MH - Educational Status MH - Employment/px [Psychology] MH - Female MH - Humans MH - Internal-External Control MH - Linear Models MH - Middle Aged MH - Nurse's Role MH - Nursing Methodology Research MH - Patient Education as Topic MH - Patient Participation/mt [Methods] MH - *Patient Participation/px [Psychology] MH - Problem Solving MH - Queensland MH - Socioeconomic Factors MH - Surveys and Questionnaires MH - Women/ed [Education] MH - *Women/px [Psychology] AB - Women diagnosed with early breast cancer are now asked by their doctors to choose from a range of options for their preferred medical treatment plan. Little information is known about women's treatment decision-making and therefore nurses do not have evidence to guide this decision support. The aim of this descriptive survey was to investigate the prediagnostic decision-making behavior of a sample (N = 377) of Australian women, regarding their treatment choices for early breast cancer. The data were collected using the Pre-Decision Portfolio Questionnaire (PDPQ) by Pierce (1996), which includes the Michigan Assessment of Decision Styles (MADS). Of 366 participating women, 19.9% strongly agreed to all three items of the MADS factor Deferring Responsibility; 0.3% strongly agreed to all four factors of Avoidance; 32.7% strongly agreed on all four items of Information Seeking; and 63.4% strongly agreed to all five items of Deliberation. Women showed a variety of preferred decision styles, depending on age, education, occupation and employment status. Only 36% of women indicated it was critically important to "get the treatment over as soon as possible;" 55% to "participate in selecting treatment;" and 53% to "read a lot of information:" The understanding of factors that are important to women when they are making decisions for medical treatment is a mandatory step in designing customized evidence-based decision support, which can be delivered by nurses to help women during this distressing experience. IS - 1541-6577 IL - 1541-6577 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 12880217 [pubmed] PP - ppublish LG - English DP - 2003 Summer DC - 20030725 EZ - 2003/07/26 05:00 DA - 2003/09/16 05:00 DT - 2003/07/26 05:00 YR - 2003 ED - 20030915 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12880217 <442. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12603376 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Masood S FA - Masood, Shahla TI - Why most women with breast cancer still undergo mastectomy. SO - Breast Journal. 9(2):69-70, 2003 Mar-Apr AS - Breast J. 9(2):69-70, 2003 Mar-Apr NJ - The breast journal PI - Journal available in: Print PI - Citation processed from: Print JC - d1h, 9505539 IO - Breast J SB - Index Medicus CP - United States MH - Adult MH - Anecdotes as Topic MH - Attitude to Health MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Humans MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - *Patient Education as Topic MH - Physician's Role MH - Physician-Patient Relations MH - Quality of Life MH - *Self Concept MH - United States IS - 1075-122X IL - 1075-122X DI - 09201 PT - Editorial ID - 12603376 [pubmed] ID - 09201 [pii] PP - ppublish LG - English DP - 2003 Mar-Apr DC - 20030226 EZ - 2003/02/27 04:00 DA - 2003/07/08 05:00 DT - 2003/02/27 04:00 YR - 2003 ED - 20030707 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12603376 <443. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12723313 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schwegler N AU - Puric E FA - Schwegler, N FA - Puric, E IN - Schwegler, N. Kantonsspital Aarau. TI - [Correlation of risk factors with the efficacy of applied therapies by breast conserving procedure in breast cancer]. [German] OT - Korrelation von Risikofakoren mit angewandten Therapien bei brusterhaltend behandelten Mammakarzinomen. SO - Praxis. 92(14):639-48, 2003 Apr 02 AS - Praxis (Bern 1994). 92(14):639-48, 2003 Apr 02 NJ - Praxis PI - Journal available in: Print PI - Citation processed from: Print JC - 101468093 IO - Praxis (Bern 1994) SB - Index Medicus CP - Switzerland MH - Adult MH - Age Factors MH - Aged MH - Aged, 80 and over MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - Breast/pa [Pathology] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Disease-Free Survival MH - Female MH - Follow-Up Studies MH - Humans MH - Lymphatic Metastasis MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Metastasis MH - Neoplasm Recurrence, Local MH - Postoperative Care MH - Radiotherapy Dosage MH - Risk Factors MH - Tamoxifen/tu [Therapeutic Use] MH - Time Factors AB - 1007 cases of female breast cancer patients treated with breast conserving surgery and subsequently irradiation with a median dose of 66 (50-80) Gy including boost with tangential high voltage photon beams. 34.6% (348/1007) received no further therapies, 53.4% (538/1007) Tamoxifen, 26% (262/1007) an adjuvant chemotherapy +/- Tamoxifen. All tumors were classified on the basis of the pathologic-anatomical spreading: 70.7% (712/1007) pT1a-c, 27.4% (276/1007) pT2. 1.9% (19/1007) pT3-4 due to the refusal of mastectomy or an error in the preoperative diagnosis. 32.5% (327/1007) showed proven axillary metastases, of which 26.3% (86/327) > or = 4 LN+. Median age 56 (23-92) years. The local relapse rate after a median follow-up of 70 (12-264) months amounted to 5.9% (59/1007). Distant metastases were registered in 11.5% (116/1007). A total of 8.8% (89/1007) died as consequence of breast cancer, 3.2% (32/1007) of other causes. In 82.6% (816/988) of the pT1/pT2 tumors the resection area had been described. In 29.8% (156/524) in the resected parts there were found rests of tumors. The LRFS falls from 94% to 82% and by remained R1 (26/524) to 47%. Correlation likewise the DMFS, which sanks from 81% to 68% respectively to 63%. We expect a second wave of metastases like the situation by local relapses. Often the R1-resection was connected with other histological high risk factors as multifocality/-centricity, necrosis or vascular invasion. If one divides the patient case sample into a first group with special risk factors (< or = 40 years of age, > or = 4 positive axillary lymph nodes, vascular invasion), and a second which exhibited none of these components, the first group had a 23-26% lower disease free survival rate. Amazing is the fact that, subsequent to a lumpectomy and irradiation, the use or non use of Tamoxifen and/or cytostatics was without proven statistical significance. The evaluation was conceived and implemented more than 20 years ago, and documentation was continuously collected ever since. We're aware of the lack of randomization, but there are less the randomized studies than rather its transformations respectively the daily routine who will decide about life and death. However, evaluations of this data by medical oncologists would, on the one hand, make it possible to better assess the importance of the available data and our results, and, on the other hand, clarify the clinical value of partially and/or completely applied medical treatments. RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) IS - 1661-8157 IL - 1661-8157 DO - https://dx.doi.org/10.1024/0369-8394.92.14.639 PT - Comparative Study PT - English Abstract PT - Journal Article ID - 12723313 [pubmed] ID - 10.1024/0369-8394.92.14.639 [doi] PP - ppublish LG - German DP - 2003 Apr 02 DC - 20030501 EZ - 2003/05/02 05:00 DA - 2003/06/10 05:00 DT - 2003/05/02 05:00 YR - 2003 ED - 20030609 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12723313 <444. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12697850 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Whelan T AU - Sawka C AU - Levine M AU - Gafni A AU - Reyno L AU - Willan A AU - Julian J AU - Dent S AU - Abu-Zahra H AU - Chouinard E AU - Tozer R AU - Pritchard K AU - Bodendorfer I FA - Whelan, Timothy FA - Sawka, Carol FA - Levine, Mark FA - Gafni, Amiram FA - Reyno, Leonard FA - Willan, Andrew FA - Julian, Jim FA - Dent, Susan FA - Abu-Zahra, Hakam FA - Chouinard, Edmond FA - Tozer, Richard FA - Pritchard, Kathleen FA - Bodendorfer, Ilona IN - Whelan, Timothy. Cancer Care Ontario (CCO), Hamilton Regional Cancer Centre, and Supportive Cancer Care Research Unit, McMaster University, Hamilton, Ontario, Canada. tim.whelan@hrcc.on.ca TI - Helping patients make informed choices: a randomized trial of a decision aid for adjuvant chemotherapy in lymph node-negative breast cancer. CM - Comment in: J Natl Cancer Inst. 2003 Apr 16;95(8):570-1; PMID: 12697842 SO - Journal of the National Cancer Institute. 95(8):581-7, 2003 Apr 16 AS - J Natl Cancer Inst. 95(8):581-7, 2003 Apr 16 NJ - Journal of the National Cancer Institute PI - Journal available in: Print PI - Citation processed from: Print JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Antineoplastic Agents/ad [Administration & Dosage] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Lymphatic Metastasis MH - Mastectomy/mt [Methods] MH - Middle Aged MH - Neoplasm Recurrence, Local MH - *Patient Participation MH - *Patient Satisfaction MH - Surveys and Questionnaires MH - Treatment Outcome AB - BACKGROUND: In recent years, patients have indicated a desire for more information about their disease and to be involved in making decisions about their care. We developed an aid called the "Decision Board" to help clinicians inform patients with lymph node-negative breast cancer of the risks and benefits of adjuvant chemotherapy. We determined whether adding the Decision Board to the medical consultation improved patient knowledge and satisfaction compared with the medical consultation alone. AB - METHODS: Between October 1995 and March 2000, 176 women with lymph node-negative breast cancer who were candidates for adjuvant chemotherapy were randomly assigned to receive the Decision Board plus the medical consultation (83 patients) or the medical consultation alone (93 patients). One week after the consultation, patients completed a questionnaire assessing their knowledge about breast cancer and chemotherapy. Satisfaction with decision making was assessed 1 week and 3, 6, and 12 months after randomization, and differences between groups were analyzed by a repeated measures analysis of variance. All statistical tests were two-sided. AB - RESULTS: Patients in the Decision Board arm were better informed about breast cancer and adjuvant chemotherapy than patients in the control arm (mean knowledge score = 80.2 [on a scale of 0-100], 95% confidence interval [CI] = 77.1 to 83.3, and 71.7, 95% CI = 69.0 to 74.4, respectively; P<.001). Over the entire study period, satisfaction with decision making was higher for patients in the Decision Board arm than for patients in the control arm (P =.032). There was no statistically significant difference between the two groups in the number of patients who chose adjuvant chemotherapy (77% and 70% for patients in the Decision Board arm and those in the control arm, respectively; P =.303). AB - CONCLUSION: When making decisions regarding adjuvant chemotherapy, patients with early breast cancer who had been exposed to the Decision Board had better knowledge of the disease and treatment options and greater satisfaction with their decision making than those who received the standard consultation. RN - 0 (Antineoplastic Agents) IS - 0027-8874 IL - 0027-8874 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 12697850 [pubmed] PP - ppublish LG - English DP - 2003 Apr 16 DC - 20030416 EZ - 2003/04/17 05:00 DA - 2003/05/08 05:00 DT - 2003/04/17 05:00 YR - 2003 ED - 20030507 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12697850 <445. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12515987 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sepucha KR AU - Belkora JK AU - Aviv C AU - Mutchnik S AU - Esserman LJ FA - Sepucha, Karen R FA - Belkora, Jeffrey K FA - Aviv, Caryn FA - Mutchnik, Stephanie FA - Esserman, Laura J IN - Sepucha, Karen R. Harvard Medical School, Boston, MA, USA. ksepucha@partners.org TI - Improving the quality of decision making in breast cancer: consultation planning template and consultation recording template. SO - Oncology Nursing Forum. 30(1):99-106, 2003 Jan-Feb AS - Oncol Nurs Forum. 30(1):99-106, 2003 Jan-Feb NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Internet JC - 7809033, 7809033 IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Benchmarking MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Carcinoma, Ductal, Breast/di [Diagnosis] MH - Carcinoma, Ductal, Breast/nu [Nursing] MH - Carcinoma, Ductal, Breast/px [Psychology] MH - Carcinoma, Ductal, Breast/th [Therapy] MH - Choice Behavior MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - Mastectomy/px [Psychology] MH - *Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - Process Assessment (Health Care) MH - Prognosis MH - Quality of Life AB - PURPOSE/OBJECTIVES: To describe two templates that can be used to improve the quality of breast cancer treatment decisions. AB - DATA SOURCES: Case study, survey of current users, three clinical trials. AB - FINDINGS: Clinical applications of the Consultation Planning Template and Consultation Recording Template vary across organizations. Clinical trials have demonstrated that the templates can improve the quality of decisions, the quality of communication between patients and providers, and satisfaction. AB - CONCLUSIONS: The templates can be adapted to different clinical settings and can improve the quality of treatment decisions. AB - IMPLICATIONS FOR NURSING: Nurses often provide the majority of education and coaching for patients making decisions. As patients' demands for involvement in decision making increase, nurses need practical tools to help patients participate. The templates are practical tools that nurses can use to help patients make better decisions. ES - 1538-0688 IL - 0190-535X DO - https://dx.doi.org/10.1188/03.ONF.99-106 PT - Case Reports PT - Evaluation Studies PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, Non-P.H.S. ID - 12515987 [pubmed] ID - 10.1188/03.ONF.99-106 [doi] PP - ppublish LG - English DP - 2003 Jan-Feb DC - 20030107 EZ - 2003/01/08 04:00 DA - 2003/04/17 05:00 DT - 2003/01/08 04:00 YR - 2003 ED - 20030416 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12515987 <446. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12641345 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Panieri E AU - Lazarus D AU - Dent DM AU - Hudson DA AU - Murray E AU - Werner ID FA - Panieri, Eugenio FA - Lazarus, Dirk FA - Dent, David M FA - Hudson, Don A FA - Murray, Elizabeth FA - Werner, I Dudley IN - Panieri, Eugenio. Department of Surgery, Groote Schuur Hospital and University of Cape Town, Faculty of Health Sciences, Cape Town, South Africa. TI - A study of the patient factors affecting reconstruction after mastectomy for breast carcinoma. SO - American Surgeon. 69(2):95-7, 2003 Feb AS - Am Surg. 69(2):95-7, 2003 Feb NJ - The American surgeon PI - Journal available in: Print PI - Citation processed from: Print JC - 43e, 0370522 IO - Am Surg SB - Index Medicus CP - United States MH - Age Factors MH - Aged MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Comorbidity MH - Counseling MH - Educational Status MH - Employment MH - Esthetics MH - Ethnic Groups MH - Female MH - Humans MH - Mammaplasty/mt [Methods] MH - *Mammaplasty/px [Psychology] MH - *Mammaplasty/sn [Statistics & Numerical Data] MH - Marital Status MH - Mastectomy MH - Middle Aged MH - Motivation MH - *Patient Acceptance of Health Care/px [Psychology] MH - *Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - Patient Education as Topic MH - *Patient Selection MH - Prospective Studies MH - Risk Factors MH - South Africa MH - Surgical Flaps AB - Breast shape may be retained after surgery for breast cancer with either wide local excision (WLE) and radiotherapy or mastectomy (M) and immediate reconstruction (M+R). We determined the proportions of patients who would be suitable for these options, would accept them, and if they declined M+R their reasons for doing so. Over a 10-month period 177 women were assessed at a combined breast clinic by general and plastic surgeons and by radiation oncologists. A prospective record was made of the patient demographic data, the clinical decisions (and their reasons), and the patient choices (and their reasons). A transverse rectus abdominis myocutaneous flap was the commonest method of reconstruction. One hundred thirty-five (76%) were judged to be suitable for locoregional surgery. Of these M+R was offered to 83 patients, whereas 53 were not considered because of combinations of cosmetic considerations (31), risk factors (25), old age (13), and oncological factors (nine). Fifty-one of the 83 (61%) offered M+R declined it because they preferred a simpler procedure (34), regarded breast appearance as unimportant (15), preferred breast conservation (five), did not have a partner (three), felt that they were too old (two), or had religious reasons (two). Ultimately 69 (51%) underwent M, 34 (25%) WLE, and 32 (24%) M+R. There was no correlation between acceptance or not of M+R and age, race, employment, education level, or marital status. We conclude that many patients were suitable for M+R, but fewer than half accepted it; this decision was unrelated to age, race, employment, or marital status. IS - 0003-1348 IL - 0003-1348 PT - Journal Article ID - 12641345 [pubmed] PP - ppublish LG - English DP - 2003 Feb DC - 20030318 EZ - 2003/03/19 04:00 DA - 2003/03/29 05:00 DT - 2003/03/19 04:00 YR - 2003 ED - 20030328 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12641345 <447. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12460220 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - De Morgan S AU - Redman S AU - White KJ AU - Cakir B AU - Boyages J FA - De Morgan, Simone FA - Redman, Sally FA - White, Kate J FA - Cakir, Burcu FA - Boyages, John IN - De Morgan, Simone. NHMRC National Breast Cancer Centre, Sydney, Australia. simoned@nbcc.org.au TI - "Well, have I got cancer or haven't I?" The psycho-social issues for women diagnosed with ductal carcinoma in situ. SO - Health Expectations. 5(4):310-8, 2002 Dec AS - Health Expect. 5(4):310-8, 2002 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Print JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Australia MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Carcinoma, Intraductal, Noninfiltrating/di [Diagnosis] MH - Carcinoma, Intraductal, Noninfiltrating/px [Psychology] MH - Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - Decision Making MH - Female MH - Focus Groups MH - Health Services Research MH - Humans MH - Information Services MH - Middle Aged MH - National Health Programs MH - *Patient Education as Topic MH - *Patient Satisfaction MH - Physician-Patient Relations MH - *Social Support AB - OBJECTIVES: To explore women's experience of being diagnosed with ductal carcinoma in situ (DCIS) in relation to the following: response to the diagnosis; understanding about the diagnosis; satisfaction with information; satisfaction with the level of involvement in treatment decision-making and satisfaction with support services. AB - DESIGN: An explorative descriptive qualitative design was used to facilitate an in-depth exploration of women's experiences. AB - SETTING AND PARTICIPANTS: Five focus group interviews were conducted in New South Wales (NSW), Australia, involving 26 women diagnosed with DCIS. AB - RESULTS: DCIS is a non-invasive breast disease, that in most cases will not recur if treated, and cannot of itself metastasize to other parts of the body. However, this study found that women were confused about whether or not they had cancer that could result in death. Women's confusion was compounded by the use of the term "carcinoma" and by the recommendation of treatments such as mastectomy. Women's confusion was not alleviated by appropriate information, with most women reporting dissatisfaction with the information they received specifically about DCIS. AB - CONCLUSIONS: This study identifies that a diagnosis of DCIS has a significant psychological impact on women. The communication challenges highlighted in this study are not only relevant to DCIS but to any other disease in which the natural history is uncertain and the evidence about treatment effectiveness is still emerging. Further research is needed in areas such as DCIS to explore the difficulties experienced in doctor-patient communication and their impact on patient outcomes, and how to optimize doctor-patient communication. IS - 1369-6513 IL - 1369-6513 DI - 199 PT - Journal Article ID - 12460220 [pubmed] ID - 199 [pii] ID - PMC5142722 [pmc] PP - ppublish LG - English DP - 2002 Dec DC - 20021203 EZ - 2002/12/04 04:00 DA - 2003/03/18 04:00 DT - 2002/12/04 04:00 YR - 2002 ED - 20030317 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=12460220 <448. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12460220 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - De Morgan S AU - Redman S AU - White KJ AU - Cakir B AU - Boyages J FA - De Morgan, Simone FA - Redman, Sally FA - White, Kate J FA - Cakir, Burcu FA - Boyages, John IN - De Morgan, Simone. NHMRC National Breast Cancer Centre, Sydney, Australia. simoned@nbcc.org.au TI - "Well, have I got cancer or haven't I?" The psycho-social issues for women diagnosed with ductal carcinoma in situ. SO - Health Expectations. 5(4):310-8, 2002 Dec AS - Health Expect. 5(4):310-8, 2002 Dec NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Print JC - dzo, 9815926 IO - Health Expect SB - Index Medicus CP - England MH - Adult MH - Aged MH - Australia MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Carcinoma, Intraductal, Noninfiltrating/di [Diagnosis] MH - Carcinoma, Intraductal, Noninfiltrating/px [Psychology] MH - Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - Decision Making MH - Female MH - Focus Groups MH - Health Services Research MH - Humans MH - Information Services MH - Middle Aged MH - National Health Programs MH - *Patient Education as Topic MH - *Patient Satisfaction MH - Physician-Patient Relations MH - *Social Support AB - OBJECTIVES: To explore women's experience of being diagnosed with ductal carcinoma in situ (DCIS) in relation to the following: response to the diagnosis; understanding about the diagnosis; satisfaction with information; satisfaction with the level of involvement in treatment decision-making and satisfaction with support services. AB - DESIGN: An explorative descriptive qualitative design was used to facilitate an in-depth exploration of women's experiences. AB - SETTING AND PARTICIPANTS: Five focus group interviews were conducted in New South Wales (NSW), Australia, involving 26 women diagnosed with DCIS. AB - RESULTS: DCIS is a non-invasive breast disease, that in most cases will not recur if treated, and cannot of itself metastasize to other parts of the body. However, this study found that women were confused about whether or not they had cancer that could result in death. Women's confusion was compounded by the use of the term "carcinoma" and by the recommendation of treatments such as mastectomy. Women's confusion was not alleviated by appropriate information, with most women reporting dissatisfaction with the information they received specifically about DCIS. AB - CONCLUSIONS: This study identifies that a diagnosis of DCIS has a significant psychological impact on women. The communication challenges highlighted in this study are not only relevant to DCIS but to any other disease in which the natural history is uncertain and the evidence about treatment effectiveness is still emerging. Further research is needed in areas such as DCIS to explore the difficulties experienced in doctor-patient communication and their impact on patient outcomes, and how to optimize doctor-patient communication. IS - 1369-6513 IL - 1369-6513 DI - 199 PT - Journal Article ID - 12460220 [pubmed] ID - 199 [pii] PP - ppublish LG - English DP - 2002 Dec DC - 20021203 EZ - 2002/12/04 04:00 DA - 2003/03/18 04:00 DT - 2002/12/04 04:00 YR - 2002 ED - 20030317 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12460220 <449. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12613483 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Roseau E FA - Roseau, Emmanuel TI - [Preventive oophorectomy in women exhibiting BRCA mutations]. [French] OT - Ovariectomie preventive chez les femmmes avec mutations BRCA. SO - Presse Medicale. 32(4):149-50, 2003 Feb 01 AS - Presse Med. 32(4):149-50, 2003 Feb 01 NJ - Presse medicale (Paris, France : 1983) PI - Journal available in: Print PI - Citation processed from: Print JC - 8302490, pmt IO - Presse Med SB - Index Medicus CP - France MH - Adult MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Cohort Studies MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Humans MH - Mammography MH - Mastectomy MH - Middle Aged MH - Multicenter Studies as Topic MH - *Mutation MH - Ovarian Neoplasms/ep [Epidemiology] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - Prospective Studies MH - Retrospective Studies MH - Risk MH - Risk Factors MH - Time Factors IS - 0755-4982 IL - 0755-4982 PT - Comparative Study PT - Journal Article ID - 12613483 [pubmed] PP - ppublish LG - French DP - 2003 Feb 01 DC - 20030303 EZ - 2003/03/05 04:00 DA - 2003/03/15 04:00 DT - 2003/03/05 04:00 YR - 2003 ED - 20030314 RD - 20161209 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=12613483 <450. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12613483 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Roseau E FA - Roseau, Emmanuel TI - [Preventive oophorectomy in women exhibiting BRCA mutations]. [French] OT - Ovariectomie preventive chez les femmmes avec mutations BRCA. SO - Presse Medicale. 32(4):149-50, 2003 Feb 01 AS - Presse Med. 32(4):149-50, 2003 Feb 01 NJ - Presse medicale (Paris, France : 1983) PI - Journal available in: Print PI - Citation processed from: Print JC - 8302490, pmt IO - Presse Med SB - Index Medicus CP - France MH - Adult MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Cohort Studies MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - *Genes, BRCA1 MH - *Genes, BRCA2 MH - Humans MH - Mammography MH - Mastectomy MH - Middle Aged MH - Multicenter Studies as Topic MH - *Mutation MH - Ovarian Neoplasms/ep [Epidemiology] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - Prospective Studies MH - Retrospective Studies MH - Risk MH - Risk Factors MH - Time Factors IS - 0755-4982 IL - 0755-4982 PT - Comparative Study PT - Journal Article ID - 12613483 [pubmed] PP - ppublish LG - French DP - 2003 Feb 01 DC - 20030303 EZ - 2003/03/05 04:00 DA - 2003/03/15 04:00 DT - 2003/03/05 04:00 YR - 2003 ED - 20030314 RD - 20161209 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12613483 <451. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12532709 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Petruseviciene D AU - Krisciunas A AU - Sameniene J FA - Petruseviciene, Daiva FA - Krisciunas, Aleksandras FA - Sameniene, Jurate IN - Petruseviciene, Daiva. Kauno medicinos universiteto Reabilitacijos klinika, Eiveniu 2, 3007 Kaunas. TI - [Efficiency of rehabilitation methods in the treatment of arm lymphedema after breast cancer surgery]. [Lithuanian] OT - Pacienciu po kruties vezio operacijos reabilitacijos priemoniu efektyvumas rankos limfoedemai gydyti. SO - Medicina (Kaunas). 38(10):1003-8, 2002 AS - Medicina (Kaunas). 38(10):1003-8, 2002 NJ - Medicina (Kaunas, Lithuania) PI - Journal available in: Print PI - Citation processed from: Print JC - 9425208 IO - Medicina (Kaunas) SB - Index Medicus CP - Netherlands MH - *Arm MH - *Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Lymph Node Excision MH - Lymphedema/et [Etiology] MH - *Lymphedema/rh [Rehabilitation] MH - *Mastectomy/ae [Adverse Effects] MH - Physical Therapy Modalities MH - Time Factors AB - In this article we analyze influence of rehabilitation methods in treatment of arm lymphedema. In Kaunas oncological hospital were examined 60 women after surgery for breast cancer. The work objective was to evaluate efficiency of rehabilitation methods in treatment of arm lymphedema and in evaluate movement amplitude of shoulder joint. Two groups of women depending on rehabilitation start were evaluated. The same methods of rehabilitation were applied to both groups: physical therapy, electrostimulation, massage, lymphodrainage with apparate. Our study indicated that women, who were treated at early period of rehabilitation (3 months), showed statistically significantly (p < 0.01) better results in increase of movement amplitude of shoulder joint. However, results of treatment of arm lymphedema, comparing with women who started rehabilitation after 12 months, were equally successful--results were not statistically significantly better (p > 0.05). IS - 1010-660X IL - 1010-660X DI - 0210-07l PT - Comparative Study PT - English Abstract PT - Journal Article ID - 12532709 [pubmed] ID - 0210-07l [pii] PP - ppublish LG - Lithuanian DP - 2002 DC - 20030120 EZ - 2003/01/21 04:00 DA - 2003/02/14 04:00 DT - 2003/01/21 04:00 YR - 2002 ED - 20030212 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12532709 <452. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12432419 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lacey MD FA - Lacey, Margaret D IN - Lacey, Margaret D. Department of Nursing, Eastern University, St. Davids, PA, USA. mlacey@eastern.edu TI - The experience of using decisional support aids by patients with breast cancer. SO - Oncology Nursing Forum. 29(10):1491-7, 2002 Nov-Dec AS - Oncol Nurs Forum. 29(10):1491-7, 2002 Nov-Dec NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Internet JC - 7809033, 7809033 IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/nu [Nursing] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Community Participation/px [Psychology] MH - Community Participation/td [Trends] MH - *Decision Making MH - Female MH - Follow-Up Studies MH - Humans MH - Middle Aged MH - Nurse-Patient Relations MH - Patient Care Planning/td [Trends] MH - *Patient Education as Topic/mt [Methods] MH - Physician-Patient Relations MH - Retrospective Studies MH - Social Support MH - Stress, Psychological MH - Surveys and Questionnaires AB - PURPOSE/OBJECTIVES: To explore the lived experience of patients with breast cancer using decisional support aids during the prediagnosis, diagnosis, and treatment phases of their disease. AB - RESEARCH APPROACH: Descriptive, phenomenologic. AB - SETTING: Community-based. AB - PARTICIPANTS: 12 women, ages 38-68, diagnosed with and treated for breast cancer. AB - METHODOLOGIC APPROACH: Audiotaped interviews were transcribed and analyzed according to Colaizzi's method. AB - MAIN RESEARCH VARIABLES: Use of decisional support aids. AB - FINDINGS: Six major themes were identified: being too stressed and overwhelmed to make a decision, feeling an internal sense of urgency to have the breast cancer managed quickly, trusting the opinion and advice of physicians about treatment decisions, appreciating the importance of support from family and friends in decision making, finding nurses were unavailable or uninvolved in decision making initially, and missing out on the benefits of a multidisciplinary approach. AB - CONCLUSIONS: Being presented with the diagnosis of breast cancer evokes a range of feelings and emotions. By identifying, explaining, and expressing their accounts, participants revealed their lived experience and its meaning. The description of this phenomena may assist other women diagnosed with breast cancer in the decision-making process. AB - INTERPRETATION: Oncology nurses need to be aware of and understand the issues surrounding the decision-making process of patients with breast cancer. Gaps clearly exist in the information and support provided to these participants. Nurses must target areas that are insufficient in providing decisional support aids and plan for partnerships to ensure a multidisciplinary approach in this process. ES - 1538-0688 IL - 0190-535X DO - https://dx.doi.org/10.1188/02.ONF.1491-1497 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 12432419 [pubmed] ID - 10.1188/02.ONF.1491-1497 [doi] PP - ppublish LG - English DP - 2002 Nov-Dec DC - 20021114 EZ - 2002/11/15 04:00 DA - 2003/02/04 04:00 DT - 2002/11/15 04:00 YR - 2002 ED - 20030203 RD - 20161124 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12432419 <453. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12464832 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Davison BJ AU - Degner LF FA - Davison, B Joyce FA - Degner, Lesley F IN - Davison, B Joyce. Prostate Center at Vancouver General Hospital, British Columbia, Canada. jdavison@vanhosp.bc.ca TI - Feasibility of using a computer-assisted intervention to enhance the way women with breast cancer communicate with their physicians. SO - Cancer Nursing. 25(6):417-24, 2002 Dec AS - Cancer Nurs. 25(6):417-24, 2002 Dec NJ - Cancer nursing PI - Journal available in: Print PI - Citation processed from: Print JC - 7805358, cnc IO - Cancer Nurs SB - Index Medicus SB - Nursing Journal CP - United States MH - Adaptation, Psychological MH - *Breast Neoplasms/px [Psychology] MH - *Communication MH - *Computer-Assisted Instruction/mt [Methods] MH - Decision Making MH - *Electronic Mail/og [Organization & Administration] MH - Feasibility Studies MH - Female MH - Humans MH - Internal-External Control MH - Manitoba MH - Middle Aged MH - Needs Assessment MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Patient Satisfaction MH - *Physician-Patient Relations MH - Surveys and Questionnaires MH - *Telemedicine/mt [Methods] AB - This study was conducted to evaluate the feasibility of using a computer intervention to enhance communication between healthcare professionals and women with breast cancer. Additional aims were to measure the extent to which women achieved their preferred decisional roles and satisfaction with the clinical medical appointment. This two-arm randomized clinical trial design included a convenience sample of 749 women with breast cancer attending 3 urban Canadian outpatient oncology clinics. Most women were older than 50 years and had a high school diploma or greater (57%). Women in the control group completed measures of decision preference before their clinic appointments. Women in the intervention group were encouraged to use the information and decision preference profiles generated by the computer program at their clinic appointments. Levels of involvement in decision making and satisfaction were measured after the clinic appointments. Results showed that although the majority of women in both groups did assume their preferred roles in decision making, a significantly higher proportion of women in the intervention group reported playing a more passive role than originally planned. Both groups reported high satisfaction levels. Future research is required to study how this computer intervention could be used by clinicians to provide information and decision support to these women. IS - 0162-220X IL - 0162-220X DI - 00002820-200212000-00001 PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 12464832 [pubmed] ID - 00002820-200212000-00001 [pii] PP - ppublish LG - English DP - 2002 Dec DC - 20021204 EZ - 2002/12/05 04:00 DA - 2003/01/11 04:00 DT - 2002/12/05 04:00 YR - 2002 ED - 20030110 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12464832 <454. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12239750 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cherubini M AU - Baxa P AU - Guarino G FA - Cherubini, Mariano FA - Baxa, Pietro FA - Guarino, Gerardo IN - Cherubini, Mariano. Unita Operativa di Clinica Chirurgica, Dipartimento di Scienze Chirurgiche Generali, Anestesiologiche e Medicina Intensiva, Universita degli Studi di Trieste. TI - The oestrogen-progesterone receptor ratio: an indicator of breast cancer evolution. SO - Chirurgia Italiana. 54(4):423-8, 2002 Jul-Aug AS - Chir Ital. 54(4):423-8, 2002 Jul-Aug NJ - Chirurgia italiana PI - Journal available in: Print PI - Citation processed from: Print JC - czz, 0151753 IO - Chir Ital SB - Index Medicus CP - Italy MH - *Breast Neoplasms/ch [Chemistry] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Lymph Node Excision MH - Mastectomy MH - Mastectomy, Segmental MH - Neoplasm Recurrence, Local/su [Surgery] MH - Phenotype MH - Prognosis MH - *Receptors, Estrogen/an [Analysis] MH - Receptors, Estrogen/ge [Genetics] MH - *Receptors, Progesterone/an [Analysis] MH - Receptors, Progesterone/ge [Genetics] MH - Survival Analysis AB - Two groups of patients were chosen from among 4,025 subjects examined in a breast screening program, one consisting of patients with stage I and the other of patients with stage IV breast cancer, characterized by neoplastic recurrence. In this comparison p53, HER and grading are of no direct help. We investigated receptor status at the time of the first operation and after complete surgical excision of the recurrence. The following variables were determined: oestrogen and progesterone receptor measures (ER, PR) in f.mol/ml, the 4 receptor phenotypes, the oestrogen-progesterone ratio and histological tumour grading in relation to oestrogen receptor positivity or negativity. Surgery consisted in quadrantectomy or total mastectomy, with axillary dissection or complete surgical excision of the recurrence. Adjuvant therapy was administered. The results show a different receptor percentage in recurrence compared to early breast cancer, which though not significant, indicates a reduced presence of ER+ PR+, ER- PR-, and an increase in the ER+PR- phenotype. Recurrence occurs more frequently when the lesion at the first operation is more advanced and if radiotherapy has not been included in the treatment. Histological grading shows a greater number of undifferentiated cells and a reduction in ER+ in recurrence, thus indicating a reduced target for the most widely used hormone treatments. The oestrogen-progesterone ratio is significantly increased (P < 0.01) in recurrence compared to stage I cancers. The cause of recurrence is a neoplastic embolism, often documented histologically. Recurrence does not necessarily mean a poor prognosis, because there is a survival rate after two years of 77% of the cases treated. These results obtained with widely used methods show the aggressiveness of some breast tumours, which can evolve and have a very poor prognosis even with the most complete therapy. RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) IS - 0009-4773 IL - 0009-4773 PT - Comparative Study PT - Journal Article ID - 12239750 [pubmed] PP - ppublish LG - English DP - 2002 Jul-Aug DC - 20020920 EZ - 2002/09/21 10:00 DA - 2002/12/04 04:00 DT - 2002/09/21 10:00 YR - 2002 ED - 20021203 RD - 20091111 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12239750 <455. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12216083 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Staradub VL AU - Hsieh YC AU - Clauson J AU - Langerman A AU - Rademaker AW AU - Morrow M FA - Staradub, Valerie L FA - Hsieh, Yi-Ching FA - Clauson, Jennifer FA - Langerman, Alexander FA - Rademaker, Alfred W FA - Morrow, Monica IN - Staradub, Valerie L. Division of Surgical Oncology, Department of Surgery, Northwestern University Medical School, Chicago, Illinois, USA. vstaradu@nmff.org TI - Factors that influence surgical choices in women with breast carcinoma. SO - Cancer. 95(6):1185-90, 2002 Sep 15 AS - Cancer. 95(6):1185-90, 2002 Sep 15 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Age Factors MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - *Choice Behavior MH - Employment MH - Female MH - Humans MH - Marital Status MH - *Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Prospective Studies MH - *Women/px [Psychology] AB - BACKGROUND: In the absence of medical contraindications, survival after undergoing breast-conserving therapy (BCT), mastectomy (M), and mastectomy with immediate reconstruction (MIR) is equal. The authors studied demographic factors to identify the variables that differed significantly among women making different surgical choices. AB - METHODS: Women with ductal carcinoma in situ or clinical Stage I or II breast carcinoma with no contraindications for BCT or MIR who were treated between 1995 and 1998 were identified from a prospectively collected data base. Demographic and tumor factors were compared using the Fisher exact test. AB - RESULTS: There were 578 women with 586 tumors who did not have contraindications for BCT or MIR. Among this group, 85.2% of women chose BCT, 9.2% of women chose M, and 5.6% of women chose MIR. Women undergoing M alone were older and were more likely to have Stage II carcinoma compared with women undergoing BCT. Patients undergoing M or MIR were more likely to have had a prior breast biopsy compared with patients who chose BCT. Marital status and employment approached significance (P = 0.06); however, a family history of breast carcinoma was not a predictor of treatment choice. AB - CONCLUSIONS: The current findings suggest a need for patient education strategies that emphasize the lack of influence of age and prior breast biopsy on the use of BCT. Differences in demographic variables may reflect true variations in patient preference among groups, emphasizing the need to address the spectrum of treatment options with patients. AB - Copyright 2002 American Cancer Society. IS - 0008-543X IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.10824 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. ID - 12216083 [pubmed] ID - 10.1002/cncr.10824 [doi] PP - ppublish GI - No: P50CA89018 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2002 Sep 15 DC - 20020906 EZ - 2002/09/07 10:00 DA - 2002/09/28 04:00 DT - 2002/09/07 10:00 YR - 2002 ED - 20020927 RD - 20071114 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12216083 <456. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11773308 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Levine M AU - Whelan T FA - Levine, M FA - Whelan, T IN - Levine, M. Cancer Care Ontario-Hamilton Regional Cancer Centre, Department of Medicine, McMaster University, 1200 Main St. W., Hamilton, Ontario L8N 3Z5, Canada. mlevine@mcmaster.ca TI - Decision-making process--communicating risk/benefits: is there an ideal technique?. [Review] [15 refs] SO - Journal of the National Cancer Institute. Monographs. (30):143-5, 2001 AS - J Natl Cancer Inst Monogr. (30):143-5, 2001 NJ - Journal of the National Cancer Institute. Monographs PI - Journal available in: Print PI - Citation processed from: Print JC - atr, 9011255 IO - J. Natl. Cancer Inst. Monographs SB - Index Medicus CP - United States MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant/px [Psychology] MH - Decision Making MH - Humans MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental/px [Psychology] MH - *Patient Education as Topic/mt [Methods] MH - Risk Assessment/mt [Methods] IS - 1052-6773 IL - 1052-6773 PT - Journal Article PT - Review ID - 11773308 [pubmed] PP - ppublish LG - English DP - 2001 DC - 20020104 EZ - 2002/01/05 10:00 DA - 2002/06/27 10:01 DT - 2002/01/05 10:00 YR - 2001 ED - 20020626 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11773308 <457. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11773285 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - National Institutes of Health Consensus Development Panel FA - National Institutes of Health Consensus Development Panel TI - National Institutes of Health Consensus Development Conference statement: adjuvant therapy for breast cancer, November 1-3, 2000. [Review] [89 refs] SO - Journal of the National Cancer Institute. Monographs. (30):5-15, 2001 AS - J Natl Cancer Inst Monogr. (30):5-15, 2001 NJ - Journal of the National Cancer Institute. Monographs PI - Journal available in: Print PI - Citation processed from: Print JC - atr, 9011255 IO - J. Natl. Cancer Inst. Monographs SB - Index Medicus CP - United States MH - Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - Humans MH - Practice Guidelines as Topic MH - Quality of Life MH - Randomized Controlled Trials as Topic AB - OBJECTIVE: Our goal was to provide health-care providers, patients, and the general public with an assessment of currently available data regarding the use of adjuvant therapy for breast cancer. AB - PARTICIPANTS: The participants included a non-Federal, non-advocate, 14-member panel representing the fields of oncology, radiology, surgery, pathology, statistics, public health, and health policy as well as patient representatives. In addition, 30 experts in medical oncology, radiation oncology, biostatistics, epidemiology, surgical oncology, and clinical trials presented data to the panel and to a conference audience of 1000. AB - EVIDENCE: The literature was searched with the use of MEDLINE for January 1995 through July 2000, and an extensive bibliography of 2230 references was provided to the panel. Experts prepared abstracts for their conference presentations with relevant citations from the literature. Evidence from randomized clinical trials and evidence from prospective studies were given precedence over clinical anecdotal experience. AB - CONSENSUS PROCESS: The panel, answering predefined questions, developed its conclusions based on the evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately after its release at the conference and was updated with the panel's final revisions. The statement is available at http://consensus.nih.gov. AB - CONCLUSIONS: The panel concludes that decisions regarding adjuvant hormonal therapy should be based on the presence of hormone receptor protein in tumor tissues. Adjuvant hormonal therapy should be offered only to women whose tumors express hormone receptor protein. Because adjuvant polychemotherapy improves survival, it should be recommended to the majority of women with localized breast cancer regardless of lymph node, menopausal, or hormone receptor status. The inclusion of anthracyclines in adjuvant chemotherapy regimens produces a small but statistically significant improvement in survival over non-anthracycline-containing regimens. Available data are currently inconclusive regarding the use of taxanes in adjuvant treatment of lymph node-positive breast cancer. The use of adjuvant dose-intensive chemotherapy regimens in high-risk breast cancer and of taxanes in lymph node-negative breast cancer should be restricted to randomized trials. Ongoing studies evaluating these treatment strategies should be supported to determine if such strategies have a role in adjuvant treatment. Studies to date have included few patients older than 70 years. There is a critical need for trials to evaluate the role of adjuvant chemotherapy in these women. There is evidence that women with a high risk of locoregional tumor recurrence after mastectomy benefit from postoperative radiotherapy. This high-risk group includes women with four or more positive lymph nodes or an advanced primary cancer. Currently, the role of postmastectomy radiotherapy for patients with one to three positive lymph nodes remains uncertain and should be tested in a randomized controlled trial. Individual patients differ in the importance they place on the risks and benefits of adjuvant treatments. Quality of life needs to be evaluated in selected randomized clinical trials to examine the impact of the major acute and long-term side effects of adjuvant treatments, particularly premature menopause, weight gain, mild memory loss, and fatigue. Methods to support shared decision-making between patients and their physicians have been successful in trials; they need to be tailored for diverse populations and should be tested for broader dissemination. [References: 89] RN - 0 (Antineoplastic Agents) IS - 1052-6773 IL - 1052-6773 PT - Consensus Development Conference PT - Consensus Development Conference, NIH PT - Journal Article PT - Review ID - 11773285 [pubmed] PP - ppublish LG - English DP - 2001 DC - 20020104 EZ - 2002/01/05 10:00 DA - 2002/06/27 10:01 DT - 2002/01/05 10:00 YR - 2001 ED - 20020626 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11773285 <458. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12039934 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lee JH AU - Glick HA AU - Hayman JA AU - Solin LJ FA - Lee, Jason H FA - Glick, Henry A FA - Hayman, James A FA - Solin, Lawrence J IN - Lee, Jason H. Department of Radiation Oncology, Division of General Internal Medicine, University of Pennsylvania Medical Center, Philadelphia, PA, USA. jasonlee@massmed.org TI - Decision-analytic model and cost-effectiveness evaluation of postmastectomy radiation therapy in high-risk premenopausal breast cancer patients. SO - Journal of Clinical Oncology. 20(11):2713-25, 2002 Jun 01 AS - J Clin Oncol. 20(11):2713-25, 2002 Jun 01 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - *Aftercare/ec [Economics] MH - *Breast Neoplasms/ec [Economics] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Cost-Benefit Analysis MH - *Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Humans MH - Lymphatic Metastasis MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - *Models, Econometric MH - Premenopause MH - Quality-Adjusted Life Years MH - Radiotherapy, Adjuvant/ec [Economics] MH - Reproducibility of Results MH - Sensitivity and Specificity MH - Survival Rate MH - *Value of Life AB - PURPOSE: To present a decision model that describes the clinical and economic outcomes of node-positive breast cancer with and without postmastectomy radiation therapy (PMRT). AB - METHODS: A Markov process was constructed to project the natural history of breast cancer following mastectomy in premenopausal node-positive women. Biannual hazards of local and distant recurrence without PMRT were derived from a large meta-analysis of adjuvant systemic therapy trials for breast cancer. The addition of PMRT reduced the risk of disease relapse by an odds ratio of 0.69. Costs of PMRT ($11,600) and recurrent breast cancer ($4,250 to 16,200/year) were estimated from available literature. The model projected number of recurrences, relapse-free and overall survival, and costs to 15 years, using a discount rate of 3%. Cost-effectiveness ratios were calculated per incremental year of life and quality-adjusted year of life gained. One- and two-way sensitivity analyses were performed to determine the sensitivity of results to clinical and economic assumptions. AB - RESULTS: The model projected 15-year relapse-free survival of 52% and 43% with and without PMRT, respectively. Overall survival was increased from 48% to 55% with PMRT, resulting in an incremental 0.29 years of life gained per subject. PMRT increased 15-year costs from $40,800 to $48,100. Cost per year of life gained was $24,900, or $22,600 when survival was adjusted for quality of life. Results of the model were relatively sensitive to radiation therapy cost and breast cancer relapse risk. AB - CONCLUSION: This analysis suggests that PMRT offers substantial clinical benefits achieved in a cost-effective manner, with an average cost per year of life gained of $24,900. Results of the model were robust under a wide range of clinical and economic parameters. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.2002.07.008 PT - Journal Article ID - 12039934 [pubmed] ID - 10.1200/JCO.2002.07.008 [doi] PP - ppublish LG - English DP - 2002 Jun 01 DC - 20020531 EZ - 2002/06/01 10:00 DA - 2002/06/21 10:01 DT - 2002/06/01 10:00 YR - 2002 ED - 20020620 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12039934 <459. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11803105 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Aillet S AU - Watier E AU - Chevrier S AU - Pailheret JP AU - Grall JY FA - Aillet, S FA - Watier, E FA - Chevrier, S FA - Pailheret, J-P FA - Grall, J-Y IN - Aillet, S. Service de Chirurgie Plastique, Reconstructrice et Esthetique, Hopital Sud, Universite de Rennes, 35056 Rennes Cedex, France. TI - Breast feeding after reduction mammaplasty performed during adolescence. SO - European Journal of Obstetrics, Gynecology, & Reproductive Biology. 101(1):79-82, 2002 Feb 10 AS - Eur J Obstet Gynecol Reprod Biol. 101(1):79-82, 2002 Feb 10 NJ - European journal of obstetrics, gynecology, and reproductive biology PI - Journal available in: Print PI - Citation processed from: Print JC - e4l, 0375672 IO - Eur. J. Obstet. Gynecol. Reprod. Biol. SB - Index Medicus CP - Ireland MH - Adult MH - *Breast Feeding MH - Female MH - Humans MH - *Mammaplasty MH - Patient Education as Topic MH - Patient Satisfaction MH - Surveys and Questionnaires AB - UNLABELLED: Reduction mammaplasty (RM) can be performed during adolescence if the functional capacity of the breast is preserved. Future breast feeding must be carefully considered in the therapeutic decision making process. AB - PURPOSE OF THE STUDY: Breast feeding after reduction mammaplasty performed during adolescence was assessed to determine surgical factors influencing outcome and patient reception of information concerning breast feeding. AB - METHODS: A questionnaire was sent to 109 women who had undergone reduction mammaplasty between 1981 and 1997 when they were 15-17 years old to ascertain their reasons for having surgery, their satisfaction, and their attitude towards breast feeding. AB - RESULTS: Sixty-five questionnaires (60%) could be analyzed. Mean delay since surgery was 8.1 years. Seventeen women (26%) had delivered 25 infants (mean 1.5). Mean delay after surgery to first delivery was 7.68 years. Five women (29%) nursed their first infant for a mean 11.3 days. None of the women interrupted breast feeding for a reason related to a nipple anomaly or difficult sucking. Twelve women (71%) did not nurse their first infant, because of the prior breast surgery for six of them. Among the 48 nulliparous women, 24 (50%) stated they would nurse their future infant. Although information on breast feeding was systematically delivered, 41 women (63%) stated they had not been informed. There was no statistical relationship between breast feeding and degree of satisfaction, patient-assessed scar quality, or nipple disorders. AB - CONCLUSION: Adolescents who undergo reduction mammaplasty can nurse their future infants with a complication rate similar to that in the general population. Special attention must be given to delivery of information on breast feeding. IS - 0301-2115 IL - 0301-2115 DI - S0301211501005176 PT - Journal Article ID - 11803105 [pubmed] ID - S0301211501005176 [pii] PP - ppublish LG - English DP - 2002 Feb 10 DC - 20020122 EZ - 2002/01/23 10:00 DA - 2002/06/12 10:01 DT - 2002/01/23 10:00 YR - 2002 ED - 20020606 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11803105 <460. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 12011131 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Grann VR AU - Jacobson JS AU - Thomason D AU - Hershman D AU - Heitjan DF AU - Neugut AI FA - Grann, Victor R FA - Jacobson, Judith S FA - Thomason, Dustin FA - Hershman, Dawn FA - Heitjan, Daniel F FA - Neugut, Alfred I IN - Grann, Victor R. Herbert Irving Comprehensive Cancer Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th Street, New York, NY 10032, USA. TI - Effect of prevention strategies on survival and quality-adjusted survival of women with BRCA1/2 mutations: an updated decision analysis. SO - Journal of Clinical Oncology. 20(10):2520-9, 2002 May 15 AS - J Clin Oncol. 20(10):2520-9, 2002 May 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Aged MH - Aged, 80 and over MH - *Anticarcinogenic Agents/tu [Therapeutic Use] MH - *BRCA1 Protein/ge [Genetics] MH - *BRCA2 Protein/ge [Genetics] MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - Disease-Free Survival MH - Female MH - Humans MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - Mutation MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovarian Neoplasms/th [Therapy] MH - Ovariectomy MH - Probability MH - Quality of Life MH - Quality-Adjusted Life Years MH - Risk Factors MH - *Tamoxifen/tu [Therapeutic Use] AB - PURPOSE: This study updates findings regarding the effects of prophylactic surgery, chemoprevention, and surveillance on the survival and quality-adjusted survival of women who test positive for BRCA1/2 mutations. AB - MATERIALS AND METHODS: Markov modeling of outcomes was performed in a simulated cohort of 30-year-old women who tested positive for BRCA1/2 mutations. The model incorporated breast and ovarian cancer incidence rates from the literature and mortality rates from the Surveillance, Epidemiology, and End Results Program. Quality adjustment of survival estimates were obtained from a survey of women aged 33 to 50 years. Sensitivity analyses were performed of varied assumptions regarding timing and effects of preventive measures on cancer incidence and adverse effects. AB - RESULTS: A 30-year-old woman could prolong her survival beyond that associated with surveillance alone by use of preventive measures: 1.8 years with tamoxifen, 2.6 years with prophylactic oophorectomy, 4.6 years with both tamoxifen and prophylactic oophorectomy, 3.5 years with prophylactic mastectomy, and 4.9 years with both surgeries. She could prolong her quality-adjusted survival by 2.8 years with tamoxifen, 4.4 years with prophylactic oophorectomy, 6.3 years with tamoxifen and oophorectomy, and 2.6 years with mastectomy, or with both surgeries. The benefits of all of these strategies would decrease if they were initiated at later ages. AB - CONCLUSION: Women who test positive for BRCA1/2 mutations may derive greater survival and quality adjusted survival benefits than previously reported from chemoprevention, prophylactic surgery, or a combination. Observational studies and clinical trials are needed to verify the results of this analysis of the long-term benefits of preventive strategies among BRCA1/2-positive women. RN - 0 (Anticarcinogenic Agents) RN - 0 (BRCA1 Protein) RN - 0 (BRCA2 Protein) RN - 094ZI81Y45 (Tamoxifen) IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.2002.10.101 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 12011131 [pubmed] ID - 10.1200/JCO.2002.10.101 [doi] PP - ppublish LG - English DP - 2002 May 15 DC - 20020515 EZ - 2002/05/16 10:00 DA - 2002/06/06 10:01 DT - 2002/05/16 10:00 YR - 2002 ED - 20020605 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=12011131 <461. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11904473 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Janni W AU - Rjosk D AU - Strobl B AU - Bergauer F AU - Linka F AU - Dimpfl T AU - Schindlbeck C AU - Rack B AU - Kaestner R AU - Sommer H FA - Janni, W FA - Rjosk, D FA - Strobl, B FA - Bergauer, F FA - Linka, F FA - Dimpfl, T FA - Schindlbeck, C FA - Rack, B FA - Kaestner, R FA - Sommer, H IN - Janni, W. 1. Frauenklinik, Klinikum der Ludwig-Maximilians-Universitat, Munchen, Deutschland. janni@fk-i.med.uni-muenchen.de TI - [Chemotherapy-associated myelosuppression in gynecological oncology]. [German] OT - Chemotherapieassoziierte Myelosuppression in der gynakologischen Onkologie. SO - Gynakologisch-Geburtshilfliche Rundschau. 41(3):166-73, 2001 AS - Gynakol Geburtshilfliche Rundsch. 41(3):166-73, 2001 NJ - Gynakologisch-geburtshilfliche Rundschau PI - Journal available in: Print PI - Citation processed from: Print JC - bk6, 9212667 IO - Gynakol Geburtshilfliche Rundsch SB - Index Medicus CP - Switzerland MH - Adult MH - Aged MH - *Antineoplastic Combined Chemotherapy Protocols/ae [Adverse Effects] MH - *Bone Marrow/de [Drug Effects] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant MH - *Cisplatin/ae [Adverse Effects] MH - Cobalt Radioisotopes/tu [Therapeutic Use] MH - Combined Modality Therapy MH - *Cyclophosphamide/ae [Adverse Effects] MH - Data Interpretation, Statistical MH - *Etoposide/ae [Adverse Effects] MH - Female MH - *Fluorouracil/ae [Adverse Effects] MH - Hematopoiesis/de [Drug Effects] MH - Humans MH - Leukopoiesis/de [Drug Effects] MH - Lymph Node Excision MH - Lymphatic Metastasis MH - Mastectomy, Segmental MH - *Methotrexate/ae [Adverse Effects] MH - Middle Aged MH - *Ovarian Neoplasms/dt [Drug Therapy] MH - Ovarian Neoplasms/su [Surgery] MH - Platelet Count MH - Radioisotope Teletherapy MH - Radiotherapy Dosage AB - INTRODUCTION AND OBJECTIVE: A clinically important myelosuppression due to adjuvant chemotherapy is seen more frequently as dosage is intensified and new drugs are used. The assessment of the cytopenia expected is frequently hampered by a lack of directly comparable data. The aim of this study was to compare - in our own patient population - the chemotherapy-associated myelosuppression of four chemotherapeutic regimens used in gynecological oncology. AB - METHODS: 79 patients with primary breast cancer and 26 patients with epithelial ovarian carcinoma underwent cytostatic treatment, and the associated myelosuppression was evaluated by the determination of cytopenia and the need for supportive therapy. The chemotherapy regimens investigated were CMF (cyclophosphamide 600 mg/m(2), methotrexate 40 mg/m(2), 5-fluorouracil 600 mg/m(2), 6xq3w), EC/CMF (epirubicin 90 mg/m(2), cyclophosphamide 600 mg/m(2), 4xq3w, followed by CMF, 3xq3w), DE (docetaxel 75 mg/m(2), epirubicin 90 mg/m(2), 6xq3w) and CC (cyclophosphamide 600 mg/m(2), carboplatin AUC 6, 6xq3w). AB - RESULTS: The EC/CMF and DE regimens were used significantly more frequently for more advanced tumor stages, but there were no differences concerning tumor-dependent prechemotherapeutic myelosuppression. Hemopoiesis was most impaired in the CC group with a mean drop of serum hemoglobin of 1.5 g/dl to the end of the cytostatic treatment; correspondingly, most transfusions of concentrated erythrocytes were needed in this group. The strongest suppression of leukopoiesis was found in the DE group, with a mean drop in leukocyte counts of 6.2 x 10(3)/microliter per cycle; in this group, a mean of 7.6 ready-made syringes with 263 microgram Lenogastrim was used to stimulate leukopoiesis. The severest drop in the mean thrombocyte count, i.e. 171.7 x 10(3)/microliter, was found in the CC group. AB - CONCLUSIONS: The CC regimen impairs thrombo- and erythropoiesis most, whereas the DE regimen causes marked leukopenia. The regimen with the smallest myelosuppression was CMF. No severe cytopenia-associated complications were detected in any of the cases investigated. RN - 0 (Cobalt Radioisotopes) RN - 6PLQ3CP4P3 (Etoposide) RN - 8N3DW7272P (Cyclophosphamide) RN - Q20Q21Q62J (Cisplatin) RN - U3P01618RT (Fluorouracil) RN - YL5FZ2Y5U1 (Methotrexate) PS - CMF regimen; CP protocol; EC regimen; VP-P protocol IS - 1018-8843 IL - 1018-8843 DI - 49471 DO - https://dx.doi.org/49471 PT - Comparative Study PT - English Abstract PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11904473 [pubmed] ID - 49471 [pii] ID - 49471 [doi] PP - ppublish LG - German DP - 2001 DC - 20020320 EZ - 2002/03/21 10:00 DA - 2002/05/30 10:01 DT - 2002/03/21 10:00 YR - 2001 ED - 20020529 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11904473 <462. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11987942 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - DeBono R AU - Thompson A AU - Stevenson JH FA - DeBono, R FA - Thompson, A FA - Stevenson, J H IN - DeBono, R. Department of Plastic Surgery, Ninewells Hospital and Medical School, Dundee, UK. TI - Immediate versus delayed free TRAM breast reconstruction: an analysis of perioperative factors and complications. SO - British Journal of Plastic Surgery. 55(2):111-6, 2002 Mar AS - Br J Plast Surg. 55(2):111-6, 2002 Mar NJ - British journal of plastic surgery PI - Journal available in: Print PI - Citation processed from: Print JC - b0w, 2984714r IO - Br J Plast Surg SB - Index Medicus CP - England MH - Adult MH - Anastomosis, Surgical MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Female MH - Graft Rejection MH - Humans MH - *Mammaplasty/mt [Methods] MH - *Mastectomy MH - Middle Aged MH - Postoperative Complications MH - Postoperative Period MH - Retrospective Studies MH - Surgical Flaps/bs [Blood Supply] AB - Immediate breast reconstruction provides superior psychological benefit to the patient compared with delayed reconstruction, and has a financial advantage. Smokers undergoing immediate free TRAM breast reconstruction have a higher incidence of flap necrosis than smokers undergoing delayed free TRAM reconstruction. Whereas the differences in psychological benefit, effects of smoking and cost are well addressed in the literature, the differences in morbidity between immediate and delayed free TRAM breast reconstruction are still unknown. Knowledge of any differences would help to determine the best timing for reconstruction, and would support surgical decision making and preoperative patient advice. We present a retrospective review of 105 consecutive free TRAM breast reconstructions performed in 97 patients (89 unilateral and eight bilateral reconstructions). There were 48 immediate reconstructions and 57 delayed reconstructions. In the immediate-reconstruction group six flaps required revision of the anastomosis, and three flaps (6%) were lost. In the delayed-reconstruction group five flaps required revision of the anastomosis, and only one flap (2%) could not be salvaged. Delayed healing of the chest-wall skin flaps only occurred in immediate reconstructions (16%, P = 0.017). AB - Copyright 2002 The British Association of Plastic Surgeons. IS - 0007-1226 IL - 0007-1226 DI - S0007122602937471 DO - https://dx.doi.org/10.1054/bjps.2002.3747 PT - Comparative Study PT - Journal Article ID - 11987942 [pubmed] ID - 10.1054/bjps.2002.3747 [doi] ID - S0007122602937471 [pii] PP - ppublish LG - English DP - 2002 Mar DC - 20020503 EZ - 2002/05/04 10:00 DA - 2002/05/15 10:01 DT - 2002/05/04 10:00 YR - 2002 ED - 20020514 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11987942 <463. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11956270 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - van Roosmalen MS AU - Verhoef LC AU - Stalmeier PF AU - Hoogerbrugge N AU - van Daal WA FA - van Roosmalen, Marielle S FA - Verhoef, Lia C G FA - Stalmeier, Peep F M FA - Hoogerbrugge, Nicoline FA - van Daal, Willem A J IN - van Roosmalen, Marielle S. Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN), University Medical Center Nijmegen, The Netherlands. m.vanroosmalen@rther.azn.nl TI - Decision analysis of prophylactic surgery or screening for BRCA1 mutation carriers: a more prominent role for oophorectomy. SO - Journal of Clinical Oncology. 20(8):2092-100, 2002 Apr 15 AS - J Clin Oncol. 20(8):2092-100, 2002 Apr 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - Genes, BRCA2 MH - Genetic Testing MH - Humans MH - Markov Chains MH - *Mastectomy MH - Mutation MH - *Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - Quality-Adjusted Life Years AB - PURPOSE: BRCA1 mutation carriers have a high risk of developing breast and ovarian cancer. Carriers may opt for prophylactic surgery and screening. Recent data suggesting that prophylactic oophorectomy reduces breast cancer risk have been incorporated in a decision analysis. AB - METHODS: A Markov model was developed to compare LE and QALE following four strategies: (1) prophylactic mastectomy and prophylactic oophorectomy (PMPO), (2) screening for breast cancer and prophylactic oophorectomy (BSPO), (3) prophylactic mastectomy and screening for ovarian cancer (PMOS), and (4) screening for breast and ovarian cancer (BSOS). The analysis was performed for a high (85% breast cancer, 63% ovarian cancer) and medium (56% breast cancer, 16% ovarian cancer) risk level. Utilities for the health states after prophylactic surgery were obtained from mutation carriers. Other model parameter values were obtained from the literature. Sensitivity analyses were performed. AB - RESULTS: When compared with BSOS, the average gain in LE for 30-year-old carriers in the high (medium) risk group was 11.7 (6.6) years for PMPO, 9.5 (5.3) years for BSPO, and 4.9 (4.4) years for PMOS. For 30-year-old carriers, BSPO had a QALE advantage when PO was performed before age 40. In the medium-risk group, there was a stronger advantage for BSPO when QALE was considered. AB - CONCLUSION: PMPO is the most effective strategy to prolong life. However, if patient preferences were taken into account, BSPO tends to be a better strategy in most women at medium risk or in young women at high risk when PO was performed before age 40. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/jco.2002.08.035 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11956270 [pubmed] ID - 10.1200/jco.2002.08.035 [doi] PP - ppublish LG - English DP - 2002 Apr 15 DC - 20020416 EZ - 2002/04/17 10:00 DA - 2002/05/01 10:01 DT - 2002/04/17 10:00 YR - 2002 ED - 20020430 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11956270 <464. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11920455 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Clauson J AU - Hsieh YC AU - Acharya S AU - Rademaker AW AU - Morrow M FA - Clauson, Jennifer FA - Hsieh, Y C FA - Acharya, Simbi FA - Rademaker, Alfred W FA - Morrow, Monica IN - Clauson, Jennifer. Lynn Sage Breast Program, Northwestern University, Chicago, Illinois, USA. TI - Results of the Lynn Sage Second-Opinion Program for local therapy in patients with breast carcinoma. Changes in management and determinants of where care is delivered. SO - Cancer. 94(4):889-94, 2002 Feb 15 AS - Cancer. 94(4):889-94, 2002 Feb 15 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/th [Therapy] MH - *Carcinoma, Intraductal, Noninfiltrating/th [Therapy] MH - *Decision Making MH - Female MH - Humans MH - Middle Aged MH - *Patient Care Planning MH - Patient Education as Topic MH - *Referral and Consultation MH - Retrospective Studies AB - BACKGROUND: The treatment options of breast conservation therapy (BCT) and immediate reconstruction for patients with carcinoma of the breast have not been adopted widely. The objectives of this study were to determine how often a second opinion on the local therapy of breast carcinoma changed patient management and to identify factors predictive of remaining at the second-opinion site for therapy. AB - METHODS: Two hundred thirty-one patients with intraductal carcinoma or Stage I and II breast carcinoma were reviewed retrospectively. At the time of the second opinion, patients completed a questionnaire regarding their initial surgical opinion and the reason for seeking consultation. AB - RESULTS: Only 46% of patients had a complete discussion of treatment options prior to the second opinion. The second opinion changed management in 54 patients (20.3%). The most common finding was eligibility for BCT in patients who were offered only mastectomy. Definitive local therapy occurred at the second-opinion site in 65.8% of patients. The only predictors of remaining at the second-opinion site were insurance type (P = 0.008) and the patient's perception that options were not discussed at the initial opinion (P < 0.001). AB - CONCLUSIONS: Second opinions provide useful information to patients and may change the management of their disease. They result in significant patient capture for an institution. AB - Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10318 IS - 0008-543X IL - 0008-543X DI - 10.1002/cncr.10318 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. ID - 11920455 [pubmed] ID - 10.1002/cncr.10318 [pii] PP - ppublish GI - No: P50-CA89018 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2002 Feb 15 DC - 20020328 EZ - 2002/03/29 10:00 DA - 2002/04/16 10:01 DT - 2002/03/29 10:00 YR - 2002 ED - 20020415 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11920455 <465. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11760103 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schapira MM AU - Nattinger AB AU - McHorney CA FA - Schapira, M M FA - Nattinger, A B FA - McHorney, C A IN - Schapira, M M. Department of Medicine, Medical College of Wisconsin, Milwaukee, 53226, USA. mschap@mcw.edu TI - Frequency or probability? A qualitative study of risk communication formats used in health care. SO - Medical Decision Making. 21(6):459-67, 2001 Nov-Dec AS - Med Decis Making. 21(6):459-67, 2001 Nov-Dec NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/et [Etiology] MH - *Communication MH - *Decision Support Techniques MH - Female MH - Focus Groups MH - Humans MH - Middle Aged MH - *Patient Participation MH - Probability MH - Risk Factors AB - BACKGROUND: The communication of probabilistic outcomes is an essential aspect of shared medical decision making. AB - METHODS: The authors conducted a qualitative study using focus groups to evaluate the response of women to various formats used in the communication of breast cancer risk. AB - FINDINGS: Graphic discrete frequency formats using highlighted human figures had greater salience than continuous probability formats using bar graphs. Potential biases in the estimation of risk magnitude were associated with the use of highlighted human figures versus bar graphs and the denominator size in graphics using highlighted human figures. The presentation of uncertainty associated with risk estimates caused some to loose trust in the information, whereas others were accepting of uncertainty in scientific data. AB - CONCLUSION: The qualitative studyidentified new constructs with regard to how patients process probabilistic information. Further research in the clinical setting is needed to provide a theoretical justification for the format used when presenting risk information to patients. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X0102100604 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11760103 [pubmed] ID - 10.1177/0272989X0102100604 [doi] PP - ppublish LG - English DP - 2001 Nov-Dec DC - 20011210 EZ - 2002/01/05 10:00 DA - 2002/03/08 10:01 DT - 2002/01/05 10:00 YR - 2001 ED - 20020307 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=11760103 <466. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11760103 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schapira MM AU - Nattinger AB AU - McHorney CA FA - Schapira, M M FA - Nattinger, A B FA - McHorney, C A IN - Schapira, M M. Department of Medicine, Medical College of Wisconsin, Milwaukee, 53226, USA. mschap@mcw.edu TI - Frequency or probability? A qualitative study of risk communication formats used in health care. SO - Medical Decision Making. 21(6):459-67, 2001 Nov-Dec AS - Med Decis Making. 21(6):459-67, 2001 Nov-Dec NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/et [Etiology] MH - *Communication MH - *Decision Support Techniques MH - Female MH - Focus Groups MH - Humans MH - Middle Aged MH - *Patient Participation MH - Probability MH - Risk Factors AB - BACKGROUND: The communication of probabilistic outcomes is an essential aspect of shared medical decision making. AB - METHODS: The authors conducted a qualitative study using focus groups to evaluate the response of women to various formats used in the communication of breast cancer risk. AB - FINDINGS: Graphic discrete frequency formats using highlighted human figures had greater salience than continuous probability formats using bar graphs. Potential biases in the estimation of risk magnitude were associated with the use of highlighted human figures versus bar graphs and the denominator size in graphics using highlighted human figures. The presentation of uncertainty associated with risk estimates caused some to loose trust in the information, whereas others were accepting of uncertainty in scientific data. AB - CONCLUSION: The qualitative studyidentified new constructs with regard to how patients process probabilistic information. Further research in the clinical setting is needed to provide a theoretical justification for the format used when presenting risk information to patients. IS - 0272-989X IL - 0272-989X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11760103 [pubmed] PP - ppublish LG - English DP - 2001 Nov-Dec DC - 20011210 EZ - 2002/01/05 10:00 DA - 2002/03/08 10:01 DT - 2002/01/05 10:00 YR - 2001 ED - 20020307 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11760103 <467. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11794205 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Riggs T FA - Riggs, T TI - Prophylactic mastectomy in carriers of BRCA mutations. SO - New England Journal of Medicine. 345(20):1499; author reply 1499-500, 2001 Nov 15 AS - N Engl J Med. 345(20):1499; author reply 1499-500, 2001 Nov 15 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Data Interpretation, Statistical MH - Female MH - Genes, BRCA1 MH - Genes, BRCA2 MH - Humans MH - *Mastectomy MH - Mutation MH - Risk MH - Sensitivity and Specificity IS - 0028-4793 IL - 0028-4793 PT - Letter ID - 11794205 [pubmed] PP - ppublish LG - English DP - 2001 Nov 15 DC - 20011105 EZ - 2002/01/17 10:00 DA - 2002/01/17 10:01 DT - 2002/01/17 10:00 YR - 2001 ED - 20020116 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11794205 <468. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11721686 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kiefer CG FA - Kiefer, C G IN - Kiefer, C G. Academy of Certified Case Managers. TI - Presenting all the choices: teaching women about breast prosthetics. SO - Medscape Womens Health. 6(5):4, 2001 Oct AS - Medscape Womens Health. 6(5):4, 2001 Oct NJ - Medscape women's health PI - Journal available in: Print PI - Citation processed from: Internet JC - c3a, 100844142 IO - Medscape Womens Health SB - Consumer Health Journals CP - United States MH - Body Image MH - Breast Implantation MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Clothing MH - Communication MH - Decision Making MH - Esthetics MH - Female MH - Humans MH - *Mammaplasty MH - *Mastectomy/px [Psychology] MH - *Patient Education as Topic MH - Patient Participation MH - Physician-Patient Relations MH - *Prostheses and Implants/td [Trends] MH - Prosthesis Design MH - Prosthesis Fitting AB - It is imperative that women facing breast cancer surgery have all their options for regaining body symmetry presented to them in a nonbiased manner. Today, women are more likely to receive information about breast reconstruction than about external breast prostheses. This may largely be due to the wealth of information available about reconstruction and the comfort level of the medical community in recommending this procedure. Breast prosthetic science is not taught in medical or nursing education programs, and few articles exist on the subject. ES - 1521-2076 IL - 1521-2076 PT - Journal Article ID - 11721686 [pubmed] PP - ppublish LG - English DP - 2001 Oct DC - 20011126 EZ - 2001/11/28 10:00 DA - 2002/01/10 10:01 DT - 2001/11/28 10:00 YR - 2001 ED - 20020104 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11721686 <469. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11471952 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tebbetts JB FA - Tebbetts, J B IN - Tebbetts, J B. jbt@plastic-surgery.com TI - A surgical perspective from two decades of breast augmentation: toward state of the art in 2001. SO - Clinics in Plastic Surgery. 28(3):425-34, v, 2001 Jul AS - Clin Plast Surg. 28(3):425-34, v, 2001 Jul NJ - Clinics in plastic surgery PI - Journal available in: Print PI - Citation processed from: Print JC - dhx, 0424767 IO - Clin Plast Surg SB - Index Medicus CP - United States MH - *Breast/su [Surgery] MH - Breast Implants MH - Choice Behavior MH - Female MH - Humans MH - *Mammaplasty/mt [Methods] MH - Patient Education as Topic MH - Patient Selection MH - Preoperative Care AB - This article summarizes the author's perspective of two decades of breast augmentation based on clinical experience using virtually every type of implant, incision location, pocket location, dissection technique and instrumentation available from 1977 to 2001. Based on this experience, the author focuses on patient education, the importance of patient choice, patient evaluation and preoperative planning, surgical techniques, patient recovery, and factors to limit reoperations. IS - 0094-1298 IL - 0094-1298 PT - Journal Article ID - 11471952 [pubmed] PP - ppublish LG - English DP - 2001 Jul DC - 20010726 EZ - 2001/07/27 10:00 DA - 2002/01/05 10:01 DT - 2001/07/27 10:00 YR - 2001 ED - 20011207 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11471952 <470. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11679382 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mayor S FA - Mayor, S TI - Row over breast cancer screening shows that scientists bring "some subjectivity into their work. SO - BMJ. 323(7319):956, 2001 Oct 27 AS - BMJ. 323(7319):956, 2001 Oct 27 NJ - BMJ (Clinical research ed.) PI - Journal available in: Print PI - Citation processed from: Print JC - 8900488, bmj, 101090866 IO - BMJ PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121506 SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/su [Surgery] MH - *Data Interpretation, Statistical MH - Female MH - Humans MH - Mammography MH - *Mass Screening/sn [Statistics & Numerical Data] MH - Mastectomy/sn [Statistics & Numerical Data] MH - *Meta-Analysis as Topic MH - Randomized Controlled Trials as Topic IS - 0959-8138 IL - 0959-535X PT - News ID - 11679382 [pubmed] ID - PMC1121506 [pmc] PP - ppublish LG - English DP - 2001 Oct 27 DC - 20011026 EZ - 2001/10/27 10:00 DA - 2002/01/05 10:01 DT - 2001/10/27 10:00 YR - 2001 ED - 20011204 RD - 20081120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11679382 <471. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11555031 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Mastaglia B AU - Kristjanson LJ FA - Mastaglia, B FA - Kristjanson, L J IN - Mastaglia, B. School of Nursing and Public Health, Edith Cowan University, Churchlands, Western Australia, Australia. B.Mastaglia@ecu.edu.au TI - Factors influencing women's decisions for choice of surgery for Stage I and Stage II breast cancer in Western Australia. SO - Journal of Advanced Nursing. 35(6):836-47, 2001 Sep AS - J Adv Nurs. 35(6):836-47, 2001 Sep NJ - Journal of advanced nursing PI - Journal available in: Print PI - Citation processed from: Print JC - 7609811, h3l IO - J Adv Nurs SB - Index Medicus SB - Nursing Journal CP - England MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Humans MH - Life Change Events MH - *Mastectomy, Modified Radical MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Staging MH - Nursing Research MH - Patient Education as Topic MH - Professional-Patient Relations MH - Western Australia AB - BACKGROUND: Internal and external factors have been reported to influence decision-making by women for breast cancer surgery. AB - AIM OF THE STUDY: The aim of the study was to describe the factors those women with Stage I or Stage II breast cancer, perceived to be important when selecting either modified radical mastectomy or breast conserving treatment. AB - DESIGN/METHOD: A descriptive correlational study was conducted. A consecutive sample of women with a diagnosis of breast cancer during a 6-month period was selected from the Health Department of Western Australia Cancer Registry. AB - RESULTS: Women who had breast conserving treatment rated the surgeon's preference as a more important factor in decision-making than women who had modified radical mastectomy. The lack of difference in long-term survival between the types of surgery was also a more important influence on decision-making for the breast conserving treatment group compared with women who had received modified radical mastectomy. Women in rural areas tended to choose modified radical mastectomy rather than breast conserving treatment. The surgeon, family and general practitioner were important sources of information. A significant association was found between women's involvement in decision-making and their use of a general practitioner as an information source. Many women wanted the decision about surgery to be entirely their own; the breast conserving treatment group preferred a more active role in decision-making compared with those who chose modified radical mastectomy. Most women had participated in the decision-making process as much as they wished, had enough time in which to make their decisions and had received sufficient information. A correlation between adequacy of information and sufficient time for decision-making was found. AB - CONCLUSION: Findings may be useful to nurses and other health professionals who endeavour to provide adequate information and support to women during their initial treatment decision-making experience. IS - 0309-2402 IL - 0309-2402 DI - jan1921 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11555031 [pubmed] ID - jan1921 [pii] PP - ppublish LG - English DP - 2001 Sep DC - 20010913 EZ - 2001/09/14 10:00 DA - 2001/11/03 10:01 DT - 2001/09/14 10:00 YR - 2001 ED - 20011101 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11555031 <472. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11567173 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Jonkman JN AU - Normand SL AU - Wolf R AU - Borbas C AU - Guadagnoli E FA - Jonkman, J N FA - Normand, S L FA - Wolf, R FA - Borbas, C FA - Guadagnoli, E IN - Jonkman, J N. Department of Mathematics and Statistics, Mississippi State University, Mississippi State, MS, USA. TI - Identifying a cohort of patients with early-stage breast cancer: a comparison of hospital discharge and primary data. SO - Medical Care. 39(10):1105-17, 2001 Oct AS - Med Care. 39(10):1105-17, 2001 Oct NJ - Medical care PI - Journal available in: Print PI - Citation processed from: Print JC - 0230027, lsm IO - Med Care SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Cohort Studies MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Logistic Models MH - Massachusetts/ep [Epidemiology] MH - *Mastectomy, Segmental/ut [Utilization] MH - *Medical Record Linkage MH - Middle Aged MH - Minnesota/ep [Epidemiology] MH - Neoplasm Staging MH - *Patient Discharge MH - *Practice Patterns, Physicians'/sn [Statistics & Numerical Data] MH - *Primary Health Care MH - Utilization Review/mt [Methods] MH - Utilization Review/sn [Statistics & Numerical Data] AB - BACKGROUND: Hospital discharge data are a potential source of information for quality of care; however, they lack detailed clinical data. AB - OBJECTIVES: To assess the usefulness of hospital discharge data for describing patterns of care. AB - RESEARCH DESIGN: Cohort study comparing hospital discharge data with data collected from medical records and patients. AB - PATIENTS: Women diagnosed with early-stage breast cancer in Massachusetts and Minnesota (1993-1995). AB - MEASURES: The percentage of patients in the primary data set who did not match a record in the discharge data set, and the percentage of patients in the discharge data set who did not match a record in the primary data set. Odds ratios for appearing in one data set, but not the other according to patient and hospital characteristics. AB - RESULTS: For patients in the primary data set, 26.9% from Massachusetts and 13.2% from Minnesota did not match a record in the discharge data set. In both states, factors associated with failure to match to the discharge data included receipt of breast conserving surgery, shorter length of stay, and treatment hospital. For patients in the discharge data set, 43.4% in Massachusetts and 30.3% in Minnesota did not match a patient in the primary data set. In both states, factors associated with failure to match to the primary data included treatment hospital and the presence of positive lymph nodes. AB - CONCLUSIONS: Hospital discharge data were fairly sensitive when linked to patients with early-stage breast cancer who were identified through hospital records. The discharge data lacked specificity, however. If discharge data are used to characterize patterns care for inpatients with early stage disease, estimates are likely to be inaccurate due to the inclusion of unsuitable patients in the denominator used to calculate procedure rates. IS - 0025-7079 IL - 0025-7079 PT - Journal Article PT - Multicenter Study PT - Research Support, U.S. Gov't, P.H.S. ID - 11567173 [pubmed] PP - ppublish GI - No: R01 CA75545 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2001 Oct DC - 20010921 EZ - 2001/09/22 10:00 DA - 2001/10/19 10:01 DT - 2001/09/22 10:00 YR - 2001 ED - 20011018 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11567173 <473. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11427832 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Morelle M AU - Moumjid-Ferdjaoui N AU - Bremond A AU - Charavel M AU - Carrere MO FA - Morelle, M FA - Moumjid-Ferdjaoui, N FA - Bremond, A FA - Charavel, M FA - Carrere, M O IN - Morelle, M. Groupe de Recherche en Economie de la Sante et Reseaux de Soins en Cancerologie (GRESAC)-Laboratoire d'Analyse des Systemes de Sante, UMR 5823 du CNRS, Centre Leon Berard, 28 rue Laennec, 69008 Lyon, France. TI - [How to evaluate the quality of information transfer from physician to patient? Choice of psychometric tests for a decision tree in a Regional Cancer Centre]. [French] OT - Comment evaluer la qualite du transfert de l'information du medecin au patient? Le choix des tests psychometriques d'un tableau de decision dans un Centre Regional de Lutte contre le Cancer. SO - Revue d Epidemiologie et de Sante Publique. 49(3):299-313, 2001 Jun AS - Rev Epidemiol Sante Publique. 49(3):299-313, 2001 Jun NJ - Revue d'epidemiologie et de sante publique PI - Journal available in: Print PI - Citation processed from: Print JC - rst, 7608039 IO - Rev Epidemiol Sante Publique SB - Index Medicus CP - France MH - Aged MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - Case-Control Studies MH - Chemotherapy, Adjuvant MH - Choice Behavior MH - *Decision Trees MH - Female MH - France/ep [Epidemiology] MH - Humans MH - Mastectomy, Segmental MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Patient Education as Topic/st [Standards] MH - *Patient Participation/px [Psychology] MH - Postmenopause/px [Psychology] MH - Predictive Value of Tests MH - Prognosis MH - Psychometrics MH - Regional Medical Programs MH - Surveys and Questionnaires MH - Survival Analysis AB - BACKGROUND: Decision boards are used to transfer information from physicians to patients to help them participate in the clinical decision-making process. We present the tests and results of the psychometric properties of a decision board in a sample of healthy volunteers. AB - METHODS: In the Regional Cancer Centre located in Lyon, we developed a decision board for post-menopausal women with breast cancer after lumpectomy without any poor prognostic factors. Two treatment options were proposed, one involving chemotherapy and the other not. We tested for the following psychometric properties: comprehension, construct validity and reliability. Comprehension was evaluated using a questionnaire, in order to test whether the rates of correct answers were due to chance alone. The construct validity was assessed by changing the information provided (relapse and survival rates, characteristics of chemotherapy) and testing whether the proportion of healthy volunteers choosing an option changed in a predictable and significant way. The reliability was evaluated using the test-retest method. Two reliability statistics were computed: the Pearson correlation and the Intraclass Correlation Coefficient. AB - RESULTS: In the sample of 40 healthy volunteers, 23 chose the option with chemotherapy and 17 the option without chemotherapy. Results show that the decision board was comprehensive, valid (the women changed their choices in a predictable way) and reliable (Pearson correlation and Intraclass Correlation Coefficient close to 1). AB - CONCLUSION: The choice of the psychometrics properties tested and the statistical tests used are discussed. The psychometric properties of our tool are found to be satisfactory. RN - 0 (Antineoplastic Agents) IS - 0398-7620 IL - 0398-7620 DI - MDOI-RESP-06-2001-49-3-0398-7620-101019-ART9 PT - English Abstract PT - Journal Article PT - Validation Studies ID - 11427832 [pubmed] ID - MDOI-RESP-06-2001-49-3-0398-7620-101019-ART9 [pii] PP - ppublish LG - French DP - 2001 Jun DC - 20010627 EZ - 2001/06/28 10:00 DA - 2001/09/28 10:01 DT - 2001/06/28 10:00 YR - 2001 ED - 20010927 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11427832 <474. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11523293 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hadley J AU - Mitchell JM AU - Mandelblatt J FA - Hadley, J FA - Mitchell, J M FA - Mandelblatt, J IN - Hadley, J. Georgetown University, USA. TI - Medicare fees and small area variations in breast-conserving surgery among elderly women. SO - Medical Care Research & Review. 58(3):334-60, 2001 Sep AS - Med Care Res Rev. 58(3):334-60, 2001 Sep NJ - Medical care research and review : MCRR PI - Journal available in: Print PI - Citation processed from: Print JC - 9506850 IO - Med Care Res Rev SB - Index Medicus CP - United States MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - *Mastectomy/ec [Economics] MH - *Mastectomy/ut [Utilization] MH - *Mastectomy, Segmental/ec [Economics] MH - *Mastectomy, Segmental/ut [Utilization] MH - *Medicare/ec [Economics] MH - Small-Area Analysis MH - United States AB - This study used data from Medicare files, the American Hospital Association's Annual Survey of Hospitals, and the 1990 census to investigate whether Medicare fees for breast-conserving surgery (BCS) and mastectomy (MST) affected the rate of BCS across 799 3-digit ZIP code areas in 1994. The full model, which was based on the conceptual framework of the supply of and demand for different treatments, explained 51 percent of the variation in BCS rates. Medicare fees were statistically significant and had the hypothesized effects: a 10 percent higher BCS fee was associated with a 7 to 10 percent higher BCS rate, while a 10 percent higher MST fee was associated with a 2 to 3 percent lower proportion receiving BCS. Other significant economic variables were proximity to a radiation therapy hospital, a teaching hospital or a cancer center, and the percentage of elderly women with incomes below the poverty rate, which were negatively related to the BCS rate. Variations in age, race, and metropolitan populations had small or insignificant effects. The single most important was the percentage of cases with one or more comorbidities. IS - 1077-5587 IL - 1077-5587 DO - https://dx.doi.org/10.1177/107755870105800303 PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Research Support, U.S. Gov't, P.H.S. ID - 11523293 [pubmed] ID - 10.1177/107755870105800303 [doi] PP - ppublish GI - No: HS08395 Organization: (HS) *AHRQ HHS* Country: United States LG - English DP - 2001 Sep DC - 20010828 EZ - 2001/08/29 10:00 DA - 2001/09/21 10:01 DT - 2001/08/29 10:00 YR - 2001 ED - 20010920 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=11523293 <475. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11523293 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hadley J AU - Mitchell JM AU - Mandelblatt J FA - Hadley, J FA - Mitchell, J M FA - Mandelblatt, J IN - Hadley, J. Georgetown University, USA. TI - Medicare fees and small area variations in breast-conserving surgery among elderly women. SO - Medical Care Research & Review. 58(3):334-60, 2001 Sep AS - Med Care Res Rev. 58(3):334-60, 2001 Sep NJ - Medical care research and review : MCRR PI - Journal available in: Print PI - Citation processed from: Print JC - 9506850 IO - Med Care Res Rev SB - Index Medicus CP - United States MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - *Mastectomy/ec [Economics] MH - *Mastectomy/ut [Utilization] MH - *Mastectomy, Segmental/ec [Economics] MH - *Mastectomy, Segmental/ut [Utilization] MH - *Medicare/ec [Economics] MH - Small-Area Analysis MH - United States AB - This study used data from Medicare files, the American Hospital Association's Annual Survey of Hospitals, and the 1990 census to investigate whether Medicare fees for breast-conserving surgery (BCS) and mastectomy (MST) affected the rate of BCS across 799 3-digit ZIP code areas in 1994. The full model, which was based on the conceptual framework of the supply of and demand for different treatments, explained 51 percent of the variation in BCS rates. Medicare fees were statistically significant and had the hypothesized effects: a 10 percent higher BCS fee was associated with a 7 to 10 percent higher BCS rate, while a 10 percent higher MST fee was associated with a 2 to 3 percent lower proportion receiving BCS. Other significant economic variables were proximity to a radiation therapy hospital, a teaching hospital or a cancer center, and the percentage of elderly women with incomes below the poverty rate, which were negatively related to the BCS rate. Variations in age, race, and metropolitan populations had small or insignificant effects. The single most important was the percentage of cases with one or more comorbidities. IS - 1077-5587 IL - 1077-5587 PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. PT - Research Support, U.S. Gov't, P.H.S. ID - 11523293 [pubmed] PP - ppublish GI - No: HS08395 Organization: (HS) *AHRQ HHS* Country: United States LG - English DP - 2001 Sep DC - 20010828 EZ - 2001/08/29 10:00 DA - 2001/09/21 10:01 DT - 2001/08/29 10:00 YR - 2001 ED - 20010920 RD - 20071114 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11523293 <476. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11512506 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Anonymous TI - Adjuvant therapy for breast cancer. [Review] [88 refs] SO - NIH Consensus Statement. 17(4):1-35, 2000 Nov 1-3 AS - NIH Consens Statement. 17(4):1-35, 2000 Nov 1-3 NJ - NIH consensus statement PI - Journal available in: Print PI - Citation processed from: Print JC - br6, 9308532 IO - NIH Consens Statement SB - Index Medicus CP - United States MH - *Antineoplastic Agents/tu [Therapeutic Use] MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant/ae [Adverse Effects] MH - Chemotherapy, Adjuvant/mt [Methods] MH - Female MH - Humans MH - Patient Selection MH - Quality of Life MH - Radiotherapy, Adjuvant/ae [Adverse Effects] MH - Radiotherapy, Adjuvant/mt [Methods] AB - OBJECTIVE: To provide health care providers, patients, and the general public with a current consensus on various issues related to the use of adjuvant therapy for breast cancer. AB - PARTICIPANTS: A nonfederal, nonadvocate, 14-member panel representing the fields of oncology, radiology, surgery, pathology, statistics, public health, health policy, and the public; 30 experts in medical oncology, molecular oncology, biostatistics, epidemiology, surgical oncology, and clinical trials who presented data to the consensus panel; a conference audience of approximately 1,000. AB - EVIDENCE: The literature was searched using MEDLINE and an extensive bibliography of references was provided to the panel. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. AB - CONSENSUS PROCESS: The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately following its release at the conference and was updated with the panel's final revisions. AB - CONCLUSIONS: During the past 10 years, substantial progress has been made in the treatment of invasive breast cancer. For the first time, breast cancer mortality rates are decreasing in the United States. Refinements of adjuvant treatment have contributed to this advance. Generally accepted prognostic and predictive factors include age, tumor size, lymph node status, histological tumor type, grade, mitotic rate, and hormonal receptor status. Novel technologies, such as tissue and expression microarrays and proteomics, hold exciting potential. Progress, however, will depend on proper design and analysis of clinical and pathological investigations. Decisions regarding adjuvant hormonal therapy should be based on the presence of hormone receptor protein in tumor tissues. Adjuvant hormonal therapy should be offered only to women whose tumors express hormone receptor protein. Because adjuvant polychemotherapy improves survival, it should be recommended to the majority of women with localized breast cancer regardless of nodal, menopausal, or hormone receptor status. The inclusion of anthracyclines in adjuvant chemotherapy regimens produces a small but statistically significant improvement in survival over non-anthracycline-containing regimens. Available data are currently inconclusive regarding the use of taxanes in adjuvant treatment of node-positive breast cancer. The use of adjuvant dose-intensive chemotherapy regimens in high-risk breast cancer and of taxanes in node-negative breast cancer should be restricted to randomized trials. Ongoing studies evaluating these treatment strategies should be supported to determine if they have a role in adjuvant treatment. Studies to date have included few patients older than 70 years. There is a critical need for trials to evaluate the role of adjuvant chemotherapy in these women. There is evidence that women with a high risk of locoregional tumor recurrence after mastectomy benefit from postoperative radiotherapy. This high-risk group includes women with four or more positive lymph nodes or an advanced primary cancer. Currently, the role of post-mastectomy radiotherapy for patients with one to three positive lymph nodes remains uncertain and should be tested in a randomized controlled trial. Individual patients differ in the importance they place on the risks and benefits of adjuvant treatments. Quality-of-life needs to be evaluated in selected randomized clinical trials to examine the impact of the major acute and long-term side effects of adjuvant treatments, particularly premature menopause, weight gain, mild memory loss, and fatigue. Methods to support shared decision-making between patients and their physicians have been successful in trials; they need to be tailored for diverse populations and should be tested for broader dissemination. [References: 88] RN - 0 (Antineoplastic Agents) RN - 0 (Antineoplastic Agents, Hormonal) IS - 1080-1707 IL - 1080-1707 PT - Consensus Development Conference PT - Consensus Development Conference, NIH PT - Journal Article PT - Review ID - 11512506 [pubmed] PP - ppublish LG - English DP - 2000 Nov 1-3 DC - 20010821 EZ - 2001/08/22 10:00 DA - 2001/09/08 10:01 DT - 2001/08/22 10:00 YR - 2000 ED - 20010906 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11512506 <477. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11443605 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bordeleau L AU - Rakovitch E AU - Naimark DM AU - Pritchard KI AU - Ackerman I AU - Sawka CA FA - Bordeleau, L FA - Rakovitch, E FA - Naimark, D M FA - Pritchard, K I FA - Ackerman, I FA - Sawka, C A IN - Bordeleau, L. Toronto-Sunnybrook Regional Cancer Center, University of Toronto, Ontario, Canada. TI - A comparison of four treatment strategies for ductal carcinoma in situ using decision analysis. SO - Cancer. 92(1):23-9, 2001 Jul 01 AS - Cancer. 92(1):23-9, 2001 Jul 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma, Intraductal, Noninfiltrating/dt [Drug Therapy] MH - *Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Combined Modality Therapy MH - *Decision Making MH - Female MH - Humans MH - Mastectomy MH - Mastectomy, Segmental MH - Risk Assessment MH - Tamoxifen/tu [Therapeutic Use] AB - BACKGROUND: The goals of the current study were to compare four treatment approaches in the management of ductal carcinoma in situ (DCIS), to determine the conditions where mastectomy may be preferred to breast-conserving therapy (BCT), and to determine conditions where the addition of tamoxifen produces better results than BCT alone. AB - METHODS: A decision analysis model was used to compare four treatment approaches after local excision for DCIS: mastectomy, irradiation, irradiation plus adjuvant tamoxifen, or observation. The model weighed the potential benefits of each treatment approach (reduction of ipsilateral and/or contralateral breast carcinoma) against the potential risks of treatment-related toxicities. In addition, the model adjusted for the potential detrimental impact of local recurrence or treatment-related toxicity on health-related quality of life (HRQOL). Base-case estimates were obtained from published randomized trial data. One-way and two-way sensitivity analyses were performed. AB - RESULTS: According to the model, the optimal treatment for DCIS was strongly dependent on the individual's risk of local recurrence and the patient's attitudes toward mastectomy. Mastectomy was preferred in patients whose estimated 10-year risk of local recurrence was > 15%, provided that mastectomy resulted in a very low reduction in quality of life (i.e., utility estimate > 0.97). Conditions where the addition of tamoxifen was preferred to breast-conserving therapy alone included the following: estimated 10-year risk of local recurrence > 38%, estimated 10-year risk of developing a contralateral breast carcinoma > 6%, or a significant decrement in HRQOL associated with the development of an invasive local recurrence or salvage mastectomy (utility estimates < 0.85). AB - CONCLUSION: Based on this quality-adjusted model, BCT appeared to be the preferred treatment for DCIS. The most important determinants of optimal management for DCIS included the risk of local recurrence and the utility of mastectomy. Formal evaluation of utilities in the context of DCIS and more accurate determination of the risk of recurrence are required. AB - Copyright 2001 American Cancer Society. RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) IS - 0008-543X IL - 0008-543X DI - 10.1002/1097-0142(20010701)92:1<23::AID-CNCR1287>3.0.CO;2-Y PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11443605 [pubmed] ID - 10.1002/1097-0142(20010701)92:1<23::AID-CNCR1287>3.0.CO;2-Y [pii] PP - ppublish LG - English DP - 2001 Jul 01 DC - 20010709 EZ - 2001/07/10 10:00 DA - 2001/07/28 10:01 DT - 2001/07/10 10:00 YR - 2001 ED - 20010726 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11443605 <478. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11438563 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eifel P AU - Axelson JA AU - Costa J AU - Crowley J AU - Curran WJ Jr AU - Deshler A AU - Fulton S AU - Hendricks CB AU - Kemeny M AU - Kornblith AB AU - Louis TA AU - Markman M AU - Mayer R AU - Roter D FA - Eifel, P FA - Axelson, J A FA - Costa, J FA - Crowley, J FA - Curran, W J Jr FA - Deshler, A FA - Fulton, S FA - Hendricks, C B FA - Kemeny, M FA - Kornblith, A B FA - Louis, T A FA - Markman, M FA - Mayer, R FA - Roter, D IN - Eifel, P. The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. TI - National Institutes of Health Consensus Development Conference Statement: adjuvant therapy for breast cancer, November 1-3, 2000. [Review] [97 refs] SO - Journal of the National Cancer Institute. 93(13):979-89, 2001 Jul 04 AS - J Natl Cancer Inst. 93(13):979-89, 2001 Jul 04 NJ - Journal of the National Cancer Institute PI - Journal available in: Print PI - Citation processed from: Print JC - j9j, 7503089 IO - J. Natl. Cancer Inst. SB - Index Medicus CP - United States MH - *Adjuvants, Pharmaceutic/ad [Administration & Dosage] MH - Adjuvants, Pharmaceutic/ae [Adverse Effects] MH - *Adjuvants, Pharmaceutic/tu [Therapeutic Use] MH - Aged MH - *Antineoplastic Agents, Hormonal/ad [Administration & Dosage] MH - Antineoplastic Agents, Hormonal/ae [Adverse Effects] MH - *Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - *Breast Neoplasms/th [Therapy] MH - Clinical Trials as Topic MH - Female MH - Humans MH - MEDLINE MH - Middle Aged AB - OBJECTIVE: Our goal was to provide health-care providers, patients, and the general public with an assessment of currently available data regarding the use of adjuvant therapy for breast cancer. AB - PARTICIPANTS: The participants included a non-Federal, non-advocate, 14-member panel representing the fields of oncology, radiology, surgery, pathology, statistics, public health, and health policy as well as patient representatives. In addition, 30 experts in medical oncology, radiation oncology, biostatistics, epidemiology, surgical oncology, and clinical trials presented data to the panel and to a conference audience of 1000. AB - EVIDENCE: The literature was searched with the use of MEDLINE(TM) for January 1995 through July 2000, and an extensive bibliography of 2230 references was provided to the panel. Experts prepared abstracts for their conference presentations with relevant citations from the literature. Evidence from randomized clinical trials and evidence from prospective studies were given precedence over clinical anecdotal experience. AB - CONSENSUS PROCESS: The panel, answering predefined questions, developed its conclusions based on the evidence presented in open forum and the scientific literature. The panel composed a draft statement, which was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the World Wide Web immediately after its release at the conference and was updated with the panel's final revisions. The statement is available at http://consensus.nih.gov. AB - CONCLUSIONS: The panel concludes that decisions regarding adjuvant hormonal therapy should be based on the presence of hormone receptor protein in tumor tissues. Adjuvant hormonal therapy should be offered only to women whose tumors express hormone receptor protein. Because adjuvant polychemotherapy improves survival, it should be recommended to the majority of women with localized breast cancer regardless of lymph node, menopausal, or hormone receptor status. The inclusion of anthracyclines in adjuvant chemotherapy regimens produces a small but statistically significant improvement in survival over non-anthracycline-containing regimens. Available data are currently inconclusive regarding the use of taxanes in adjuvant treatment of lymph node-positive breast cancer. The use of adjuvant dose-intensive chemotherapy regimens in high-risk breast cancer and of taxanes in lymph node-negative breast cancer should be restricted to randomized trials. Ongoing studies evaluating these treatment strategies should be supported to determine if such strategies have a role in adjuvant treatment. Studies to date have included few patients older than 70 years. There is a critical need for trials to evaluate the role of adjuvant chemotherapy in these women. There is evidence that women with a high risk of locoregional tumor recurrence after mastectomy benefit from postoperative radiotherapy. This high-risk group includes women with four or more positive lymph nodes or an advanced primary cancer. Currently, the role of postmastectomy radiotherapy for patients with one to three positive lymph nodes remains uncertain and should be tested in a randomized controlled trial. Individual patients differ in the importance they place on the risks and benefits of adjuvant treatments. Quality of life needs to be evaluated in selected randomized clinical trials to examine the impact of the major acute and long-term side effects of adjuvant treatments, particularly premature menopause, weight gain, mild memory loss, and fatigue. Methods to support shared decision-making between patients and their physicians have been successful in trials; they need to be tailored for diverse populations and should be tested for broader dissemination. [References: 97] RN - 0 (Adjuvants, Pharmaceutic) RN - 0 (Antineoplastic Agents, Hormonal) IS - 0027-8874 IL - 0027-8874 PT - Consensus Development Conference PT - Journal Article PT - Review ID - 11438563 [pubmed] PP - ppublish LG - English DP - 2001 Jul 04 DC - 20010704 EZ - 2001/07/05 10:00 DA - 2001/07/28 10:01 DT - 2001/07/05 10:00 YR - 2001 ED - 20010726 RD - 20140728 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11438563 <479. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11407276 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Molenaar S AU - Sprangers MA AU - Rutgers EJ AU - Mulder HJ AU - Luiten EJ AU - de Haes JC FA - Molenaar, S FA - Sprangers, M A FA - Rutgers, E J FA - Mulder, H J FA - Luiten, E J FA - de Haes, J C IN - Molenaar, S. Academisch Medisch Centrum, afd. Medische Psychologie, Meibergdreef 9, 1105 AZ Amsterdam. j.molenaar@amc.uva.nl TI - [Interactive cd-rom on the choice between breast-sparing treatment and mastectomy: positive responses from patients and surgeons]. [Dutch] OT - Interactieve cd-rom over de keuze tussen borstsparende behandeling en amputatie: positieve reacties van patienten en chirurgen. SO - Nederlands Tijdschrift voor Geneeskunde. 145(21):1004-8, 2001 May 26 AS - Ned Tijdschr Geneeskd. 145(21):1004-8, 2001 May 26 NJ - Nederlands tijdschrift voor geneeskunde PI - Journal available in: Print PI - Citation processed from: Print JC - nuk, 0400770 IO - Ned Tijdschr Geneeskd SB - Index Medicus CP - Netherlands MH - Adult MH - Aged MH - *Breast Neoplasms/su [Surgery] MH - *CD-ROM MH - Decision Making MH - Female MH - Humans MH - Male MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental/mt [Methods] MH - *Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Netherlands MH - *Patient Education as Topic/mt [Methods] MH - *Patient Satisfaction/sn [Statistics & Numerical Data] MH - *Physicians/sn [Statistics & Numerical Data] MH - Surveys and Questionnaires AB - OBJECTIVE: To assess how breast cancer patients and surgeons rate an interactive decision aid, using CD-ROM technology, developed to support a choice between breast-conserving therapy and mastectomy. AB - DESIGN: Questionnaire investigation. AB - METHOD: Written questionnaires were presented to patients as soon as they had finished using the CD-ROM. They responded on a 5-point scale. Surgeons (n = 14) were sent a written questionnaire to investigate their experiences of using the CD-ROM program. AB - RESULTS: The interactive CD-ROM was offered to 92 consecutive breast cancer patients. Responses were obtained from 86 (93%) of the patients. The remainder were inadvertently not given the questionnaire. All of the patients evaluated the program as positive. Most of the patients found the program to be 'interesting', 'clear', 'useful', 'encouraging', and 'reassuring'. A majority (n = 76) expressed the view that the amount of information received was 'just right'. The interactive, computer-based method was evaluated as 'agreeable' by 74 patients. Almost all of the patients (n = 82) recommended that the program be shown to other patients. All of the surgeons (n = 14) stated that their patients' evaluations of the program were positive. Moreover, most of the surgeons (n = 10) were of the opinion that the program 'considerably contributed' to the provision of information. With the exception of one surgeon (n = 13), they all held the view that the program can be offered to breast cancer patients facing a choice between breast-conservation or mastectomy on a standard basis. AB - CONCLUSION: Interactive decision-making support by means of a CD-ROM for patients with breast cancer, received positive evaluations from both the patients and surgeons. IS - 0028-2162 IL - 0028-2162 PT - Comparative Study PT - English Abstract PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11407276 [pubmed] PP - ppublish LG - Dutch DP - 2001 May 26 DC - 20010615 EZ - 2001/06/16 10:00 DA - 2001/07/20 10:01 DT - 2001/06/16 10:00 YR - 2001 ED - 20010719 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11407276 <480. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11259883 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Seroussi B AU - Bouaud J AU - Antoine EC FA - Seroussi, B FA - Bouaud, J FA - Antoine, E C IN - Seroussi, B. Service d'Informatique Medicale, DSI/AP-HP & Departement de Biomatiques, Universite Paris 6, Paris, France. bs@biomath.jussieu.fr TI - ONCODOC: a successful experiment of computer-supported guideline development and implementation in the treatment of breast cancer. SO - Artificial Intelligence in Medicine. 22(1):43-64, 2001 Apr AS - Artif Intell Med. 22(1):43-64, 2001 Apr NJ - Artificial intelligence in medicine PI - Journal available in: Print PI - Citation processed from: Print JC - bup, 8915031 IO - Artif Intell Med SB - Index Medicus CP - Netherlands MH - *Artificial Intelligence MH - *Breast Neoplasms/th [Therapy] MH - Computers MH - *Decision Support Systems, Clinical MH - Female MH - Health Plan Implementation MH - Humans MH - *Physician's Role MH - *Practice Guidelines as Topic AB - Originally published as textual documents, clinical practice guidelines have poorly penetrated medical practice because their editorial properties do not allow the reader to easily solve, at the point of care, a given medical problem. However, despite the proliferation of implemented clinical practice guidelines as decision support systems providing an easy access to patient-centered information, there is still little evidence of high physician compliance to guidelines recommendations. Apart from physicians' psychological reluctance, the incompleteness of guideline knowledge and the impreciseness of the terms used, another reason may be that, although suited to average patients, clinical practice guideline recommendations are not a substitute for the physician-controlled clinical judgement that should be applied to each actual individual patient. Therefore, computer-based approaches based on the automation of context-free operationalization of guideline knowledge, although providing uniform optimal strategies to problem-focused care delivery, may generate inappropriate inferences for a specific patient that the physician does not follow in practice. Rather than providing automated decision support, ONCODOC allows the clinician to control the operationalization of guideline knowledge through his hypertextual reading of a knowledge base encoded as a decision tree. In this way, he has the opportunity to interpret the information provided in the context of his patient, therefore, controlling his categorization to the closest matching formal patient. Experimented in life-size ONCODOC demonstrated good appropriation of the system by physicians with significantly high scores of compliance. We successfully tested the implemented strategy and the knowledge base in a second medical institution, giving then a noticeable example of reuse and sharing of encoded guideline knowledge across institutions. IS - 0933-3657 IL - 0933-3657 DI - S0933-3657(00)00099-3 PT - Journal Article ID - 11259883 [pubmed] ID - S0933-3657(00)00099-3 [pii] PP - ppublish LG - English DP - 2001 Apr DC - 20010322 EZ - 2001/03/22 10:00 DA - 2001/06/22 10:01 DT - 2001/03/22 10:00 YR - 2001 ED - 20010621 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11259883 <481. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11297648 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Thomson CS AU - Hole DJ AU - Twelves CJ AU - Brewster DH AU - Black RJ AU - Scottish Cancer Therapy Network FA - Thomson, C S FA - Hole, D J FA - Twelves, C J FA - Brewster, D H FA - Black, R J FA - Scottish Cancer Therapy Network IN - Thomson, C S. Scottish Cancer Intelligence Unit, Information and Statistics Division, Trinity Park House, Edinburgh EH5 3SQ, UK. catherine.thomson@isd.csa.scot.nhs.uk TI - Prognostic factors in women with breast cancer: distribution by socioeconomic status and effect on differences in survival. SO - Journal of Epidemiology & Community Health. 55(5):308-15, 2001 May AS - J Epidemiol Community Health. 55(5):308-15, 2001 May NJ - Journal of epidemiology and community health PI - Journal available in: Print PI - Citation processed from: Print JC - i1p, 7909766 IO - J Epidemiol Community Health PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1731899 SB - Index Medicus CP - England MH - Adult MH - Age Distribution MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/ch [Chemistry] MH - *Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/th [Therapy] MH - Chi-Square Distribution MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Middle Aged MH - Prognosis MH - Proportional Hazards Models MH - Receptors, Estrogen/an [Analysis] MH - Registries MH - Scotland/ep [Epidemiology] MH - *Social Class MH - Survival Rate AB - STUDY OBJECTIVE: To quantify and investigate differences in survival from breast cancer between women resident in affluent and deprived areas and define the contribution of underlying factors to this variation. AB - DESIGN: Analysis of two datasets relating to breast cancer patients in Scotland: (1) population-based cancer registry data; (2) a subset of cancer registration records supplemented by abstraction of prognostic variables (stage, node status, tumour size, oestrogen receptor (ER) status, type of surgery, use of radiotherapy and use of adjuvant systemic therapy) from medical records. AB - SETTING: Scotland. AB - PATIENTS: (1) Cancer registration data on 21,751 women aged under 85 years diagnosed with primary breast cancer between 1978 and 1987; (2) national clinical audit data on 2035 women aged under 85 years diagnosed with primary breast cancer during 1987 for whom adequate medical records were available. AB - MAIN RESULTS: Survival differences of 10% between affluent and deprived women were observed in both datasets, across all age groups. In the audit dataset, the distribution of ER status varied by deprivation group (65% ER positive in affluent group v 48% ER positive in deprived group; under 65 age group). Women aged under 65 with non-metastatic disease were more likely to have breast conservation than a mastectomy if they were affluent (45%) than deprived (32%); the affluent were more likely to receive endocrine therapy (65%) than the deprived (50%). However, these factors accounted for about 20% of the observed difference in survival between women resident in affluent and deprived areas. AB - CONCLUSIONS: Deprived women with breast cancer have poorer outcomes than affluent women. This can only partly be explained by deprived women having more ER negative tumours than affluent women. Further research is required to identify other reasons for poorer outcomes in deprived women, with a view to reducing these survival differences. RN - 0 (Receptors, Estrogen) IS - 0143-005X IL - 0143-005X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11297648 [pubmed] ID - PMC1731899 [pmc] PP - ppublish LG - English DP - 2001 May DC - 20010412 EZ - 2001/04/12 10:00 DA - 2001/06/02 10:01 DT - 2001/04/12 10:00 YR - 2001 ED - 20010531 RD - 20140613 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11297648 <482. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11206942 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Goel V AU - Sawka CA AU - Thiel EC AU - Gort EH AU - O'Connor AM FA - Goel, V FA - Sawka, C A FA - Thiel, E C FA - Gort, E H FA - O'Connor, A M IN - Goel, V. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. vivek.goel@utoronto.ca TI - Randomized trial of a patient decision aid for choice of surgical treatment for breast cancer. SO - Medical Decision Making. 21(1):1-6, 2001 Jan-Feb AS - Med Decis Making. 21(1):1-6, 2001 Jan-Feb NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - *Patient Education as Topic MH - *Patient Participation AB - A decision aid for the surgical treatment of early breast cancer was evaluated in a randomized controlled trial. The decision aid, a tape and workbook, includes explicit presentation of probabilities, photographs and graphics, and a values clarification exercise. Community surgeons were randomized to use the decision aid or a control pamphlet. Patients completed a questionnaire prior to using the decision aid, after reviewing it but prior to surgery, and 6 months after enrollment. There was no difference in anxiety, knowledge, or decisional regret across the 2 groups. There was a nonsignificant trend toward lower decisional conflict in the decision aid group. A subgroup of women who were initially leaning toward mastectomy or were unsure had lower decisional conflict. Although the decision aid had minimal impact on the main study outcomes, a subgroup may have benefited. Such subgroups should be identified, and appropriate decision support interventions should be developed and evaluated. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X0102100101 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 11206942 [pubmed] ID - 10.1177/0272989X0102100101 [doi] PP - ppublish LG - English DP - 2001 Jan-Feb DC - 20010206 EZ - 2001/02/24 12:00 DA - 2001/05/22 10:01 DT - 2001/02/24 12:00 YR - 2001 ED - 20010510 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=11206942 <483. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11206942 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Goel V AU - Sawka CA AU - Thiel EC AU - Gort EH AU - O'Connor AM FA - Goel, V FA - Sawka, C A FA - Thiel, E C FA - Gort, E H FA - O'Connor, A M IN - Goel, V. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. vivek.goel@utoronto.ca TI - Randomized trial of a patient decision aid for choice of surgical treatment for breast cancer. SO - Medical Decision Making. 21(1):1-6, 2001 Jan-Feb AS - Med Decis Making. 21(1):1-6, 2001 Jan-Feb NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Mastectomy MH - Middle Aged MH - *Patient Education as Topic MH - *Patient Participation AB - A decision aid for the surgical treatment of early breast cancer was evaluated in a randomized controlled trial. The decision aid, a tape and workbook, includes explicit presentation of probabilities, photographs and graphics, and a values clarification exercise. Community surgeons were randomized to use the decision aid or a control pamphlet. Patients completed a questionnaire prior to using the decision aid, after reviewing it but prior to surgery, and 6 months after enrollment. There was no difference in anxiety, knowledge, or decisional regret across the 2 groups. There was a nonsignificant trend toward lower decisional conflict in the decision aid group. A subgroup of women who were initially leaning toward mastectomy or were unsure had lower decisional conflict. Although the decision aid had minimal impact on the main study outcomes, a subgroup may have benefited. Such subgroups should be identified, and appropriate decision support interventions should be developed and evaluated. IS - 0272-989X IL - 0272-989X PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 11206942 [pubmed] PP - ppublish LG - English DP - 2001 Jan-Feb DC - 20010206 EZ - 2001/02/24 12:00 DA - 2001/05/22 10:01 DT - 2001/02/24 12:00 YR - 2001 ED - 20010510 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11206942 <484. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11250997 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Molenaar S AU - Sprangers MA AU - Rutgers EJ AU - Luiten EJ AU - Mulder J AU - Bossuyt PM AU - van Everdingen JJ AU - Oosterveld P AU - de Haes HC FA - Molenaar, S FA - Sprangers, M A FA - Rutgers, E J FA - Luiten, E J FA - Mulder, J FA - Bossuyt, P M FA - van Everdingen, J J FA - Oosterveld, P FA - de Haes, H C IN - Molenaar, S. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands. J.Molenaar@AMC.UvA.NL TI - Decision support for patients with early-stage breast cancer: effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life. SO - Journal of Clinical Oncology. 19(6):1676-87, 2001 Mar 15 AS - J Clin Oncol. 19(6):1676-87, 2001 Mar 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Aged MH - Body Image MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *CD-ROM MH - Decision Making MH - *Decision Making, Computer-Assisted MH - Female MH - Humans MH - Longitudinal Studies MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Patient Satisfaction MH - Quality of Life AB - PURPOSE: To investigate the effects of the Interactive Breast Cancer CDROM as a decision aid for breast cancer patients with a choice between breast conserving therapy (BCT) and mastectomy (MT). AB - PATIENTS AND METHODS: Consecutive patients with stage I and II breast cancer were enrolled. A quasi-experimental, longitudinal, and pretest/posttest design was used. Follow-up was scheduled 3 and 9 months after discharge from the hospital. Control patients (n = 88) received standard care (oral information and brochures). The CDROM was provided to patients in the experimental condition (n = 92) as a supplement to standard procedures. Outcome variables were treatment decision, satisfaction, and quality of life (QoL). AB - RESULTS: No effect on treatment decision was found. CDROM patients expressed more general satisfaction with information at 3 and 9 months (95% confidence interval for the difference (d) between the means (d: 4.1 to 12.5 and 5.7 to 14.2 respectively). CDROM patients were also more satisfied with their treatment decision at 3 and at 9 months (d: 0.1 to 0.4; 0.2 to 0.5). Moreover, at 9 months, CDROM patients were more satisfied with breast cancer-specific information (d: 0.9 to 16.5), the decision-making process (d: 0.1 to 0.4), and communication (d: 0.2 to 11.0). At 3 and 9 months, a positive effect was found on general health (d: 0.2 to 14.5 and 0.3 to 15.0). Moreover, at 9 months, CDROM patients reported better physical functioning (d: 5.1 to 19.8), less pain (d: -17.9 to -4.5), and fewer arm symptoms (d: -14.1 to -0.5). AB - CONCLUSION: The Interactive Breast Cancer CDROM improved decision making in patients with early-stage breast cancer with a choice between BCT and MT, as evaluated in terms of patients' satisfaction and QoL. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.2001.19.6.1676 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 11250997 [pubmed] ID - 10.1200/JCO.2001.19.6.1676 [doi] PP - ppublish LG - English DP - 2001 Mar 15 DC - 20010319 EZ - 2001/03/17 10:00 DA - 2001/04/17 10:01 DT - 2001/03/17 10:00 YR - 2001 ED - 20010412 RD - 20170210 UP - 20170213 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=11250997 <485. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11250997 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Molenaar S AU - Sprangers MA AU - Rutgers EJ AU - Luiten EJ AU - Mulder J AU - Bossuyt PM AU - van Everdingen JJ AU - Oosterveld P AU - de Haes HC FA - Molenaar, S FA - Sprangers, M A FA - Rutgers, E J FA - Luiten, E J FA - Mulder, J FA - Bossuyt, P M FA - van Everdingen, J J FA - Oosterveld, P FA - de Haes, H C IN - Molenaar, S. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands. J.Molenaar@AMC.UvA.NL TI - Decision support for patients with early-stage breast cancer: effects of an interactive breast cancer CDROM on treatment decision, satisfaction, and quality of life. SO - Journal of Clinical Oncology. 19(6):1676-87, 2001 Mar 15 AS - J Clin Oncol. 19(6):1676-87, 2001 Mar 15 NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Aged MH - Body Image MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *CD-ROM MH - Decision Making MH - *Decision Making, Computer-Assisted MH - Female MH - Humans MH - Longitudinal Studies MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Patient Satisfaction MH - Quality of Life AB - PURPOSE: To investigate the effects of the Interactive Breast Cancer CDROM as a decision aid for breast cancer patients with a choice between breast conserving therapy (BCT) and mastectomy (MT). AB - PATIENTS AND METHODS: Consecutive patients with stage I and II breast cancer were enrolled. A quasi-experimental, longitudinal, and pretest/posttest design was used. Follow-up was scheduled 3 and 9 months after discharge from the hospital. Control patients (n = 88) received standard care (oral information and brochures). The CDROM was provided to patients in the experimental condition (n = 92) as a supplement to standard procedures. Outcome variables were treatment decision, satisfaction, and quality of life (QoL). AB - RESULTS: No effect on treatment decision was found. CDROM patients expressed more general satisfaction with information at 3 and 9 months (95% confidence interval for the difference (d) between the means (d: 4.1 to 12.5 and 5.7 to 14.2 respectively). CDROM patients were also more satisfied with their treatment decision at 3 and at 9 months (d: 0.1 to 0.4; 0.2 to 0.5). Moreover, at 9 months, CDROM patients were more satisfied with breast cancer-specific information (d: 0.9 to 16.5), the decision-making process (d: 0.1 to 0.4), and communication (d: 0.2 to 11.0). At 3 and 9 months, a positive effect was found on general health (d: 0.2 to 14.5 and 0.3 to 15.0). Moreover, at 9 months, CDROM patients reported better physical functioning (d: 5.1 to 19.8), less pain (d: -17.9 to -4.5), and fewer arm symptoms (d: -14.1 to -0.5). AB - CONCLUSION: The Interactive Breast Cancer CDROM improved decision making in patients with early-stage breast cancer with a choice between BCT and MT, as evaluated in terms of patients' satisfaction and QoL. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/jco.2001.19.6.1676 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't ID - 11250997 [pubmed] ID - 10.1200/jco.2001.19.6.1676 [doi] PP - ppublish LG - English DP - 2001 Mar 15 DC - 20010319 EZ - 2001/03/17 10:00 DA - 2001/04/17 10:01 DT - 2001/03/17 10:00 YR - 2001 ED - 20010412 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11250997 <486. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11177139 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cyran EM AU - Crane LA AU - Palmer L FA - Cyran, E M FA - Crane, L A FA - Palmer, L IN - Cyran, E M. Division of General Internal Medicine, Campus Box B-212, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262, USA. Lisa.Cyran@UCHSC.edu TI - Physician sex and other factors associated with type of breast cancer surgery in older women. SO - Archives of Surgery. 136(2):185-91, 2001 Feb AS - Arch Surg. 136(2):185-91, 2001 Feb NJ - Archives of surgery (Chicago, Ill. : 1960) PI - Journal available in: Print PI - Citation processed from: Print JC - 8ia, 9716528 IO - Arch Surg SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Age Factors MH - Aged MH - Aged, 80 and over MH - *Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - Interviews as Topic MH - Logistic Models MH - Male MH - *Mastectomy MH - *Mastectomy, Segmental MH - *Physicians, Women MH - Random Allocation MH - Registries/sn [Statistics & Numerical Data] MH - Sex Factors MH - Truth Disclosure AB - HYPOTHESIS: Physician-related factors as well as patient characteristics may explain why women aged 65 years or older with early-stage breast cancer undergo lumpectomy less often than younger women, despite National Institutes of Health recommendations favoring lumpectomy over mastectomy. AB - DESIGN: A descriptive and analytical retrospective computer-assisted telephone survey. AB - SETTING: A population-based random sample of breast cancer survivors in Colorado, identified from the Colorado Central Cancer Registry. AB - PATIENTS: Women aged 65 to 84 years when diagnosed as having stage I or II breast cancer, treated 1 to 6 years previously with mastectomy or lumpectomy, and without recurrence or second primary cancers. Among women contacted, 58% participated. Results of 198 interviews are reported. AB - METHODS: Survey questions included patient decision-making participation and physician recommendations, sources and amount of treatment information provided by physicians, physician characteristics, and patient surgery preferences and demographic characteristics. A multivariate logistic regression model identified factors independently associated with lumpectomy. AB - RESULTS: Lumpectomy was strongly associated with higher patient education, female physician sex, patient age 75 years or older, and amount of physician-provided information. The number of physician-provided information sources was associated with surgery explanations, and female physicians provided more sources of information. A physician decision or recommendation for surgery type was reported by 61% of women, of whom 93% underwent the recommended procedure. A subset of patients (13%) reported deferring the surgery decision to someone else. AB - CONCLUSIONS: These results suggest that better-educated and better-informed older women are more likely to undergo lumpectomy, and that physicians may influence breast cancer patients' decisions about surgery type. IS - 0004-0010 IL - 0004-0010 DI - soa0080 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 11177139 [pubmed] ID - soa0080 [pii] PP - ppublish GI - No: 5T32-PE10006 Organization: (PE) *BHP HRSA HHS* Country: United States LG - English DP - 2001 Feb DC - 20010222 EZ - 2001/02/15 11:00 DA - 2001/04/06 10:01 DT - 2001/02/15 11:00 YR - 2001 ED - 20010405 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11177139 <487. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11110334 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Dow KH FA - Dow, K H IN - Dow, K H. School of Nursing, College of Health and Public Affairs, University of Central Florida, Orlando, 32816, USA. TI - Pregnancy and breast cancer. [Review] [28 refs] SO - JOGNN - Journal of Obstetric, Gynecologic, & Neonatal Nursing. 29(6):634-40, 2000 Nov-Dec AS - J Obstet Gynecol Neonatal Nurs. 29(6):634-40, 2000 Nov-Dec NJ - Journal of obstetric, gynecologic, and neonatal nursing : JOGNN PI - Journal available in: Print PI - Citation processed from: Print JC - jg8, 8503123 IO - J Obstet Gynecol Neonatal Nurs SB - Index Medicus SB - Nursing Journal CP - United States MH - Amenorrhea/ci [Chemically Induced] MH - Antineoplastic Agents/ae [Adverse Effects] MH - *Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - Female MH - Humans MH - Infertility, Female/ci [Chemically Induced] MH - Mastectomy MH - Maternal-Child Nursing MH - Patient Education as Topic MH - Patient Selection MH - Pregnancy MH - *Pregnancy Complications, Neoplastic/di [Diagnosis] MH - Pregnancy Complications, Neoplastic/mo [Mortality] MH - *Pregnancy Complications, Neoplastic/th [Therapy] MH - Social Support MH - Survival Analysis MH - Time Factors AB - Pregnancy-associated breast cancer (PABC) and pregnancy subsequent to breast cancer are two areas of concern facing women of childbearing age. The current approach to the management of PABC is to treat the cancer with some modification because of the pregnancy. The clinical management of both PABC and pregnancy occurring after breast cancer in young survivors, with emphasis on issues in clinical decision making, clinical management, and client education and support, are addressed. [References: 28] RN - 0 (Antineoplastic Agents) IS - 0884-2175 IL - 0090-0311 DI - S0884-2175(15)33854-5 PT - Journal Article PT - Review ID - 11110334 [pubmed] ID - S0884-2175(15)33854-5 [pii] PP - ppublish LG - English DP - 2000 Nov-Dec DC - 20010301 EZ - 2000/12/08 11:00 DA - 2001/04/06 10:01 DT - 2000/12/08 11:00 YR - 2000 ED - 20010405 RD - 20161020 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11110334 <488. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11005553 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - McCready DR AU - Chapman JA AU - Hanna WM AU - Kahn HJ AU - Yap K AU - Fish EB AU - Lickley HL FA - McCready, D R FA - Chapman, J A FA - Hanna, W M FA - Kahn, H J FA - Yap, K FA - Fish, E B FA - Lickley, H L IN - McCready, D R. Department of Surgical Oncology, University Health Network, Princess Margaret Hospital, University of Toronto, Ontario, Canada. TI - Factors associated with local breast cancer recurrence after lumpectomy alone: postmenopausal patients. CM - Comment in: Ann Surg Oncol. 2000 Sep;7(8):552-3; PMID: 11005551 SO - Annals of Surgical Oncology. 7(8):562-7, 2000 Sep AS - Ann Surg Oncol. 7(8):562-7, 2000 Sep NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Carcinoma in Situ/pa [Pathology] MH - Carcinoma in Situ/su [Surgery] MH - Carcinoma, Ductal, Breast/pa [Pathology] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Lymphatic Metastasis MH - *Mastectomy, Segmental MH - Neoplasm Invasiveness MH - *Neoplasm Recurrence, Local/ep [Epidemiology] MH - *Postmenopause MH - Receptors, Estrogen/an [Analysis] MH - Receptors, Progesterone/an [Analysis] AB - BACKGROUND: We have been following a cohort of patients who underwent a lumpectomy without receiving adjuvant radiotherapy or adjuvant systemic therapy. We now report the experience of a postmenopausal subgroup. AB - METHODS: The postmenopausal subgroup included 244 patients accrued between 1977 and 1986 and followed up. The end point was ipsilateral local breast cancer recurrence. The factors studied were the patient's age in years; tumor size (in mm); nodal status (N-, Nx, N+); estrogen and progesterone receptor status (< 10, - 10 fmol/mg protein); presence or absence of lymphovascular/perineural invasion; presence or absence, and type, of DCIS (none, non-comedo, comedo); percentage of DCIS; histological grade (1,2,3); and nuclear grade (1,2,3). Univariate analyses consisted of Kaplan-Meier plots and the Wilcoxon (Peto-Prentice) test statistic; the multivariate analyses were step-wise Cox and log-normal regressions. AB - RESULTS: The median follow-up of those patients still alive was 9.1 years, and the overall relapse rate was 24% (59/244). The univariate results indicated that the characteristics of smaller tumor size, negative nodes, positive ER status, and no lymphovascular or perineural invasion were associated with significantly (P <.05) lower relapse. From the multivariate analyses, the factors lymphovascular or perineural invasion, age, and amount of DCIS were all significantly associated with local relapse with both Cox and log-normal regressions. Additionally, there was weak evidence of an association between ER (P = .08 in the Cox regression and in the log-normal) and nodal status (P = .09 in the log-normal regression) with local relapse. We also are able to define a low-risk subgroup (N-, age -65, no comedo, ER positive, no emboli) with a crude 10-year local recurrence rate of 9%. AB - CONCLUSION: With longer follow-up, and for postmenopausal patients, there continues to be support for the theory that local relapse is affected by the factors lymphovascular or perineural invasion, age, amount of DCIS, ER, and nodal status. A low risk subgroup has been identified. RN - 0 (Receptors, Estrogen) RN - 0 (Receptors, Progesterone) IS - 1068-9265 IL - 1068-9265 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 11005553 [pubmed] PP - ppublish LG - English DP - 2000 Sep DC - 20010102 EZ - 2000/09/27 11:00 DA - 2001/02/28 10:01 DT - 2000/09/27 11:00 YR - 2000 ED - 20010111 RD - 20070718 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=11005553 <489. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10929847 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Unic I AU - Verhoef LC AU - Stalmeier PF AU - van Daal WA FA - Unic, I FA - Verhoef, L C FA - Stalmeier, P F FA - van Daal, W A IN - Unic, I. Joint Center for Radiation Oncology Arnhem-Nijmegen, University Medical Center Nijmegen, The Netherlands. TI - Prophylactic mastectomy or screening in women suspected to have the BRCA1/2 mutation: a prospective pilot study of women's treatment choices and medical and decision-analytic recommendations. SO - Medical Decision Making. 20(3):251-62, 2000 Jul-Sep AS - Med Decis Making. 20(3):251-62, 2000 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - BRCA1 Protein/ge [Genetics] MH - BRCA2 Protein MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Decision Support Techniques MH - Educational Status MH - Female MH - Heterozygote MH - Humans MH - Marital Status MH - *Mastectomy MH - Middle Aged MH - Neoplasm Proteins/ge [Genetics] MH - Netherlands MH - *Patient Participation MH - Probability MH - Prospective Studies MH - *Quality-Adjusted Life Years MH - Time Factors MH - Transcription Factors/ge [Genetics] AB - BACKGROUND: Women suspected to have the BRCA1/2 mutation may choose between two management options: breast cancer screening and prophylactic mastectomy (PM). AB - OBJECTIVES: To compare women's treatment choices with medical and decision-analytic recommendations and to explore variables related to the women's choices. AB - METHODS: After provision of information, individual time-tradeoff values for the health outcome "living after PM" were assessed and incorporated into a decision-analytic model, which compared the management options PM and screening with respect to their effects on quality-adjusted life expectancy. AB - RESULTS: Of the 54 women suspected to have the mutation, 51 completed the shared-decision-making procedure. Quality-adjusted life expectancy after PM management was longer for 67% of proven carriers and for 58% of women awaiting the DNA-test result. Twelve proven carriers made definitive treatment choices: eight (67%) chose PM and four (33%) chose screening. All carriers' treatment choices agreed with the normative decision-analytic recommendations. Four (33%) disagreed with the medical recommendations. Of the 36 women awaiting DNA-test results, 32 made hypothetical treatment choices. The agreement between these hypothetical treatment choices and the decision-analytic recommendations was good (78%). Combining data from all 48 women, being married (OR = 14.00, p = 0.006), having children (OR = 4.71, p = 0.02), low desire to participate (OR = 0.14, p = 0.004), high decisional stress (OR = 5.22, p = 0.01), a lower estimate of the "probability of cure for screen-detected breast cancer" (OR = 0.13, p = 0.004), and higher time-tradeoff values for PM (OR = 182, p < 0.0001) made a choice for PM more likely. AB - CONCLUSIONS: The complete agreement between the decision-analytic recommendations and the carriers' choices suggests that women act in accordance with normative decision theory. The disagreement between the carriers' choices and the medical recommendations suggests that women's choices and physicians' recommendations were guided by different arguments. The strong association between time-tradeoff value and treatment choice suggests that the time-tradeoff is a valid method to assess preferences. RN - 0 (BRCA1 Protein) RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X0002000301 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10929847 [pubmed] ID - 10.1177/0272989X0002000301 [doi] PP - ppublish LG - English DP - 2000 Jul-Sep DC - 20001129 EZ - 2000/08/10 11:00 DA - 2001/02/28 10:01 DT - 2000/08/10 11:00 YR - 2000 ED - 20001129 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=10929847 <490. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10929847 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Unic I AU - Verhoef LC AU - Stalmeier PF AU - van Daal WA FA - Unic, I FA - Verhoef, L C FA - Stalmeier, P F FA - van Daal, W A IN - Unic, I. Joint Center for Radiation Oncology Arnhem-Nijmegen, University Medical Center Nijmegen, The Netherlands. TI - Prophylactic mastectomy or screening in women suspected to have the BRCA1/2 mutation: a prospective pilot study of women's treatment choices and medical and decision-analytic recommendations. SO - Medical Decision Making. 20(3):251-62, 2000 Jul-Sep AS - Med Decis Making. 20(3):251-62, 2000 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - BRCA1 Protein/ge [Genetics] MH - BRCA2 Protein MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Making MH - *Decision Support Techniques MH - Educational Status MH - Female MH - Heterozygote MH - Humans MH - Marital Status MH - *Mastectomy MH - Middle Aged MH - Neoplasm Proteins/ge [Genetics] MH - Netherlands MH - *Patient Participation MH - Probability MH - Prospective Studies MH - *Quality-Adjusted Life Years MH - Time Factors MH - Transcription Factors/ge [Genetics] AB - BACKGROUND: Women suspected to have the BRCA1/2 mutation may choose between two management options: breast cancer screening and prophylactic mastectomy (PM). AB - OBJECTIVES: To compare women's treatment choices with medical and decision-analytic recommendations and to explore variables related to the women's choices. AB - METHODS: After provision of information, individual time-tradeoff values for the health outcome "living after PM" were assessed and incorporated into a decision-analytic model, which compared the management options PM and screening with respect to their effects on quality-adjusted life expectancy. AB - RESULTS: Of the 54 women suspected to have the mutation, 51 completed the shared-decision-making procedure. Quality-adjusted life expectancy after PM management was longer for 67% of proven carriers and for 58% of women awaiting the DNA-test result. Twelve proven carriers made definitive treatment choices: eight (67%) chose PM and four (33%) chose screening. All carriers' treatment choices agreed with the normative decision-analytic recommendations. Four (33%) disagreed with the medical recommendations. Of the 36 women awaiting DNA-test results, 32 made hypothetical treatment choices. The agreement between these hypothetical treatment choices and the decision-analytic recommendations was good (78%). Combining data from all 48 women, being married (OR = 14.00, p = 0.006), having children (OR = 4.71, p = 0.02), low desire to participate (OR = 0.14, p = 0.004), high decisional stress (OR = 5.22, p = 0.01), a lower estimate of the "probability of cure for screen-detected breast cancer" (OR = 0.13, p = 0.004), and higher time-tradeoff values for PM (OR = 182, p < 0.0001) made a choice for PM more likely. AB - CONCLUSIONS: The complete agreement between the decision-analytic recommendations and the carriers' choices suggests that women act in accordance with normative decision theory. The disagreement between the carriers' choices and the medical recommendations suggests that women's choices and physicians' recommendations were guided by different arguments. The strong association between time-tradeoff value and treatment choice suggests that the time-tradeoff is a valid method to assess preferences. RN - 0 (BRCA1 Protein) RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0272-989X IL - 0272-989X PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10929847 [pubmed] PP - ppublish LG - English DP - 2000 Jul-Sep DC - 20001129 EZ - 2000/08/10 11:00 DA - 2001/02/28 10:01 DT - 2000/08/10 11:00 YR - 2000 ED - 20001129 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10929847 <491. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10894323 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Burack RC AU - George J AU - Gurney JG FA - Burack, R C FA - George, J FA - Gurney, J G IN - Burack, R C. Department of Internal Medicine, Wayne State University, Detroit, Michigan, USA. TI - Mammography use among women as a function of age and patient involvement in decision-making. SO - Journal of the American Geriatrics Society. 48(7):817-21, 2000 Jul AS - J Am Geriatr Soc. 48(7):817-21, 2000 Jul NJ - Journal of the American Geriatrics Society PI - Journal available in: Print PI - Citation processed from: Print JC - 7503062, h6v IO - J Am Geriatr Soc SB - Index Medicus CP - United States MH - Adult MH - Age Factors MH - Aged MH - Breast Neoplasms/pc [Prevention & Control] MH - Female MH - Health Surveys MH - Humans MH - *Mammography/ut [Utilization] MH - Middle Aged MH - *Patient Acceptance of Health Care/sn [Statistics & Numerical Data] MH - *Patient Participation/sn [Statistics & Numerical Data] MH - United States AB - OBJECTIVE: To assess the extent to which self-reported patient involvement in decision-making for initiation of mammography differs with age. AB - DESIGN: Data from the 1992 National Health Interview Survey (NHIS) Cancer Control Supplement were evaluated. Prevalences were weighted and variances were adjusted using SUDAAN software to account for the complex, multistage sampling probability design of the NHIS. Logistic regression was used to evaluate the relative likelihood of self-reported involvement in the decision to have a mammogram within the preceding year as a function of age and other covariates. AB - PARTICIPANTS: Mammography use was assessed among 3,863 NHIS female respondents 40 years of age or older. The analysis of decision-making was restricted to the subgroup of 1,064 women who reported a screening mammogram within the preceding year and who provided information on the other relevant variables. AB - MEASUREMENTS AND MAIN RESULTS: The probability of reported mammography use within the preceding year declines among older groups of interviewees. Among women with a mammogram in the preceding year, the weighted percentage of women reporting active involvement in the decision (patient decision or decided jointly with a physician) declines from 51% among women 40 to 45 years of age to 19% among those aged 75 years or older. The adjusted odds ratio comparing the likelihood of participating in the decision to have a mammogram for the oldest women, compared with the youngest, was 0.31 (95% confidence interval 0.15 to 0.61). AB - CONCLUSIONS: Older women are substantially less likely than younger women to report active involvement in the mammography decision-making process. Increased use of screening mammography among older women will require greater promotion by physicians. Other interventions, such as directed educational efforts, may also be needed to increase mammography demand among older women. IS - 0002-8614 IL - 0002-8614 PT - Journal Article ID - 10894323 [pubmed] PP - ppublish LG - English DP - 2000 Jul DC - 20000724 EZ - 2000/07/14 11:00 DA - 2000/08/01 11:00 DT - 2000/07/14 11:00 YR - 2000 ED - 20000724 RD - 20080310 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10894323 <492. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10690385 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Protiere C AU - Viens P AU - Genre D AU - Cowen D AU - Camerlo J AU - Gravis G AU - Alzieu C AU - Bertucci F AU - Resbeut M AU - Maraninchi D AU - Moatti JP FA - Protiere, C FA - Viens, P FA - Genre, D FA - Cowen, D FA - Camerlo, J FA - Gravis, G FA - Alzieu, C FA - Bertucci, F FA - Resbeut, M FA - Maraninchi, D FA - Moatti, J P IN - Protiere, C. Institut Paoli-Calmettes, Regional Centre for Cancer Care, Marseilles, France. TI - Patient participation in medical decision-making: a French study in adjuvant radio-chemotherapy for early breast cancer. SO - Annals of Oncology. 11(1):39-45, 2000 Jan AS - Ann Oncol. 11(1):39-45, 2000 Jan NJ - Annals of oncology : official journal of the European Society for Medical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - ayf, 9007735 IO - Ann. Oncol. SB - Index Medicus CP - England MH - Adult MH - *Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - Attitude to Health MH - *Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant MH - *Choice Behavior MH - Combined Modality Therapy MH - Cyclophosphamide/ad [Administration & Dosage] MH - Educational Status MH - Female MH - France MH - Humans MH - Middle Aged MH - Mitoxantrone/ad [Administration & Dosage] MH - *Patient Participation MH - Physicians/px [Psychology] MH - Surveys and Questionnaires AB - BACKGROUND: Shared decision-making is increasingly advocated as an ideal model. However, very few studies have tested the feasibility of giving patients the opportunity to participate in the choice of treatment. AB - PATIENTS AND METHODS: Women, with non-metastatic breast cancer, eligible for non-intensified adjuvant chemotherapy attending our hospital were proposed two administrations of chemotherapy and radiotherapy: a sequential and a concomitant one. Two patient-questionnaires were used to elicit motivations for their choice and their degree of comfort with the process of decision-making and one questionnaire to test physicians' ability to predict patients' choice. AB - RESULTS: Participation rate in the study was 75.3% (n = 64). Majority (64%) of patients chose the concomitant treatment. Multivariate analysis revealed that patients with a lower level of education, who discussed the choice with social circle, and who most feared side-effects were more likely to choose the sequential treatment. Physicians were able to predict patients' choice in 66% of cases. 89% of patients declared that they were fully satisfied with having participated in the choice of treatment and 79% supported shared decision-making. AB - CONCLUSIONS: Results are in favour of promoting active participation of cancer-patients in medical decision-making. The adequate degree of such participation remains however to be elicited and tested for therapeutic choices implying more difficult trade-offs between quantity and quality of life. RN - 8N3DW7272P (Cyclophosphamide) RN - BZ114NVM5P (Mitoxantrone) IS - 0923-7534 IL - 0923-7534 PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10690385 [pubmed] PP - ppublish LG - English DP - 2000 Jan DC - 20000314 EZ - 2000/02/26 09:00 DA - 2000/03/18 09:00 DT - 2000/02/26 09:00 YR - 2000 ED - 20000314 RD - 20161017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10690385 <493. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10696733 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Grann VR AU - Jacobson JS AU - Whang W AU - Hershman D AU - Heitjan DF AU - Antman KH AU - Neugut AI FA - Grann, V R FA - Jacobson, J S FA - Whang, W FA - Hershman, D FA - Heitjan, D F FA - Antman, K H FA - Neugut, A I IN - Grann, V R. Herbert Irving Comprehensive Cancer Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. TI - Prevention with tamoxifen or other hormones versus prophylactic surgery in BRCA1/2-positive women: a decision analysis. SO - The Cancer Journal from Scientific American. 6(1):13-20, 2000 Jan-Feb AS - Cancer J Sci Am. 6(1):13-20, 2000 Jan-Feb NJ - The cancer journal from Scientific American PI - Journal available in: Print PI - Citation processed from: Print JC - cr8, 9513568, 9513568 IO - Cancer J Sci Am SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Anticarcinogenic Agents/tu [Therapeutic Use] MH - BRCA2 Protein MH - *Breast Neoplasms/ep [Epidemiology] MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Cohort Studies MH - Contraceptives, Oral/tu [Therapeutic Use] MH - Disease-Free Survival MH - Female MH - *Genes, BRCA1 MH - Humans MH - Markov Chains MH - *Mastectomy MH - Middle Aged MH - Monte Carlo Method MH - *Mutation MH - *Neoplasm Proteins/ge [Genetics] MH - *Ovarian Neoplasms/ep [Epidemiology] MH - *Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - Quality of Life MH - Raloxifene Hydrochloride/tu [Therapeutic Use] MH - Risk Factors MH - *Tamoxifen/tu [Therapeutic Use] MH - *Transcription Factors/ge [Genetics] AB - PURPOSE: Recent randomized controlled trials have shown that tamoxifen and raloxifene may prevent invasive breast cancer. This decision analysis study compares the outcomes of chemoprevention with tamoxifen, raloxifene, or oral contraceptives with the outcomes of prophylactic surgery among women with high-risk BRCA1/2 mutations. AB - PATIENTS AND METHODS: We used a simulated cohort of 30-year-old women who tested positive for BRCA1/2 mutations and constructed a Markov model with Monte Carlo simulations, incorporating cumulative breast and ovarian cancer incidence rates from the literature and survival figures from SEER data. We assumed that prophylactic surgery reduces ovarian cancer risk by 45% and breast cancer risk by 90%, that tamoxifen reduces invasive breast cancer risk by 49%, and that raloxifene has similar efficacy and safety in premenopausal and postmenopausal women. We used data obtained from high-risk women by a time trade-off questionnaire to calculate quality-adjusted life-years. We based our cost estimates for hospital and ambulatory care on Health Care Financing Administration payments, the SEER-HCFA database, and the Pharmacy Fundamental Reference. AB - RESULTS: In our model, a 30-year-old BRCA1/2+ woman could prolong survival by 0.9 years (95% probability interval, 0.4-1.2 years) by having bilateral oophorectomy, 3.4 years (2.7-3.7 years) by having bilateral mastectomy, and 4.3 years (3.6-4.6 years) by having both procedures instead of surveillance alone. Chemoprevention with tamoxifen and raloxifene increased survival by 1.6 years (1.0-2.1 years) and 2.2 years (1.3-2.8 years), respectively. Chemoprevention yielded more quality-adjusted life-years than did prophylactic surgery, even when treatment was delayed to age 40 or 50 years. All these procedures were cost-effective or cost-saving compared with surveillance alone. AB - DISCUSSION: Our model suggests that although surgery may yield more substantial survival and cost benefits, quality of life issues may make chemoprevention a more attractive option for young women at high genetic risk. RN - 0 (Anticarcinogenic Agents) RN - 0 (BRCA2 Protein) RN - 0 (Contraceptives, Oral) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) RN - 094ZI81Y45 (Tamoxifen) RN - 4F86W47BR6 (Raloxifene Hydrochloride) IS - 1081-4442 IL - 1081-4442 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. ID - 10696733 [pubmed] PP - ppublish GI - No: P30 CA13696-26 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2000 Jan-Feb DC - 20000313 EZ - 2000/03/04 09:00 DA - 2000/03/18 09:00 DT - 2000/03/04 09:00 YR - 2000 ED - 20000313 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10696733 <494. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10478127 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Reaby LL FA - Reaby, L L IN - Reaby, L L. School of Nursing, Faculty of Applied Science, University of Canberra, Australia. TI - Breast restoration decision making. SO - Plastic Surgical Nursing. 19(1):22-9, 1999 Spring AS - Plast Surg Nurs. 19(1):22-9, 1999 Spring NJ - Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses PI - Journal available in: Print PI - Citation processed from: Print JC - 8403490, p8m IO - Plast Surg Nurs SB - Nursing Journal CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - Mammaplasty/nu [Nursing] MH - *Mammaplasty/px [Psychology] MH - Mastectomy/ae [Adverse Effects] MH - Mastectomy/nu [Nursing] MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - Models, Psychological MH - Nursing Methodology Research MH - Patient Education as Topic/mt [Methods] MH - Social Support MH - Surveys and Questionnaires AB - Women diagnosed with breast cancer have many physiological and psychological adjustments to make following mastectomy. The present study described in this article sought to determine the decision-making patterns used by two groups of women. Nurses need to be well informed and professionally confident to provide the individualized care and support deserved by women throughout the breast cancer trajectory. A major outcome of such professional care is confident women who understand their disease, treatments, and methods to manage stresses as they occur. IS - 0741-5206 IL - 0741-5206 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10478127 [pubmed] PP - ppublish LG - English DP - 1999 Spring DC - 20000217 EZ - 1999/09/09 09:00 DA - 2000/02/19 09:00 DT - 1999/09/09 09:00 YR - 1999 ED - 20000217 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10478127 <495. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10665701 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schrag D AU - Kuntz KM AU - Garber JE AU - Weeks JC FA - Schrag, D FA - Kuntz, K M FA - Garber, J E FA - Weeks, J C IN - Schrag, D. Department of Adult Oncology, Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Mass, USA. TI - Life expectancy gains from cancer prevention strategies for women with breast cancer and BRCA1 or BRCA2 mutations. CM - Comment in: JAMA. 2000 Jun 21;283(23):3070-2; PMID: 10865296 CM - Comment in: JAMA. 2000 Jun 21;283(23):3070; author reply 3071-2; PMID: 10865295 SO - JAMA. 283(5):617-24, 2000 Feb 02 AS - JAMA. 283(5):617-24, 2000 Feb 02 NJ - JAMA PI - Journal available in: Print PI - Citation processed from: Print JC - 7501160 IO - JAMA SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - *Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - BRCA2 Protein MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Support Techniques MH - Female MH - Genes, BRCA1 MH - Humans MH - *Life Expectancy MH - Markov Chains MH - *Mastectomy MH - Mutation MH - Neoplasm Proteins/ge [Genetics] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/mo [Mortality] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - Prognosis MH - Risk MH - *Tamoxifen/tu [Therapeutic Use] MH - Transcription Factors/ge [Genetics] AB - CONTEXT: Women with BRCA1- or BRCA2-associated breast cancer are at increased risk for contralateral breast cancer and ovarian cancer and therefore may consider secondary cancer prevention strategies, such as prophylactic surgery and tamoxifen therapy. It is not proven to what extent these strategies reduce risk of second cancers in such patients. AB - OBJECTIVE: To examine the effect of tamoxifen therapy, bilateral prophylactic oophorectomy (PO), prophylactic contralateral mastectomy (PCM), and combinations of these strategies on life expectancy for women with unilateral breast cancer and a BRCA1 or BRCA2 gene mutation. AB - DESIGN AND SETTING: Decision analysis using a Markov model. Probabilities for developing contralateral breast cancer and ovarian cancer, dying from these cancers, dying from primary breast cancer, and the reduction in cancer incidence and mortality due to prophylactic surgeries and/or tamoxifen were estimated from published studies. AB - PARTICIPANTS: Hypothetical breast cancer patients with BRCA1 or BRCA2 mutations facing decisions about secondary cancer prevention strategies. AB - INTERVENTIONS: Seven strategies, including 5 years of tamoxifen use, PO, PCM, and combinations of these strategies, compared with careful surveillance. AB - MAIN OUTCOME MEASURES: Total and incremental life expectancy (LE) with each intervention strategy. AB - RESULTS: Depending on the assumed penetrance of the BRCA mutation, compared with surveillance alone, 30-year-old early-stage breast cancer patients with BRCA mutations gain in LE 0.4 to 1.3 years from tamoxifen therapy, 0.2 to 1.8 years from PO, and 0.6 to 2.1 years from PCM. The magnitude of these gains is least for women with low-penetrance mutations (assumed contralateral breast cancer risk of 24% and ovarian cancer risk of 6%) and greatest for those with high-penetrance mutations (assumed contralateral breast cancer risk of 65% and ovarian cancer risk of 40%.) Older age and poorer prognosis from primary breast cancer further attenuate these gains. AB - CONCLUSIONS: Interventions to prevent second cancers, particularly PCM, may offer substantial LE gain for young women with BRCA-associated early-stage breast cancer. Estimates of LE gain may help women and their physicians consider the uncertainties, risks, and advantages of these interventions and lead to more informed choices about cancer prevention strategies. RN - 0 (Antineoplastic Agents, Hormonal) RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) RN - 094ZI81Y45 (Tamoxifen) IS - 0098-7484 IL - 0098-7484 DI - joc90720 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10665701 [pubmed] ID - joc90720 [pii] PP - ppublish LG - English DP - 2000 Feb 02 DC - 20000216 EZ - 2000/02/09 09:00 DA - 2000/02/19 09:00 DT - 2000/02/09 09:00 YR - 2000 ED - 20000216 RD - 20161017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10665701 <496. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10561209 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Whelan T AU - Levine M AU - Gafni A AU - Sanders K AU - Willan A AU - Mirsky D AU - Schnider D AU - McCready D AU - Reid S AU - Kobylecky A AU - Reed K FA - Whelan, T FA - Levine, M FA - Gafni, A FA - Sanders, K FA - Willan, A FA - Mirsky, D FA - Schnider, D FA - McCready, D FA - Reid, S FA - Kobylecky, A FA - Reed, K IN - Whelan, T. Supportive Cancer Care Research Unit and Departments of Medicine, Clinical Epidemiology and Biostatistics, and Surgery, McMaster University, Hamilton, Ontario, Canada. tim_whelan@hrcc.on.ca TI - Mastectomy or lumpectomy? Helping women make informed choices. SO - Journal of Clinical Oncology. 17(6):1727-35, 1999 Jun AS - J Clin Oncol. 17(6):1727-35, 1999 Jun NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Disease Management MH - Female MH - Humans MH - *Informed Consent MH - Mastectomy/sn [Statistics & Numerical Data] MH - *Mastectomy MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - *Mastectomy, Segmental MH - Middle Aged MH - Patient Acceptance of Health Care MH - *Patient Education as Topic/mt [Methods] MH - Time Factors AB - PURPOSE: To develop an instrument to help clinicians inform their patients about surgical treatment options for the treatment of breast cancer and to evaluate the impact of the instrument on the clinical encounter. AB - METHODS: We developed an instrument, called the Decision Board, to present information regarding the benefits and risks of breast-conserving therapy (lumpectomy plus radiation therapy) and mastectomy to women with early-stage breast cancer to enable them to express a preference for the type of surgery. Seven surgeons from different communities in Ontario administered the instrument to women with newly diagnosed clinical stage I or II breast cancer over an 18-month period. Patients and surgeons were interviewed regarding acceptability of the instrument. The rates of breast-conserving surgery performed by surgeons before and after the introduction of the instrument were compared. AB - RESULTS: The Decision Board was administered to 175 patients; 98% reported that the Decision Board was easy to understand, and 81% indicated that it helped them make a decision. The average score on a true/false test of comprehension was 11.8 of 14 (84%) (range, 6 to 14). Surgeons found the Decision Board to be helpful in presenting information to patients in 91% of consultations. The rate of breast-conserving surgery decreased when the Decision Board was introduced (88% v 73%, P =.001) AB - CONCLUSION: The Decision Board is a simple method to improve communication and facilitate shared decision making. It was well accepted by patients and surgeons and easily applied in the community. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.1999.17.6.1727 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10561209 [pubmed] ID - 10.1200/JCO.1999.17.6.1727 [doi] PP - ppublish LG - English DP - 1999 Jun DC - 20000113 EZ - 1999/11/24 00:00 DA - 1999/11/24 00:01 DT - 1999/11/24 YR - 1999 ED - 20000113 RD - 20170210 UP - 20170213 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=10561209 <497. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10561209 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Whelan T AU - Levine M AU - Gafni A AU - Sanders K AU - Willan A AU - Mirsky D AU - Schnider D AU - McCready D AU - Reid S AU - Kobylecky A AU - Reed K FA - Whelan, T FA - Levine, M FA - Gafni, A FA - Sanders, K FA - Willan, A FA - Mirsky, D FA - Schnider, D FA - McCready, D FA - Reid, S FA - Kobylecky, A FA - Reed, K IN - Whelan, T. Supportive Cancer Care Research Unit and Departments of Medicine, Clinical Epidemiology and Biostatistics, and Surgery, McMaster University, Hamilton, Ontario, Canada. tim_whelan@hrcc.on.ca TI - Mastectomy or lumpectomy? Helping women make informed choices. SO - Journal of Clinical Oncology. 17(6):1727-35, 1999 Jun AS - J Clin Oncol. 17(6):1727-35, 1999 Jun NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/di [Diagnosis] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Disease Management MH - Female MH - Humans MH - *Informed Consent MH - Mastectomy/sn [Statistics & Numerical Data] MH - *Mastectomy MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - *Mastectomy, Segmental MH - Middle Aged MH - Patient Acceptance of Health Care MH - *Patient Education as Topic/mt [Methods] MH - Time Factors AB - PURPOSE: To develop an instrument to help clinicians inform their patients about surgical treatment options for the treatment of breast cancer and to evaluate the impact of the instrument on the clinical encounter. AB - METHODS: We developed an instrument, called the Decision Board, to present information regarding the benefits and risks of breast-conserving therapy (lumpectomy plus radiation therapy) and mastectomy to women with early-stage breast cancer to enable them to express a preference for the type of surgery. Seven surgeons from different communities in Ontario administered the instrument to women with newly diagnosed clinical stage I or II breast cancer over an 18-month period. Patients and surgeons were interviewed regarding acceptability of the instrument. The rates of breast-conserving surgery performed by surgeons before and after the introduction of the instrument were compared. AB - RESULTS: The Decision Board was administered to 175 patients; 98% reported that the Decision Board was easy to understand, and 81% indicated that it helped them make a decision. The average score on a true/false test of comprehension was 11.8 of 14 (84%) (range, 6 to 14). Surgeons found the Decision Board to be helpful in presenting information to patients in 91% of consultations. The rate of breast-conserving surgery decreased when the Decision Board was introduced (88% v 73%, P =.001) AB - CONCLUSION: The Decision Board is a simple method to improve communication and facilitate shared decision making. It was well accepted by patients and surgeons and easily applied in the community. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/jco.1999.17.6.1727 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10561209 [pubmed] ID - 10.1200/jco.1999.17.6.1727 [doi] PP - ppublish LG - English DP - 1999 Jun DC - 20000113 EZ - 1999/11/24 00:00 DA - 1999/11/24 00:01 DT - 1999/11/24 YR - 1999 ED - 20000113 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10561209 <498. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10620889 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Sandrick K FA - Sandrick, K TI - Physicians study tool to help patients select treatment for breast cancer. SO - Bulletin of the American College of Surgeons. 84(9):24-8, 1999 Sep AS - Bull Am Coll Surg. 84(9):24-8, 1999 Sep NJ - Bulletin of the American College of Surgeons PI - Journal available in: Print PI - Citation processed from: Print JC - bdc, 7507024, 750724 IO - Bull Am Coll Surg SB - Health Administration Journals CP - United States MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - *Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Mastectomy, Segmental MH - Ontario MH - *Patient Education as Topic MH - *Patient Participation IS - 0002-8045 IL - 0002-8045 PT - Journal Article ID - 10620889 [pubmed] PP - ppublish LG - English DP - 1999 Sep DC - 19991123 EZ - 2000/01/06 00:00 DA - 2000/01/06 00:01 DT - 2000/01/06 YR - 1999 ED - 19991123 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10620889 <499. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10467873 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schmidt JG FA - Schmidt, J G IN - Schmidt, J G. Institut fur Klinische Epidemiologie, Einsiedeln. TI - [Evidence-based medicine: modern scientific methods for determining usefulness]. [German] OT - Evidence Based Medicine: Moderne wissenschaftliche Methoden zur Bestimmung des Nutzens. SO - Swiss Surgery. 5(4):177-82, 1999 AS - Swiss Surg. 5(4):177-82, 1999 NJ - Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera PI - Journal available in: Print PI - Citation processed from: Print JC - cdj, 9514313 IO - Swiss Surg SB - Index Medicus CP - Switzerland MH - Adult MH - Aged MH - Bias (Epidemiology) MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/su [Surgery] MH - Clinical Trials as Topic/sn [Statistics & Numerical Data] MH - *Clinical Trials as Topic MH - Decision Support Techniques MH - *Evidence-Based Medicine MH - Female MH - Humans MH - Mastectomy, Radical/sn [Statistics & Numerical Data] MH - Mastectomy, Segmental/sn [Statistics & Numerical Data] MH - Middle Aged MH - Outcome and Process Assessment (Health Care)/sn [Statistics & Numerical Data] MH - Patient Satisfaction MH - Prognosis AB - For quite some time, clinical epidemiology has introduced the art of critical appraisal of evidence as well as the methods of how to design sound clinical studies and trials. Almost unnoticed by most medical institutions a new hierarchy of evidence has emerged which puts well thought out trials, able to document unbiased treatment benefit in terms of patient suffering, above pathophysiological theory. Many controlled trials have shown, in the meantime, that the control of laboratory or other kind of pathologies and the correction of anatomical abnormalities do not necessarily mean a benefit for the patient. Concepts relating to this dissection of evidence include: Surrogate fallacy ("cosmetics" of laboratory results or ligament or cartilage "cosmetics" in surgery), confounding (spurious causal relationships), selection bias (comparison with selected groups) as well as lead-time bias (mistaking earlier diagnosis as increase of survival), length bias (overlooking differences in the aggressiveness of diseases as determinants of disease stage distributions) and overdiagnosis bias (mistaking the increasing detection of clinically silent pathologies as improvement of prognosis). Moreover, absolute instead of relative risk reduction needs to be used to measure patient benefit. The incorporation of decision-analysis and of the concepts or clinical epidemiology will improve the efficiency and quality of medicine much more effectively than the sole focus on technical medical performance. Evidence based medicine is the systematic and critical appraisal of medical interventions, based on the understanding how to avoid the fallacies and biases mentioned. IS - 1023-9332 IL - 1023-9332 PT - English Abstract PT - Journal Article ID - 10467873 [pubmed] PP - ppublish LG - German DP - 1999 DC - 19991021 EZ - 1999/09/01 00:00 DA - 1999/09/01 00:01 DT - 1999/09/01 YR - 1999 ED - 19991021 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10467873 <500. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10424830 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stalmeier PF AU - Unic IJ AU - Verhoef LC AU - Van Daal WA FA - Stalmeier, P F FA - Unic, I J FA - Verhoef, L C FA - Van Daal, W A IN - Stalmeier, P F. Nijmegen Institute for Cognition and Information, The Netherlands. Stalmeier@nici.kun.nl TI - Evaluation of a shared decision making program for women suspected to have a genetic predisposition to breast cancer: preliminary results. SO - Medical Decision Making. 19(3):230-41, 1999 Jul-Sep AS - Med Decis Making. 19(3):230-41, 1999 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Cost of Illness MH - *Decision Making MH - Decision Support Techniques MH - Female MH - *Genetic Predisposition to Disease/ge [Genetics] MH - Genetic Predisposition to Disease/px [Psychology] MH - Genetic Testing/px [Psychology] MH - Heterozygote Detection MH - Humans MH - Mass Screening/px [Psychology] MH - Mastectomy, Modified Radical/px [Psychology] MH - Middle Aged MH - *Patient Participation MH - Patient Satisfaction MH - Risk Assessment AB - BACKGROUND: Women suspected to have a genetic predisposition to breast cancer face the difficult choice between regular breast cancer screening and prophylactic mastectomy. The authors developed a shared decision making program (SDMP) to support this decision. AB - OBJECTIVES: To evaluate the SDMP in terms of practicality, beneficial effects, and patient satisfaction. AB - DESIGN: A one-group pretest-posttest design was used. AB - MEASURES: Decision uncertainty, decision burden, subjective knowledge, and risk comprehension were assessed before and after the SDMP. Additional measures were obtained for concepts related to breast cancer concern, desire to participate in the program, satisfaction, program acceptability, and emotional reaction to the program information. AB - RESULTS: Seventy-two women, most of whom were awaiting the genetic test results, participated. Decision uncertainty (effect size d = 0.37) and decision burden (d = 0.41) were reduced by the SDMP. Subjective knowledge (averaged d = 0.94) and risk comprehension were improved. The women were satisfied with the SDMP and found its rationale acceptable. Women who had strong emotional reactions to the information benefited less from the SDMP, whereas women with strong desires to participate in the decision benefited more. AB - CONCLUSIONS: There is a need to give patients more information, especially about prophylactic mastectomy and among gene carriers. Beneficial effects were observed irrespective of whether genetic status was known, suggesting that information concerning treatment options should be made available as soon as DNA testing begins. The better psychological outcomes of women with stronger desires to participate may arise because the desire to participate is characteristic of emotional stability. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9901900302 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10424830 [pubmed] ID - 10.1177/0272989X9901900302 [doi] PP - ppublish LG - English DP - 1999 Jul-Sep DC - 19990930 EZ - 1999/07/29 00:00 DA - 1999/07/29 00:01 DT - 1999/07/29 YR - 1999 ED - 19990930 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=10424830 <501. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10424830 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stalmeier PF AU - Unic IJ AU - Verhoef LC AU - Van Daal WA FA - Stalmeier, P F FA - Unic, I J FA - Verhoef, L C FA - Van Daal, W A IN - Stalmeier, P F. Nijmegen Institute for Cognition and Information, The Netherlands. Stalmeier@nici.kun.nl TI - Evaluation of a shared decision making program for women suspected to have a genetic predisposition to breast cancer: preliminary results. SO - Medical Decision Making. 19(3):230-41, 1999 Jul-Sep AS - Med Decis Making. 19(3):230-41, 1999 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Cost of Illness MH - *Decision Making MH - Decision Support Techniques MH - Female MH - *Genetic Predisposition to Disease/ge [Genetics] MH - Genetic Predisposition to Disease/px [Psychology] MH - Genetic Testing/px [Psychology] MH - Heterozygote Detection MH - Humans MH - Mass Screening/px [Psychology] MH - Mastectomy, Modified Radical/px [Psychology] MH - Middle Aged MH - *Patient Participation MH - Patient Satisfaction MH - Risk Assessment AB - BACKGROUND: Women suspected to have a genetic predisposition to breast cancer face the difficult choice between regular breast cancer screening and prophylactic mastectomy. The authors developed a shared decision making program (SDMP) to support this decision. AB - OBJECTIVES: To evaluate the SDMP in terms of practicality, beneficial effects, and patient satisfaction. AB - DESIGN: A one-group pretest-posttest design was used. AB - MEASURES: Decision uncertainty, decision burden, subjective knowledge, and risk comprehension were assessed before and after the SDMP. Additional measures were obtained for concepts related to breast cancer concern, desire to participate in the program, satisfaction, program acceptability, and emotional reaction to the program information. AB - RESULTS: Seventy-two women, most of whom were awaiting the genetic test results, participated. Decision uncertainty (effect size d = 0.37) and decision burden (d = 0.41) were reduced by the SDMP. Subjective knowledge (averaged d = 0.94) and risk comprehension were improved. The women were satisfied with the SDMP and found its rationale acceptable. Women who had strong emotional reactions to the information benefited less from the SDMP, whereas women with strong desires to participate in the decision benefited more. AB - CONCLUSIONS: There is a need to give patients more information, especially about prophylactic mastectomy and among gene carriers. Beneficial effects were observed irrespective of whether genetic status was known, suggesting that information concerning treatment options should be made available as soon as DNA testing begins. The better psychological outcomes of women with stronger desires to participate may arise because the desire to participate is characteristic of emotional stability. IS - 0272-989X IL - 0272-989X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 10424830 [pubmed] PP - ppublish LG - English DP - 1999 Jul-Sep DC - 19990930 EZ - 1999/07/29 00:00 DA - 1999/07/29 00:01 DT - 1999/07/29 YR - 1999 ED - 19990930 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10424830 <502. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10437453 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Timonen L AU - Sihvonen M FA - Timonen, L FA - Sihvonen, M TI - [Guidance for breast cancer patients in the surgical ward and in the outpatient department]. [Finnish] OT - Rintasyopapotilaan ohjaus yliopistollisen keskussairaalan kirurgisella vuodeosastolla ja poliklinikalla. SO - Hoitotiede. 10(5):299-308, 1998 AS - Hoitotiede. 10(5):299-308, 1998 NJ - Hoitotiede PI - Journal available in: Print PI - Citation processed from: Print JC - aoy, 9104138, 9104138 IO - Hoitotiede SB - Nursing Journal CP - Finland MH - Adaptation, Psychological MH - Adult MH - Aged MH - Aged, 80 and over MH - Ambulatory Care MH - *Attitude to Health MH - Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - Female MH - Hospital Units MH - Humans MH - Length of Stay MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - Surveys and Questionnaires AB - The purpose of this study was to examine the perceptions of breast cancer patients, who had undergone a breast operation. The study focused on patients' perceptions of the length of hospital stay and the sources and contents of information given to them. Patients also evaluated how they could participate in the decision making concerning the choice of operation. Data were collected by questionnaires given to 100 patients at one hospital. The questionnaires were returned circa 2 weeks later when the patients visited the hospital for follow up examinations. Of the sample, 71% responded to the questionnaire. All patients had undergone an operation, either resection of the breast, ablation of the breast, or immediate reconstruction of the breast. The results were presented in frequencies and percentages. The average time spent by patients in surgical ward was 3, 5 days for resection and ablation and 11 days for reconstruction. Most patients (86%) considered, that the hospital stay was sufficiently long. The patients felt that the information they received had met their needs quite well. They were well-informed about operation, illness in general, exercises of arms and anesthesia. They got less information about future treatments (hormonal treatment, chemotherapy, x-ray and reconstruction of the breast). The greatest need for further information was about future treatments. Most patients (72%) considered that they had coped well at home; even drainage had not caused much trouble. Patients had received most information from surgeons, nurses and written sources. Two-thirds (66%) of the patients reported, that they could participate in decision making concerning the choice of operation. IS - 0786-5686 IL - 0786-5686 PT - English Abstract PT - Journal Article ID - 10437453 [pubmed] PP - ppublish LG - Finnish DP - 1998 DC - 19990812 EZ - 1999/08/07 00:00 DA - 1999/08/07 00:01 DT - 1999/08/07 YR - 1998 ED - 19990812 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10437453 <503. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10372578 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tengs TO AU - Winer EP AU - Paddock S AU - Aguilar-Chavez O AU - Berry DA FA - Tengs, T O FA - Winer, E P FA - Paddock, S FA - Aguilar-Chavez, O FA - Berry, D A IN - Tengs, T O. School of Social Ecology, University of California at Irvine, 92697-7075, USA. tengs@uci.edu TI - Testing for the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes: a decision analysis. SO - Medical Decision Making. 18(4):365-75, 1998 Oct-Dec AS - Med Decis Making. 18(4):365-75, 1998 Oct-Dec NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1/ph [Physiology] MH - *Genes, Tumor Suppressor/ph [Physiology] MH - Genetic Predisposition to Disease MH - *Genetic Testing MH - Humans MH - Incidence MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - Ovarian Neoplasms/ep [Epidemiology] MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy MH - Predictive Value of Tests MH - Quality-Adjusted Life Years MH - *Risk Assessment/mt [Methods] MH - Survival Analysis MH - United States/ep [Epidemiology] AB - OBJECTIVE: The authors developed a Markov decision model to evaluate the health implications of testing for mutations in the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes. Prophylactic measures considered included various combinations of immediate and delayed bilateral mastectomy and oophorectomy or taking no action. AB - METHODS: The model incorporated the likelihood of developing breast and/or ovarian cancer, survival, and quality of life. Parameter values were taken from public databases, the published literature, and a survey of cancer experts. Outcomes considered were additional life expectancy and quality-adjusted life years (QALYs). Results are reported for 30-year-old cancer-free women at various levels of hereditary risk. AB - RESULTS AND CONCLUSIONS: The vast majority of women will not benefit from testing because their pre-test risks are low and surgical prophylaxis is undesirable. However, women who have family histories of early breast and/or ovarian cancer may gain up to 2 QALYs by allowing genetic testing to inform their decisions. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9801800402 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 10372578 [pubmed] ID - 10.1177/0272989X9801800402 [doi] PP - ppublish GI - No: P50 CA68438 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 1998 Oct-Dec DC - 19990803 EZ - 1999/06/18 00:00 DA - 1999/06/18 00:01 DT - 1999/06/18 YR - 1998 ED - 19990803 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=10372578 <504. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10394256 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bouaud J AU - Seroussi B AU - Antoine EC AU - Gozy M AU - Khayat D AU - Boisvieux JF FA - Bouaud, J FA - Seroussi, B FA - Antoine, E C FA - Gozy, M FA - Khayat, D FA - Boisvieux, J F IN - Bouaud, J. Service d'Informatique Medicale, AP-HP, Universite Paris 6, France. TI - [Patient-centered consultation of "good practice guidelines": OncoDoc, a decision support system for the management of breast cancer patients]. [Review] [7 refs] [French] OT - Consultation centree-patient d'un 'guide de bonnes pratiques': OncoDoc, un systeme d'aide a la decision therapeutique applique au cancer du sein. SO - Therapie. 54(2):209-15, 1999 Mar-Apr AS - Therapie. 54(2):209-15, 1999 Mar-Apr NJ - Therapie PI - Journal available in: Print PI - Citation processed from: Print JC - vq6, 0420544 IO - Therapie SB - Index Medicus CP - France MH - Breast Neoplasms/ec [Economics] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making, Computer-Assisted MH - *Decision Support Systems, Clinical MH - Female MH - Humans MH - Internet MH - *Patient-Centered Care MH - Practice Guidelines as Topic AB - Beyond considerations of cost-effectiveness, clinical practice guidelines (CPG) can reduce practice variations and thus improve the quality of care. However, despite the proliferation of implemented CPG and their wide diffusion thanks to Internet-based technologies, physicians' compliance with formal standards is weak. Developed according to a document-based paradigm, OncoDoc proposes an original framework for implementing CPG. Domain knowledge has been encoded as a decision tree whose branches are both exclusive and exhaustive. This generic knowledge is operationalized at the point of care by the interactive building, through hypertextual navigation, of a patient-based clinical context leading to specific therapeutic recommendations. OncoDoc has first been applied to the management of breast cancer patients and demonstrated within a full-scale experimentation in a clinical setting a compliance of 80 per cent. [References: 7] IS - 0040-5957 IL - 0040-5957 PT - English Abstract PT - Journal Article PT - Review ID - 10394256 [pubmed] PP - ppublish LG - French DP - 1999 Mar-Apr DC - 19990803 EZ - 1999/07/08 00:00 DA - 1999/07/08 00:01 DT - 1999/07/08 YR - 1999 ED - 19990803 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10394256 <505. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10372578 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tengs TO AU - Winer EP AU - Paddock S AU - Aguilar-Chavez O AU - Berry DA FA - Tengs, T O FA - Winer, E P FA - Paddock, S FA - Aguilar-Chavez, O FA - Berry, D A IN - Tengs, T O. School of Social Ecology, University of California at Irvine, 92697-7075, USA. tengs@uci.edu TI - Testing for the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes: a decision analysis. SO - Medical Decision Making. 18(4):365-75, 1998 Oct-Dec AS - Med Decis Making. 18(4):365-75, 1998 Oct-Dec NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Breast Neoplasms/ep [Epidemiology] MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1/ph [Physiology] MH - *Genes, Tumor Suppressor/ph [Physiology] MH - Genetic Predisposition to Disease MH - *Genetic Testing MH - Humans MH - Incidence MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - Ovarian Neoplasms/ep [Epidemiology] MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy MH - Predictive Value of Tests MH - Quality-Adjusted Life Years MH - *Risk Assessment/mt [Methods] MH - Survival Analysis MH - United States/ep [Epidemiology] AB - OBJECTIVE: The authors developed a Markov decision model to evaluate the health implications of testing for mutations in the BRCA1 and BRCA2 breast-ovarian cancer susceptibility genes. Prophylactic measures considered included various combinations of immediate and delayed bilateral mastectomy and oophorectomy or taking no action. AB - METHODS: The model incorporated the likelihood of developing breast and/or ovarian cancer, survival, and quality of life. Parameter values were taken from public databases, the published literature, and a survey of cancer experts. Outcomes considered were additional life expectancy and quality-adjusted life years (QALYs). Results are reported for 30-year-old cancer-free women at various levels of hereditary risk. AB - RESULTS AND CONCLUSIONS: The vast majority of women will not benefit from testing because their pre-test risks are low and surgical prophylaxis is undesirable. However, women who have family histories of early breast and/or ovarian cancer may gain up to 2 QALYs by allowing genetic testing to inform their decisions. IS - 0272-989X IL - 0272-989X PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 10372578 [pubmed] PP - ppublish GI - No: P50 CA68438 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 1998 Oct-Dec DC - 19990803 EZ - 1999/06/18 00:00 DA - 1999/06/18 00:01 DT - 1999/06/18 YR - 1998 ED - 19990803 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10372578 <506. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9917020 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Carter KJ AU - Ritchey NP AU - Castro F AU - Caccamo LP AU - Kessler E AU - Erickson BA FA - Carter, K J FA - Ritchey, N P FA - Castro, F FA - Caccamo, L P FA - Kessler, E FA - Erickson, B A IN - Carter, K J. St. Elizabeth Health Center, Youngstown State University, Ohio 44501-1790, USA. TI - Analysis of three decision-making methods: a breast cancer patient as a model. SO - Medical Decision Making. 19(1):49-57, 1999 Jan-Mar AS - Med Decis Making. 19(1):49-57, 1999 Jan-Mar NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - *Decision Making MH - Female MH - Humans MH - Markov Chains MH - Mastectomy MH - Methods MH - *Models, Theoretical MH - Tamoxifen/tu [Therapeutic Use] AB - PURPOSE: To compare three decision making techniques using a common clinical problem. AB - METHODS: Two recently developed methods, the analytic hierarchy process (AHP) and the analytic network process (ANP), were compared with a Markov process in the evaluation of the optimal post-lumpectomy treatment strategy for an elderly woman with a mammographically detected, nonpalpable early-stage breast cancer. The following treatment alternatives were considered: observation, radiation, tamoxifen, combination radiation and tamoxifen, and simple mastectomy. All three decision methods incorporated patient preferences. AB - RESULTS: The models agreed on the ranking of the preferred treatment, radiation and tamoxifen, but there were variations in the rankings of the other treatment choices. Individual differences between the three models were uncovered. The Markov process provided estimates of quality-adjusted life expectancy and distribution of health events. Both AHP and ANP required less development time than the Markov process. AB - CONCLUSION: All three methods may be useful tools to the clinician in analyzing complex medical problems. The Markov is the most labor-intensive method but provides detailed results, whereas the AHP and the ANP give only rank orders of the alternatives. The most important considerations in choosing between these methods are time to project completion and the detail of information sought. RN - 0 (Antineoplastic Agents) RN - 094ZI81Y45 (Tamoxifen) IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9901900107 PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9917020 [pubmed] ID - 10.1177/0272989X9901900107 [doi] PP - ppublish LG - English DP - 1999 Jan-Mar DC - 19990413 EZ - 1999/01/23 00:00 DA - 1999/01/23 00:01 DT - 1999/01/23 YR - 1999 ED - 19990413 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9917020 <507. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9917020 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Carter KJ AU - Ritchey NP AU - Castro F AU - Caccamo LP AU - Kessler E AU - Erickson BA FA - Carter, K J FA - Ritchey, N P FA - Castro, F FA - Caccamo, L P FA - Kessler, E FA - Erickson, B A IN - Carter, K J. St. Elizabeth Health Center, Youngstown State University, Ohio 44501-1790, USA. TI - Analysis of three decision-making methods: a breast cancer patient as a model. SO - Medical Decision Making. 19(1):49-57, 1999 Jan-Mar AS - Med Decis Making. 19(1):49-57, 1999 Jan-Mar NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Antineoplastic Agents/tu [Therapeutic Use] MH - *Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - *Decision Making MH - Female MH - Humans MH - Markov Chains MH - Mastectomy MH - Methods MH - *Models, Theoretical MH - Tamoxifen/tu [Therapeutic Use] AB - PURPOSE: To compare three decision making techniques using a common clinical problem. AB - METHODS: Two recently developed methods, the analytic hierarchy process (AHP) and the analytic network process (ANP), were compared with a Markov process in the evaluation of the optimal post-lumpectomy treatment strategy for an elderly woman with a mammographically detected, nonpalpable early-stage breast cancer. The following treatment alternatives were considered: observation, radiation, tamoxifen, combination radiation and tamoxifen, and simple mastectomy. All three decision methods incorporated patient preferences. AB - RESULTS: The models agreed on the ranking of the preferred treatment, radiation and tamoxifen, but there were variations in the rankings of the other treatment choices. Individual differences between the three models were uncovered. The Markov process provided estimates of quality-adjusted life expectancy and distribution of health events. Both AHP and ANP required less development time than the Markov process. AB - CONCLUSION: All three methods may be useful tools to the clinician in analyzing complex medical problems. The Markov is the most labor-intensive method but provides detailed results, whereas the AHP and the ANP give only rank orders of the alternatives. The most important considerations in choosing between these methods are time to project completion and the detail of information sought. RN - 0 (Antineoplastic Agents) RN - 094ZI81Y45 (Tamoxifen) IS - 0272-989X IL - 0272-989X PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9917020 [pubmed] PP - ppublish LG - English DP - 1999 Jan-Mar DC - 19990413 EZ - 1999/01/23 00:00 DA - 1999/01/23 00:01 DT - 1999/01/23 YR - 1999 ED - 19990413 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9917020 <508. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10339125 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Anonymous TI - Program finds a better way to manage breast cancer. SO - Healthcare Demand & Disease Management. 4(12):186-8, 1998 Dec AS - Healthc Demand Dis Manag. 4(12):186-8, 1998 Dec NJ - Healthcare demand & disease management PI - Journal available in: Print PI - Citation processed from: Print JC - cz4, 9891547 IO - Healthc Demand Dis Manag SB - Health Administration Journals CP - United States MH - Adult MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Decision Making MH - *Disease Management MH - Female MH - Humans MH - Mastectomy/px [Psychology] MH - Patient Care Planning MH - Patient Education as Topic MH - *Social Support MH - Stress, Psychological MH - Texas MH - Time Management AB - Women faced with a breast cancer diagnosis often find that inattention to their psychosocial needs is nearly as problematic as the disease itself. Find out how this model breast cancer program fills that void. IS - 1094-2521 IL - 1094-2521 PT - Journal Article ID - 10339125 [pubmed] PP - ppublish LG - English DP - 1998 Dec DC - 19990223 EZ - 1999/05/26 00:00 DA - 1999/05/26 00:01 DT - 1999/05/26 YR - 1998 ED - 19990223 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10339125 <509. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9926781 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stafford D AU - Szczys R AU - Becker R AU - Anderson J AU - Bushfield S FA - Stafford, D FA - Szczys, R FA - Becker, R FA - Anderson, J FA - Bushfield, S IN - Stafford, D. University of North Dakota Department of Surgery, Altru Health System, Grand Forks 58206, USA. TI - How breast cancer treatment decisions are made by women in North Dakota. SO - American Journal of Surgery. 176(6):515-9, 1998 Dec AS - Am J Surg. 176(6):515-9, 1998 Dec NJ - American journal of surgery PI - Journal available in: Print PI - Citation processed from: Print JC - 3z4, 0370473 IO - Am. J. Surg. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Humans MH - *Mastectomy, Radical MH - *Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Staging MH - North Dakota MH - Patient Education as Topic MH - Physician-Patient Relations MH - Prognosis MH - Radiation Oncology MH - Rural Population AB - BACKGROUND: Although equally effective, women in rural midwestern states choose modified radical mastectomy (MRM) over breast conservation surgery for early stage breast cancer. This study assessed treatment decisions by the women of North Dakota. AB - METHODS: Surveys were sent to women treated for early stage breast cancer from 1990 through 1992. Separate surveys were sent out to surgeons in the state. The questions assessed physician and patient perceptions of treatment and the decision making process. AB - RESULTS: A majority of surgeons believed that the long-term and disease-free survival was equal and that the preference for choosing MRM was due mostly to inconvenience of radiotherapy. The women reported that the surgeon was the most influential in the treatment decision and that concerns over radiation, duration of treatment, and travel restrictions all were factors in the decision. AB - CONCLUSIONS: Education of surgeons and patients plus the early involvement of the radiation oncologist in discussing options is essential in the treatment of early stage breast cancer. IS - 0002-9610 IL - 0002-9610 DI - S0002-9610(98)00257-8 PT - Journal Article ID - 9926781 [pubmed] ID - S0002-9610(98)00257-8 [pii] PP - ppublish LG - English DP - 1998 Dec DC - 19990211 EZ - 1999/02/02 00:00 DA - 1999/02/02 00:01 DT - 1999/02/02 YR - 1998 ED - 19990211 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9926781 <510. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9917577 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rosenthal TC AU - Puck SM FA - Rosenthal, T C FA - Puck, S M IN - Rosenthal, T C. Department of Family Medicine, State University of New York at Buffalo, USA. TI - Screening for genetic risk of breast cancer. [Review] [23 refs] CM - Comment in: Am Fam Physician. 1999 Jan 1;59(1):43-4, 46; PMID: 9917573 SO - American Family Physician. 59(1):99-104, 106, 1999 Jan 01 AS - Am Fam Physician. 59(1):99-104, 106, 1999 Jan 01 NJ - American family physician PI - Journal available in: Print PI - Citation processed from: Print JC - 3bt, 1272646 IO - Am Fam Physician SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Algorithms MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Decision Making MH - Female MH - Genes, BRCA1/ge [Genetics] MH - *Genes, Tumor Suppressor/ge [Genetics] MH - *Genetic Testing MH - *Heterozygote MH - Humans MH - *Mutation MH - Patient Education as Topic MH - Practice Guidelines as Topic MH - Teaching Materials AB - Approximately 10 to 15 percent of all breast cancers are thought to be familial and about one third of these cases are due to an inherited mutation in a BRCA1 or BRCA2 breast cancer-susceptibility gene. The lifetime incidence of breast cancer in mutation carriers is above 50 percent, and carriers of BRCA1 mutation also have a substantially increased risk of ovarian cancer. BRCA1 and 2 mutations are associated with early-onset breast cancer, and some experts call for aggressive screening of affected persons. Monthly self-examination of the breasts beginning at age 18 and annual clinical examinations and mammography after age 25 have been recommended but are of unproven benefit. Prophylactic mastectomy and oophorectomy have been advocated by some authorities, but these interventions are disfiguring and for some carriers of the gene, they are unnecessary. The patient's decision to undergo genetic screening is complicated by the technical difficulty of the test, the substantial cost and the still incomplete understanding of the penetrance of disease in known mutation carriers. [References: 23] IS - 0002-838X IL - 0002-838X PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 9917577 [pubmed] PP - ppublish LG - English DP - 1999 Jan 01 DC - 19990204 EZ - 1999/01/26 00:00 DA - 1999/01/26 00:01 DT - 1999/01/26 YR - 1999 ED - 19990204 RD - 20091119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9917577 <511. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9807191 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rothberg AD AU - Desmond Sonnenfeld E AU - Mogari D FA - Rothberg, A D FA - Desmond Sonnenfeld, E FA - Mogari, D IN - Rothberg, A D. Medscheme Managed Healthcare Division, Randburg, Gauteng. TI - A review of selection criteria used by medical scheme advisers to approve or deny procedures with a cosmetic component. CM - Comment in: S Afr Med J. 1999 Mar;89(3):212, 214; PMID: 10226660 CM - Comment in: S Afr Med J. 1999 Aug;89(8):814-5; PMID: 10488347 SO - South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 88(10):1334-7, 1998 Oct AS - SAMJ, S. Afr. med. j.. 88(10):1334-7, 1998 Oct NJ - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde PI - Journal available in: Print PI - Citation processed from: Print JC - 0404520 IO - S. Afr. Med. J. SB - Index Medicus CP - South Africa MH - Child MH - Data Interpretation, Statistical MH - Ear, External/su [Surgery] MH - Female MH - Health Care Costs/sn [Statistics & Numerical Data] MH - Health Care Costs/td [Trends] MH - Humans MH - *Insurance Claim Review MH - *Insurance Coverage MH - Lasers, Excimer MH - Mammaplasty/ec [Economics] MH - Photorefractive Keratectomy/ec [Economics] MH - *Reconstructive Surgical Procedures/ec [Economics] MH - Retrospective Studies AB - OBJECTIVE: To review and apply statistical tests to the selection criteria used by two medical advisers to approve or deny applications for three common cosmetic or reconstructive procedures within a large group of medical schemes. AB - DESIGN: A retrospective descriptive study which applied multiple regression analysis, frequency analysis, comparison of means and simple correlations to the data sets for three procedures. AB - SETTING: Administrative records from the clinical files of medical advisers and the administrator's claims database. AB - SUBJECTS: Data were reviewed for 1,143 members who, between January and December 1996, submitted applications for breast reduction, excimer laser refractive surgery, or otoplasty. AB - MAIN OUTCOME MEASURES: The primary outcome measure was the statistical relationship between medical advisers' selection criteria and final decision. In addition, the financial implications of these cosmetic/reconstructive procedures were assessed. AB - RESULTS: For the three procedures reviewed there was a statistically significant relationship between 5 of 13 preoperative criteria requested and the medical advisers' opinion. Excimer laser surgery was generally approved on the basis of the refractive error (myopia > -3.00; astigmatism > -1.5 dioptres); otoplasty was generally approved for children aged > or = 12 years; and breast reduction was usually covered for women with a sternal-nipple distance > 29.0 cm and with a cup size > or = DD. The other data submitted were similarly distributed between the approved and denied groups. AB - CONCLUSIONS: Review of medical advisers' decisions is important in an era of protocols, guidelines and 'standard operating procedures'. Selection criteria for approval of applications for medically necessary cosmetic/reconstructive surgery must be reviewed and revised to provide a reliable, reproducible and statistically valid process. IS - 0256-9574 PT - Journal Article ID - 9807191 [pubmed] PP - ppublish LG - English DP - 1998 Oct DC - 19990113 EZ - 1998/11/10 00:00 DA - 1998/11/10 00:01 DT - 1998/11/10 YR - 1998 ED - 19990113 RD - 20140912 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9807191 <512. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9681904 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gafni A AU - Charles C AU - Whelan T FA - Gafni, A FA - Charles, C FA - Whelan, T IN - Gafni, A. Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. TI - The physician-patient encounter: the physician as a perfect agent for the patient versus the informed treatment decision-making model. CM - Comment in: Soc Sci Med. 1998 Aug;47(3):355-6; PMID: 9681905 SO - Social Science & Medicine. 47(3):347-54, 1998 Aug AS - Soc Sci Med. 47(3):347-54, 1998 Aug NJ - Social science & medicine (1982) PI - Journal available in: Print PI - Citation processed from: Print JC - ut9, 8303205 IO - Soc Sci Med OI - Source: KIE. 127957 OI - Source: NRCBL. VF 8.1 SB - Bioethics Journals SB - Index Medicus CP - England MH - Breast Neoplasms/dt [Drug Therapy] MH - Chemotherapy, Adjuvant MH - *Decision Making MH - Decision Support Techniques MH - Female MH - Humans MH - *Informed Consent MH - *Patient Advocacy MH - Patient Care Planning MH - *Patient Participation MH - Physician-Patient Relations KW - Analytical Approach; Professional Patient Relationship AB - Assuming a goal of arriving at a treatment decision which is based on the physician's knowledge and the patient's preferences, we discuss the feasibility of implementing two treatment decision-making models: (1) the physician as a perfect agent for the patient, and (2) the informed treatment decision-making models. Both models fall under the rubric of agency models, however, the requirements from the physician and the patient are different. An important distinction between the two models is that in the former the patient delegates authority to her doctor to make medical decisions and thus the challenge is to encourage the physician to find out the patient's preferences. In the latter, the patient retains the authority to make medical decisions and the physician role is that of information transfer. The challenge here is to encourage the physician to transfer the knowledge in a clear and nonbiased way. We argue that the choice of model depends among other things on the ease of implementation (e.g., is it simpler to transfer patient's preferences to doctors or to transfer technical knowledge to patients?). Also the choice of treatment decision-making model is likely to have an impact on the type of incentives or regulations (i.e., contracts) needed to promote the chosen model. We show that in theory both models result in the same outcome. We argue that the approach of transferring information to the patient is easier (but not easy) and, hence, more feasible than transferring each patient's preferences to the physician in each medical encounter. We also argue that because better "technology" exists to transfer medical information to patients and time costs are involved in both tasks (i.e. transferring preferences or information), it is more feasible to design contracts to motivate physicians to transfer information to patients than to design contracts to motivate physicians to find out their patients' utility functions. We illustrate our arguments using a clinical example of the choice of adjuvant chemotherapy versus no adjuvant chemotherapy for women with early stage breast cancer. We also discuss issues relating to the current realities of clinical practice and their potential implications for the way that economists model physician-patient clinical encounters. NT - 49 refs. NT - KIE Bib: professional patient relationship IS - 0277-9536 IL - 0277-9536 DI - S0277953698000914 PT - Journal Article ID - 9681904 [pubmed] ID - S0277953698000914 [pii] PP - ppublish LG - English DP - 1998 Aug DC - 19981015 EZ - 1998/07/29 00:00 DA - 1998/07/29 00:01 DT - 1998/07/29 YR - 1998 ED - 19981015 RD - 20060807 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9681904 <513. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9679264 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Steginga S AU - Occhipinti S AU - Wilson K AU - Dunn J FA - Steginga, S FA - Occhipinti, S FA - Wilson, K FA - Dunn, J IN - Steginga, S. Australian Catholic University in Brisbane, Queensland, Australia. TI - Domains of distress: the experience of breast cancer in Australia. SO - Oncology Nursing Forum. 25(6):1063-70, 1998 Jul AS - Oncol Nurs Forum. 25(6):1063-70, 1998 Jul NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Print JC - 7809033, pad IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Body Image MH - *Breast Neoplasms/nu [Nursing] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Fear MH - Female MH - Focus Groups MH - Humans MH - Libido MH - Mastectomy/px [Psychology] MH - Middle Aged MH - Neoplasm Recurrence, Local/px [Psychology] MH - Oncology Nursing MH - Postoperative Complications/px [Psychology] MH - Psychometrics MH - Social Support MH - Stress, Psychological MH - *Surveys and Questionnaires AB - PURPOSE/OBJECTIVES: To describe difficulties experienced by women after treatment for primary breast cancer. AB - DESIGN: Descriptive and exploratory. AB - SETTING: Queensland, Australia. AB - SAMPLE: 245 women (70% response rate) less than 16 weeks postsurgery for breast cancer completed a survey. The mean age for this sample was 55 years; 71% had undergone mastectomy, and 29% had undergone conservative breast surgery. AB - METHODS: Focus groups were used to generate items for the survey, "Experience of Breast Cancer Questionnaire" (EBCQ). The EBCQ and the psychological subscale of the Rotterdam Symptom Checklist (RSCL) were administered by mail to the sample. AB - MAIN RESEARCH VARIABLES: Psychological distress, fear of recurrence, decisional uncertainty, informational support, self-image and social relationships, sexual morbidity, and physical effects of treatments. AB - FINDINGS: Factor analysis of the EBCQ identified five factors, accounting for 60% of the variance. These included psychological effects, treatment concerns, physical effects, self-image, and chemotherapy effects. Four of the five subscales had reliability coefficients of greater than 0.80. Psychological effects included cognitive and emotional effects. Treatment concerns included decisional uncertainty and poorly perceived informational support. Physical effects reflected the symptom pattern of axillary dissection. Self-image included breast loss and social isolation. AB - CONCLUSIONS: Nurses who assist women in adjusting to breast cancer should consider the effect of fear of recurrence and perceptions of body image on the recovery process. Because participation in treatment decisions may increase the demands on women at diagnosis, informational support appropriate to each woman's needs is essential. How self-esteem can affect self-image and social relationships after breast cancer requires further investigation. AB - IMPLICATIONS FOR NURSING PRACTICE: Understanding the experience of illness from the perspective of the patient assists nurses in validating their nursing practice and provides clinically relevant information to guide intervention. In particular, supportive psychological care should target both emotional and cognitive responses to breast cancer. Informational support is integral to a patient's satisfaction with treatment decisions and is likely to predict adjustment. When assisting women to adjust to self-image changes, nurses may need to target women's perceptions about their body image. IS - 0190-535X IL - 0190-535X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9679264 [pubmed] PP - ppublish LG - English DP - 1998 Jul DC - 19980925 EZ - 1998/07/29 00:00 DA - 1998/07/29 00:01 DT - 1998/07/29 YR - 1998 ED - 19980925 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9679264 <514. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9679991 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Unic I AU - Stalmeier PF AU - Verhoef LC AU - van Daal WA FA - Unic, I FA - Stalmeier, P F FA - Verhoef, L C FA - van Daal, W A IN - Unic, I. Institute for Radiotherapy, Radboud University Hospital, Nijmegen, The Netherlands. TI - Assessment of the time-tradeoff values for prophylactic mastectomy of women with a suspected genetic predisposition to breast cancer. SO - Medical Decision Making. 18(3):268-77, 1998 Jul-Sep AS - Med Decis Making. 18(3):268-77, 1998 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Genes, BRCA1/ge [Genetics] MH - Genetic Predisposition to Disease MH - Heterozygote MH - Humans MH - Life Expectancy MH - Mass Screening MH - Mastectomy/ae [Adverse Effects] MH - *Mastectomy MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - *Primary Prevention/mt [Methods] MH - Reproducibility of Results MH - Surveys and Questionnaires/st [Standards] MH - Time Factors AB - BACKGROUND: Female carriers of the breast-cancer-susceptibility genes BRCA1 and BRCA2 are at high risk for breast cancer (85%). They face the choice between prophylactic mastectomy (PM) and breast cancer screening. For this treatment choice, a shared-decision-making program was developed. In this program, the time tradeoff (TTO) was used to assess preferences for PM. AB - PURPOSE: Assessment of the feasibility, constant proportional tradeoff, and reliability of using the TTO for this purpose. AB - METHODS: Fifty-four women suspected to carry the BRCA1/2 mutation were provided with comprehensive relevant information. Their preferences for PM were assessed on two occasions. Discrepancies between preferences indicated by the two tests were resolved by testing a third time. The preferences assessed on the last occasion were used for individual decision analyses. In order to test constant proportional tradeoff, the TTO consisted of four items with different numbers of life years. AB - RESULTS: Forty-two women (78%) completed the TTO twice and nine women (17%) performed the test a third time. Three women (5%) completed the TTO only once. The mean TTO value for PM at the last replication was 0.69 (SD=0.30). Violations of constant proportional tradeoff were significant: the largest tradeoffs were recorded for the shortest durations. Pearson's correlation coefficient between the TTO values for the two last sessions was 0.96. AB - CONCLUSION: Assessment of individual preferences by the TTO in this patient group is feasible and reliable. Therefore, the TTO can be used in clinical settings to elicit treatment preferences of women proven or suspected to have a genetic predisposition to breast cancer. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9801800303 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9679991 [pubmed] ID - 10.1177/0272989X9801800303 [doi] PP - ppublish LG - English DP - 1998 Jul-Sep DC - 19980921 EZ - 1998/07/29 00:00 DA - 1998/07/29 00:01 DT - 1998/07/29 YR - 1998 ED - 19980921 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9679991 <515. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9679991 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Unic I AU - Stalmeier PF AU - Verhoef LC AU - van Daal WA FA - Unic, I FA - Stalmeier, P F FA - Verhoef, L C FA - van Daal, W A IN - Unic, I. Institute for Radiotherapy, Radboud University Hospital, Nijmegen, The Netherlands. TI - Assessment of the time-tradeoff values for prophylactic mastectomy of women with a suspected genetic predisposition to breast cancer. SO - Medical Decision Making. 18(3):268-77, 1998 Jul-Sep AS - Med Decis Making. 18(3):268-77, 1998 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - *Decision Support Techniques MH - Feasibility Studies MH - Female MH - Genes, BRCA1/ge [Genetics] MH - Genetic Predisposition to Disease MH - Heterozygote MH - Humans MH - Life Expectancy MH - Mass Screening MH - Mastectomy/ae [Adverse Effects] MH - *Mastectomy MH - Middle Aged MH - Patient Education as Topic/mt [Methods] MH - *Patient Participation/mt [Methods] MH - Patient Participation/px [Psychology] MH - *Primary Prevention/mt [Methods] MH - Reproducibility of Results MH - Surveys and Questionnaires/st [Standards] MH - Time Factors AB - BACKGROUND: Female carriers of the breast-cancer-susceptibility genes BRCA1 and BRCA2 are at high risk for breast cancer (85%). They face the choice between prophylactic mastectomy (PM) and breast cancer screening. For this treatment choice, a shared-decision-making program was developed. In this program, the time tradeoff (TTO) was used to assess preferences for PM. AB - PURPOSE: Assessment of the feasibility, constant proportional tradeoff, and reliability of using the TTO for this purpose. AB - METHODS: Fifty-four women suspected to carry the BRCA1/2 mutation were provided with comprehensive relevant information. Their preferences for PM were assessed on two occasions. Discrepancies between preferences indicated by the two tests were resolved by testing a third time. The preferences assessed on the last occasion were used for individual decision analyses. In order to test constant proportional tradeoff, the TTO consisted of four items with different numbers of life years. AB - RESULTS: Forty-two women (78%) completed the TTO twice and nine women (17%) performed the test a third time. Three women (5%) completed the TTO only once. The mean TTO value for PM at the last replication was 0.69 (SD=0.30). Violations of constant proportional tradeoff were significant: the largest tradeoffs were recorded for the shortest durations. Pearson's correlation coefficient between the TTO values for the two last sessions was 0.96. AB - CONCLUSION: Assessment of individual preferences by the TTO in this patient group is feasible and reliable. Therefore, the TTO can be used in clinical settings to elicit treatment preferences of women proven or suspected to have a genetic predisposition to breast cancer. IS - 0272-989X IL - 0272-989X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9679991 [pubmed] PP - ppublish LG - English DP - 1998 Jul-Sep DC - 19980921 EZ - 1998/07/29 00:00 DA - 1998/07/29 00:01 DT - 1998/07/29 YR - 1998 ED - 19980921 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9679991 <516. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9638787 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hallowell N FA - Hallowell, N IN - Hallowell, N. Centre for Family Research, Faculty of Social and Political Sciences, University of Cambridge, UK. TI - 'You don't want to lose your ovaries because you think 'I might become a man". Women's perceptions of prophylactic surgery as a cancer risk management option. SO - Psycho-Oncology. 7(3):263-75, 1998 May-Jun AS - Psychooncology. 7(3):263-75, 1998 May-Jun NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Print JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - Adult MH - Body Image MH - Cost of Illness MH - Decision Making MH - *Elective Surgical Procedures/px [Psychology] MH - England MH - *Family Health MH - Female MH - Follow-Up Studies MH - Gender Identity MH - Humans MH - Interview, Psychological MH - *Mastectomy/px [Psychology] MH - Menopause/px [Psychology] MH - Middle Aged MH - Neoplasms/ge [Genetics] MH - Neoplasms/pc [Prevention & Control] MH - *Neoplasms/px [Psychology] MH - Neoplasms/su [Surgery] MH - Observation MH - *Ovariectomy/px [Psychology] MH - *Patient Acceptance of Health Care MH - Patient Education as Topic MH - Risk Assessment MH - Social Responsibility MH - Women's Health AB - This preliminary study provides insight into the meaning of prophylactic surgery as a risk management strategy for women who have a familial risk of breast or ovarian cancer. Data were collected during observations of genetic consultations and in semi-structured interviews with 41 women following their attendance at genetic counselling. The option of prophylactic surgery was raised in 29 consultations and discussed in 35 of the post-clinic interviews. Fifteen women said they would consider having an oophorectomy in the future and nine said they would consider having a mastectomy. The implications of undergoing oophorectomy and mastectomy were discussed during the post-clinic interviews. Prophylactic surgery was described by the counsellees as providing individuals with a means to (a) fulfil their obligations to other family members and (b) reduce risk and contain their fear of cancer. The costs of this form of risk management, were described as: (a) compromising social obligations; (b) upsetting the natural balance of the body; (c) not offering protection from cancer; (d) operative and post-operative complications; (e) the onset of menopause (f) the effects on body image, gender and personal identity and (g) potential effects on sexual relationships. IS - 1057-9249 IL - 1057-9249 DO - https://dx.doi.org/10.1002/(SICI)1099-1611(199805/06)7:3<263::AID-PON307>3.0.CO;2-Q PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9638787 [pubmed] ID - 10.1002/(SICI)1099-1611(199805/06)7:3<263::AID-PON307>3.0.CO;2-Q [doi] PP - ppublish LG - English DP - 1998 May-Jun DC - 19980916 EZ - 1998/06/25 00:00 DA - 1998/06/25 00:01 DT - 1998/06/25 YR - 1998 ED - 19980916 RD - 20141120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9638787 <517. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9638786 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Reaby LL FA - Reaby, L L IN - Reaby, L L. School of Nursing, Faculty of Applied Science, University of Canberra, ACT, Australia. TI - The quality and coping patterns of women's decision-making regarding breast cancer surgery. SO - Psycho-Oncology. 7(3):252-62, 1998 May-Jun AS - Psychooncology. 7(3):252-62, 1998 May-Jun NJ - Psycho-oncology PI - Journal available in: Print PI - Citation processed from: Print JC - cps, 9214524 IO - Psychooncology SB - Index Medicus CP - England MH - *Adaptation, Psychological MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms MH - *Decision Making MH - Female MH - Health Surveys MH - Humans MH - Interview, Psychological MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - New South Wales MH - *Patient Acceptance of Health Care MH - Patient Education as Topic MH - Patient Participation MH - Physician-Patient Relations MH - Retrospective Studies MH - Women's Health AB - This study addressed issues regarding the decision-making process used by women who had mastectomy as their surgical treatment for breast cancer. The seven criteria for quality decision-making and the conflict model proposed by Janis and Mann (1977) were used as the study's conceptual framework along with the notion by Simon (1957) of 'bounded rationality'. Four coping patterns emerged: vigilance (actively searches for information and advice), satisficing (being satisfied, chooses first solution that meets the desired objectives), complacency (accepts advice without questions or fully comprehending), and defensive avoidance (rationalises and avoids discussion and consideration of the problem). The participants primarily left the decision for surgical treatment of breast cancer to their surgeons using satisficing, complacency and defensive avoidance. When the option of lumpectomy was offered to some of the participants (34%), they rejected this treatment alternative using the coping patterns of satisfying and defensive avoidance. Those women who were not offered lumpectomy (66%) did not seek a rationale for not being given this alternative. The findings indicated that the women's decision-making process was halted in Stage 2 of the criteria for quality decision-making actively searched for and viewed a number of alternatives. The study's findings are discussed in relation to improving the quality of the decision-making process for women regarding their breast cancer surgical treatment. IS - 1057-9249 IL - 1057-9249 DO - https://dx.doi.org/10.1002/(SICI)1099-1611(199805/06)7:3<252::AID-PON309>3.0.CO;2-O PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9638786 [pubmed] ID - 10.1002/(SICI)1099-1611(199805/06)7:3<252::AID-PON309>3.0.CO;2-O [doi] PP - ppublish LG - English DP - 1998 May-Jun DC - 19980916 EZ - 1998/06/25 00:00 DA - 1998/06/25 00:01 DT - 1998/06/25 YR - 1998 ED - 19980916 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9638786 <518. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9704741 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Geller G AU - Bernhardt BA AU - Doksum T AU - Helzlsouer KJ AU - Wilcox P AU - Holtzman NA FA - Geller, G FA - Bernhardt, B A FA - Doksum, T FA - Helzlsouer, K J FA - Wilcox, P FA - Holtzman, N A IN - Geller, G. Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. ggeller@welchlink.welch.jhu.edu TI - Decision-making about breast cancer susceptibility testing: how similar are the attitudes of physicians, nurse practitioners, and at-risk women?. SO - Journal of Clinical Oncology. 16(8):2868-76, 1998 Aug AS - J Clin Oncol. 16(8):2868-76, 1998 Aug NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. OI - Source: KIE. 110557 OI - Source: NRCBL. VF 9.5.5 SB - Bioethics Journals SB - Index Medicus CP - United States MH - Adult MH - *Attitude of Health Personnel MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Decision Making MH - Disease Susceptibility MH - Female MH - *Genetic Testing/px [Psychology] MH - Humans MH - Informed Consent MH - Medicine MH - Middle Aged MH - Nurse Practitioners/px [Psychology] MH - Patient Education as Topic MH - Risk Factors MH - Specialization MH - Surveys and Questionnaires KW - Empirical Approach; Genetics and Reproduction AB - PURPOSE: To determine what consumers and providers would want to discuss about breast cancer susceptibility testing (BCST) and their preferred role in testing decisions. AB - METHODS: We surveyed 426 at-risk women, 143 nurse practitioners, and 296 physicians in five specialties in Maryland. AB - RESULTS: All groups believe it is important to discuss how the chance of breast cancer can be reduced and what the chances are of getting breast cancer if the test is positive. Both provider groups attributed more importance than consumers to discussing whether cancer can occur if the test is negative. Discussing the risk of depression and anxiety was more important to providers than consumers. Eighty-two percent of women would want their providers to make a recommendation about testing, but only 43% of nurse practitioners and 68% of physicians would do so. Eighteen percent of physicians underestimated the importance of informed consent for testing and 34% of discussing the risk of insurance discrimination. Fewer than 6% of women, if found to have a mutation, would be likely to undergo prophylactic mastectomy, whereas 12% of nurse practitioners and 34% of physicians would be likely to recommend such surgery. One third of respondents in all three groups supported testing a 13-year old daughter of a mutation-carrier. AB - CONCLUSION: Physicians should place greater value on informed consent and discussing practical aspects of testing, and physicians and nurse practitioners should pay more attention to the limitations of testing children, insurance discrimination, and consumers' desire for provider recommendations. In light of the limited discordance between nurse practitioners and consumers, nurse practitioners can play an increasing role in education and counseling about BCST. NT - 38 refs. NT - KIE Bib: genetic screening IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.1998.16.8.2868 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 9704741 [pubmed] ID - 10.1200/JCO.1998.16.8.2868 [doi] PP - ppublish GI - No: R01 NR04062-01 Organization: (NR) *NINR NIH HHS* Country: United States LG - English DP - 1998 Aug DC - 19980831 EZ - 1998/08/15 00:00 DA - 1998/08/15 00:01 DT - 1998/08/15 YR - 1998 ED - 19980831 RD - 20170210 UP - 20170213 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9704741 <519. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9719120 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Panzarella T AU - Meakin JW FA - Panzarella, T FA - Meakin, J W IN - Panzarella, T. Biostatistics Department, Princess Margaret Hospital, Toronto, Ontario, Canada. TI - Analysis of cause-specific failure endpoints using simple proportions: an example from a randomized controlled clinical trial in early breast cancer. SO - International Journal of Radiation Oncology, Biology, Physics. 41(5):1093-7, 1998 Jul 15 AS - Int J Radiat Oncol Biol Phys. 41(5):1093-7, 1998 Jul 15 NJ - International journal of radiation oncology, biology, physics PI - Journal available in: Print PI - Citation processed from: Print JC - g97, 7603616 IO - Int. J. Radiat. Oncol. Biol. Phys. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Combined Modality Therapy MH - *Data Interpretation, Statistical MH - Female MH - Humans MH - Middle Aged MH - Prednisone/tu [Therapeutic Use] MH - Radiotherapy Dosage MH - Retrospective Studies MH - Time Factors MH - Treatment Failure AB - PURPOSE: To describe a statistically valid method for analyzing cause-specific failure data based on simple proportions, that is easy to understand and apply, and outline under what conditions its implementation is well-suited. AB - METHODS AND MATERIALS: In the comparison of treatment groups, time to first failure (in any site) was analyzed first, followed by an analysis of the pattern of first failure, preferably at the latest complete follow-up time common to each group. AB - RESULTS: A retrospective analysis of time to contralateral breast cancer in 777 early breast cancer patients was undertaken. Patients previously treated by mastectomy plus radiation therapy to the chest wall and regional nodal areas were randomized to receive further radiation and prednisone (R+P), radiation alone (R), or no further treatment (NT). Those randomized to R+P had a statistically significantly delayed time to first failure compared to the group randomized to NT (p = 0.0008). Patients randomized to R also experienced a delayed time to first failure compared to NT, but the difference was not statistically significant (p = 0.14). At 14 years from the date of surgery (the latest common complete follow-up time) the distribution of first failures was statistically significantly different between R+P and NT (p = 0.005), but not between R and NT (p = 0.09). The contralateral breast cancer first failure rate at 14 years from surgery was 7.2% for NT, 4.6% for R, and 3.7% for R+P. The corresponding Kaplan-Meier estimates were 13.2%, 8.2%, and 5.4%, respectively. AB - CONCLUSION: Analyzing cause-specific failure data using methods developed for survival endpoints is problematic. We encourage the use of the two-step analysis strategy described when, as in the example presented, competing causes of failure are not likely to be statistically independent, and when a treatment comparison at a single time-point is clinically relevant and feasible; that is, all patients have complete follow-up to this point. RN - 0 (Antineoplastic Agents, Hormonal) RN - VB0R961HZT (Prednisone) IS - 0360-3016 IL - 0360-3016 DI - S0360-3016(98)00146-1 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial ID - 9719120 [pubmed] ID - S0360-3016(98)00146-1 [pii] PP - ppublish LG - English DP - 1998 Jul 15 DC - 19980831 EZ - 1998/08/27 00:00 DA - 1998/08/27 00:01 DT - 1998/08/27 YR - 1998 ED - 19980831 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9719120 <520. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9704741 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Geller G AU - Bernhardt BA AU - Doksum T AU - Helzlsouer KJ AU - Wilcox P AU - Holtzman NA FA - Geller, G FA - Bernhardt, B A FA - Doksum, T FA - Helzlsouer, K J FA - Wilcox, P FA - Holtzman, N A IN - Geller, G. Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA. ggeller@welchlink.welch.jhu.edu TI - Decision-making about breast cancer susceptibility testing: how similar are the attitudes of physicians, nurse practitioners, and at-risk women?. SO - Journal of Clinical Oncology. 16(8):2868-76, 1998 Aug AS - J Clin Oncol. 16(8):2868-76, 1998 Aug NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. OI - Source: KIE. 110557 OI - Source: NRCBL. VF 9.5.5 SB - Bioethics Journals SB - Index Medicus CP - United States MH - Adult MH - *Attitude of Health Personnel MH - *Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Decision Making MH - Disease Susceptibility MH - Female MH - *Genetic Testing/px [Psychology] MH - Humans MH - Informed Consent MH - Medicine MH - Middle Aged MH - Nurse Practitioners/px [Psychology] MH - Patient Education as Topic MH - Risk Factors MH - Specialization MH - Surveys and Questionnaires KW - Empirical Approach; Genetics and Reproduction AB - PURPOSE: To determine what consumers and providers would want to discuss about breast cancer susceptibility testing (BCST) and their preferred role in testing decisions. AB - METHODS: We surveyed 426 at-risk women, 143 nurse practitioners, and 296 physicians in five specialties in Maryland. AB - RESULTS: All groups believe it is important to discuss how the chance of breast cancer can be reduced and what the chances are of getting breast cancer if the test is positive. Both provider groups attributed more importance than consumers to discussing whether cancer can occur if the test is negative. Discussing the risk of depression and anxiety was more important to providers than consumers. Eighty-two percent of women would want their providers to make a recommendation about testing, but only 43% of nurse practitioners and 68% of physicians would do so. Eighteen percent of physicians underestimated the importance of informed consent for testing and 34% of discussing the risk of insurance discrimination. Fewer than 6% of women, if found to have a mutation, would be likely to undergo prophylactic mastectomy, whereas 12% of nurse practitioners and 34% of physicians would be likely to recommend such surgery. One third of respondents in all three groups supported testing a 13-year old daughter of a mutation-carrier. AB - CONCLUSION: Physicians should place greater value on informed consent and discussing practical aspects of testing, and physicians and nurse practitioners should pay more attention to the limitations of testing children, insurance discrimination, and consumers' desire for provider recommendations. In light of the limited discordance between nurse practitioners and consumers, nurse practitioners can play an increasing role in education and counseling about BCST. NT - 38 refs. NT - KIE Bib: genetic screening IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/jco.1998.16.8.2868 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 9704741 [pubmed] ID - 10.1200/jco.1998.16.8.2868 [doi] PP - ppublish GI - No: R01 NR04062-01 Organization: (NR) *NINR NIH HHS* Country: United States LG - English DP - 1998 Aug DC - 19980831 EZ - 1998/08/15 00:00 DA - 1998/08/15 00:01 DT - 1998/08/15 YR - 1998 ED - 19980831 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9704741 <521. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9656665 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gramlich EP AU - Waitzfelder BE FA - Gramlich, E P FA - Waitzfelder, B E IN - Gramlich, E P. Hawaii Quality and Cost Consortium, Pacific Health Research Institute, Honolulu, USA. gramlich@jabsom.biomed.hawaii.edu TI - Interactive video assists in clinical decision making. SO - Methods of Information in Medicine. 37(2):201-5, 1998 Jun AS - Methods Inf Med. 37(2):201-5, 1998 Jun NJ - Methods of information in medicine PI - Journal available in: Print PI - Citation processed from: Print JC - mvi, 0210453 IO - Methods Inf Med SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - Attitude of Health Personnel MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Decision Making, Organizational MH - Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Hawaii MH - Humans MH - Mastectomy MH - Middle Aged MH - Minimally Invasive Surgical Procedures MH - Patient Education as Topic MH - *Patient Participation MH - Patient Satisfaction MH - Physician-Patient Relations MH - Program Evaluation MH - Treatment Outcome MH - *Videotape Recording AB - The Hawaii Quality and Cost Consortium began a project in 1993 to implement and evaluate interactive videodisk programs to assist in clinical decision-making for breast cancer. Communication problems between physicians and patients, limitations of available outcomes data and varying preferences of individual patients can result in treatment outcomes that are less than satisfactory. Shared Decision-making Programs (SDPs) were developed by the Foundation for Informed Medical Decision Making (FIMDM) in Hanover, New Hampshire, to assist in the treatment decision-making process. Utilizing interactive videodisks, the programs provide patients with clear, unbiased information about available treatment options. With this information, patients can become more active participants in making treatment decisions. The SDPs for breast cancer were implemented at two sites in Hawaii. Evaluation data from 103 patients overwhelmingly indicate that patients find the programs clear, balanced and very good or excellent in terms of the amount of information presented and overall rating. IS - 0026-1270 IL - 0026-1270 DI - 98020201 PT - Journal Article ID - 98020201 [pii] PP - ppublish LG - English DP - 1998 Jun DC - 19980728 EZ - 1998/07/10 00:00 DA - 1998/07/10 00:01 DT - 1998/07/10 YR - 1998 ED - 19980728 RD - 20170410 UP - 20170412 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9656665 <522. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9656665 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gramlich EP AU - Waitzfelder BE FA - Gramlich, E P FA - Waitzfelder, B E IN - Gramlich, E P. Hawaii Quality and Cost Consortium, Pacific Health Research Institute, Honolulu, USA. gramlich@jabsom.biomed.hawaii.edu TI - Interactive video assists in clinical decision making. SO - Methods of Information in Medicine. 37(2):201-5, 1998 Jun AS - Methods Inf Med. 37(2):201-5, 1998 Jun NJ - Methods of information in medicine PI - Journal available in: Print PI - Citation processed from: Print JC - mvi, 0210453 IO - Methods Inf Med SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Aged, 80 and over MH - Attitude of Health Personnel MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Decision Making, Organizational MH - Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Hawaii MH - Humans MH - Mastectomy MH - Middle Aged MH - Minimally Invasive Surgical Procedures MH - Patient Education as Topic MH - *Patient Participation MH - Patient Satisfaction MH - Physician-Patient Relations MH - Program Evaluation MH - Treatment Outcome MH - *Videotape Recording AB - The Hawaii Quality and Cost Consortium began a project in 1993 to implement and evaluate interactive videodisk programs to assist in clinical decision-making for breast cancer. Communication problems between physicians and patients, limitations of available outcomes data and varying preferences of individual patients can result in treatment outcomes that are less than satisfactory. Shared Decision-making Programs (SDPs) were developed by the Foundation for Informed Medical Decision Making (FIMDM) in Hanover, New Hampshire, to assist in the treatment decision-making process. Utilizing interactive videodisks, the programs provide patients with clear, unbiased information about available treatment options. With this information, patients can become more active participants in making treatment decisions. The SDPs for breast cancer were implemented at two sites in Hawaii. Evaluation data from 103 patients overwhelmingly indicate that patients find the programs clear, balanced and very good or excellent in terms of the amount of information presented and overall rating. IS - 0026-1270 IL - 0026-1270 DI - 98020201 PT - Journal Article ID - 9656665 [pubmed] ID - 98020201 [pii] PP - ppublish LG - English DP - 1998 Jun DC - 19980728 EZ - 1998/07/10 00:00 DA - 1998/07/10 00:01 DT - 1998/07/10 YR - 1998 ED - 19980728 RD - 20141120 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9656665 <523. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9527266 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Velanovich V FA - Velanovich, V IN - Velanovich, V. Department of Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689, USA. TI - Axillary lymph node dissection for breast cancer: a decision analysis of T1 lesions. SO - Annals of Surgical Oncology. 5(2):131-9, 1998 Mar AS - Ann Surg Oncol. 5(2):131-9, 1998 Mar NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus SB - AIDS/HIV Journals CP - United States MH - Axilla MH - Biomarkers, Tumor/an [Analysis] MH - Breast Neoplasms/dt [Drug Therapy] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/rt [Radiotherapy] MH - *Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant MH - Decision Making MH - *Decision Support Techniques MH - Female MH - Humans MH - Life Expectancy MH - Lymph Node Excision/ae [Adverse Effects] MH - *Lymph Node Excision MH - Lymph Nodes/pa [Pathology] MH - Lymphatic Metastasis/pa [Pathology] MH - Mastectomy, Modified Radical MH - Mastectomy, Segmental MH - Mastectomy, Simple MH - Neoplasm Staging MH - Probability MH - Quality of Life MH - Quality-Adjusted Life Years MH - Radiotherapy, Adjuvant MH - Risk Factors MH - Sensitivity and Specificity MH - Treatment Outcome AB - BACKGROUND: The value of routine axillary dissection for patients with breast cancer is still being debated. The argument centers around whether the information gained by knowing the lymph node status, which aids in making the decision about adjuvant chemotherapy, justifies the morbidity. This study quantitatively analyzes the potential outcomes of routine, selective, and no axillary dissection. AB - METHODS: A decision analysis was performed of the strategies of lumpectomy and radiation versus simple mastectomy followed by no dissection, selective dissection, or routine dissection. Factors included biologic markers to identify high-risk lesions, the morbidity of axillary dissection, the effects of adjuvant chemotherapy on lymph node-negative and lymph node-positive disease, and the life expectancy of patients with high-risk and low-risk node-negative and node-positive lesions. Sensitivity analysis was done to determine threshold levels of these factors in choosing an option. AB - RESULTS: We discovered an advantage in quality-adjusted life expectancy (QALE) for no axillary dissection until the probability of positive lymph nodes reaches >15%; after that, selective node dissection is superior. Selective dissection is superior for lower morbidity rates of axillary dissection. Routine dissection is never a superior strategy. The difference among these strategies is small, however, with no one strategy providing a QALE greater than 1 year longer than any other. AB - CONCLUSIONS: Axillary dissection can be avoided in patients with high-risk lesions who would be candidates for adjuvant chemotherapy regardless of lymph node status, and possibly in patients with low-risk T1a lesions, but it should be recommended for low-risk T1b and T1c lesions for which lymph node status may determine the need for adjuvant chemotherapy. RN - 0 (Biomarkers, Tumor) IS - 1068-9265 IL - 1068-9265 PT - Journal Article ID - 9527266 [pubmed] PP - ppublish LG - English DP - 1998 Mar DC - 19980611 EZ - 1998/04/04 00:00 DA - 1998/04/04 00:01 DT - 1998/04/04 YR - 1998 ED - 19980611 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9527266 <524. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9517288 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Tabory E AU - Sered S FA - Tabory, E FA - Sered, S IN - Tabory, E. Dept. of Sociology and Anthropology, Bar-Ilan University, Ramat Gan. TI - [Accessibility of information and informed consent: experiences of breast cancer patients]. [Hebrew] SO - Harefuah. 134(2):88-92, 160, 1998 Jan 15 AS - Harefuah. 134(2):88-92, 160, 1998 Jan 15 NJ - Harefuah PI - Journal available in: Print PI - Citation processed from: Print JC - 0034351, fzf IO - Harefuah SB - Index Medicus CP - Israel MH - Adult MH - Aged MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - *Informed Consent MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - *Patient Education as Topic MH - Socioeconomic Factors AB - We studied the social and cultural frameworks that impact on breast cancer patients in the medical system. The subjects were 98 Jewish women who had undergone mastectomy or lumpectomy for cancer 6 months to 3 years prior to the interview. They emanated from a variety of socioeconomic and ethnic backgrounds, and reflected the age range of women with breast cancer in the general Jewish population of Israel. Patients were asked about each stage of the medical process they had experienced: diagnosis, surgery, oncological care, and follow-up care. The interview revealed a general perception of having received insufficient information regarding their medical condition and treatment. The problem tended to be most severe during the diagnostic stage, when women had not yet been officially included as patients within the system. The problem was relatively severe during follow-up care, when they often did not have an address for their questions. Few women received a schedule of follow-up care that allowed them to carry on with the many necessary tests in an orderly and comprehensive manner. Most important, systematic absence of informed consent also characterized the decision-making process regarding surgery and oncological treatment. Few women felt they had been informed about treatment options, side-effects, or long-term implications of the treatment offered. We found no indication of inequitable medical treatment that would suggest a manifest pattern of discrimination, but we did find some social variables related to a feeling of insufficient personal care and information. In particular, older women said they received less attention, support, and information from the medical staff relative to the younger women. IS - 0017-7768 IL - 0017-7768 PT - English Abstract PT - Journal Article ID - 9517288 [pubmed] PP - ppublish LG - Hebrew DP - 1998 Jan 15 DC - 19980508 EZ - 1998/03/28 00:00 DA - 1998/03/28 00:01 DT - 1998/03/28 YR - 1998 ED - 19980508 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9517288 <525. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9508180 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Grann VR AU - Panageas KS AU - Whang W AU - Antman KH AU - Neugut AI FA - Grann, V R FA - Panageas, K S FA - Whang, W FA - Antman, K H FA - Neugut, A I IN - Grann, V R. Herbert Irving Comprehensive Cancer Center of Columbia University, School of Public Health, New York, NY 10032, USA. VRG2@columbia.edu TI - Decision analysis of prophylactic mastectomy and oophorectomy in BRCA1-positive or BRCA2-positive patients. CM - Comment in: J Clin Oncol. 1998 Jul;16(7):2573-5; PMID: 9667284 SO - Journal of Clinical Oncology. 16(3):979-85, 1998 Mar AS - J Clin Oncol. 16(3):979-85, 1998 Mar NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - BRCA2 Protein MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Cost-Benefit Analysis MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - Humans MH - Markov Chains MH - Mastectomy/ec [Economics] MH - *Mastectomy MH - Middle Aged MH - Mutation MH - *Neoplasm Proteins/an [Analysis] MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/mo [Mortality] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy/ec [Economics] MH - *Ovariectomy MH - Probability MH - Quality of Life MH - Quality-Adjusted Life Years MH - Risk Factors MH - Survival Analysis MH - *Transcription Factors/an [Analysis] AB - PURPOSE: Young Ashkenazi Jewish women or those from high-risk families who test positive for BRCA1 or BRCA2 mutant genes have a significant risk of developing breast or ovarian cancer by the age of 70 years. Many question whether they should have prophylactic surgical procedures, ie, bilateral mastectomy and/or oophorectomy. AB - METHODS: A Markov model was developed to determine the survival, quality of life, and cost-effectiveness of prophylactic surgical procedures. The probabilities of developing breast and ovarian cancer were based on literature review among women with the BRCA1 or BRCA2 gene and mortality rates were determined from Surveillance, Epidemiology, and End Results (SEER) data for 1973 to 1992. The costs for hospital and ambulatory care were estimated from Health Care Financing Administration (HCFA) payments in 1995, supplemented by managed care and fee-for-service data. Utility measures for quality-adjusted life-years (QALYs) were explicitly determined using the time-trade off method. Estimated risks for breast and ovarian cancer after prophylactic surgeries were obtained from the literature. AB - RESULTS: For a 30-year-old woman, according to her cancer risks, prophylactic oophorectomy improved survival by 0.4 to 2.6 years; mastectomy, by 2.8 to 3.4 years; and mastectomy and oophorectomy, by 3.3 to 6.0 years over surveillance. The QALYs saved were 0.5 for oophorectomy and 1.9 for the combined procedures in the high-risk model. Prophylactic surgeries were cost-effective compared with surveillance for years of life saved, but not for QALYs. AB - CONCLUSION: Among women who test positive for a BRCA1 or BRCA2 gene mutation, prophylactic surgery at a young age substantially improves survival, but unless genetic risk of cancer is high, provides no benefit for quality of life. Prophylactic surgery is cost-effective for years of life saved compared with other medical interventions that are deemed cost-effective. RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.1998.16.3.979 PT - Journal Article ID - 9508180 [pubmed] ID - 10.1200/JCO.1998.16.3.979 [doi] PP - ppublish LG - English DP - 1998 Mar DC - 19980324 EZ - 1998/03/21 00:00 DA - 1998/03/21 00:01 DT - 1998/03/21 YR - 1998 ED - 19980324 RD - 20170210 UP - 20170213 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9508180 <526. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9508180 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Grann VR AU - Panageas KS AU - Whang W AU - Antman KH AU - Neugut AI FA - Grann, V R FA - Panageas, K S FA - Whang, W FA - Antman, K H FA - Neugut, A I IN - Grann, V R. Herbert Irving Comprehensive Cancer Center of Columbia University, School of Public Health, New York, NY 10032, USA. VRG2@columbia.edu TI - Decision analysis of prophylactic mastectomy and oophorectomy in BRCA1-positive or BRCA2-positive patients. CM - Comment in: J Clin Oncol. 1998 Jul;16(7):2573-5; PMID: 9667284 SO - Journal of Clinical Oncology. 16(3):979-85, 1998 Mar AS - J Clin Oncol. 16(3):979-85, 1998 Mar NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - BRCA2 Protein MH - Breast Neoplasms/ge [Genetics] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Cost-Benefit Analysis MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - Humans MH - Markov Chains MH - Mastectomy/ec [Economics] MH - *Mastectomy MH - Middle Aged MH - Mutation MH - *Neoplasm Proteins/an [Analysis] MH - Ovarian Neoplasms/ge [Genetics] MH - Ovarian Neoplasms/mo [Mortality] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy/ec [Economics] MH - *Ovariectomy MH - Probability MH - Quality of Life MH - Quality-Adjusted Life Years MH - Risk Factors MH - Survival Analysis MH - *Transcription Factors/an [Analysis] AB - PURPOSE: Young Ashkenazi Jewish women or those from high-risk families who test positive for BRCA1 or BRCA2 mutant genes have a significant risk of developing breast or ovarian cancer by the age of 70 years. Many question whether they should have prophylactic surgical procedures, ie, bilateral mastectomy and/or oophorectomy. AB - METHODS: A Markov model was developed to determine the survival, quality of life, and cost-effectiveness of prophylactic surgical procedures. The probabilities of developing breast and ovarian cancer were based on literature review among women with the BRCA1 or BRCA2 gene and mortality rates were determined from Surveillance, Epidemiology, and End Results (SEER) data for 1973 to 1992. The costs for hospital and ambulatory care were estimated from Health Care Financing Administration (HCFA) payments in 1995, supplemented by managed care and fee-for-service data. Utility measures for quality-adjusted life-years (QALYs) were explicitly determined using the time-trade off method. Estimated risks for breast and ovarian cancer after prophylactic surgeries were obtained from the literature. AB - RESULTS: For a 30-year-old woman, according to her cancer risks, prophylactic oophorectomy improved survival by 0.4 to 2.6 years; mastectomy, by 2.8 to 3.4 years; and mastectomy and oophorectomy, by 3.3 to 6.0 years over surveillance. The QALYs saved were 0.5 for oophorectomy and 1.9 for the combined procedures in the high-risk model. Prophylactic surgeries were cost-effective compared with surveillance for years of life saved, but not for QALYs. AB - CONCLUSION: Among women who test positive for a BRCA1 or BRCA2 gene mutation, prophylactic surgery at a young age substantially improves survival, but unless genetic risk of cancer is high, provides no benefit for quality of life. Prophylactic surgery is cost-effective for years of life saved compared with other medical interventions that are deemed cost-effective. RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/jco.1998.16.3.979 PT - Journal Article ID - 9508180 [pubmed] ID - 10.1200/jco.1998.16.3.979 [doi] PP - ppublish LG - English DP - 1998 Mar DC - 19980324 EZ - 1998/03/21 00:00 DA - 1998/03/21 00:01 DT - 1998/03/21 YR - 1998 ED - 19980324 RD - 20161102 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9508180 <527. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9367022 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Smitt MC AU - Heltzel M FA - Smitt, M C FA - Heltzel, M IN - Smitt, M C. Department of Radiation Oncology, Stanford University Medical Center, California, USA. TI - Women's use of resources in decision-making for early-stage breast cancer: results of a community-based survey. SO - Annals of Surgical Oncology. 4(7):564-9, 1997 Oct-Nov AS - Ann Surg Oncol. 4(7):564-9, 1997 Oct-Nov NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Adult MH - Aged MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Female MH - Humans MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Staging MH - Patient Acceptance of Health Care MH - *Referral and Consultation MH - Surveys and Questionnaires AB - BACKGROUND: The majority of women with stage I/II breast cancer may choose between mastectomy and breast-conserving therapy (BCT). A survey was designed to examine the resources women used in making this decision. AB - METHODS: From 1990 to 1994, 261 patients were diagnosed with or treated for stage I/II breast cancer at Washington Hospital (Fremont, CA). One-hundred seventy-six surviving patients received a questionnaire asking them to anonymously rank various medical and nonmedical persons, audio and visual materials, and decision criteria on a 5-point scale with regard to their influence on that individual's choice to undergo BCT or mastectomy. The BCT and mastectomy groups were similar demographically; approximately 50% were college-educated. Statistical significance of the difference in means between groups was assessed with the t test. The response rate to the survey was 65%. AB - RESULTS: The average survey ranking was > 1.0 for the following: surgeon (4.5), primary care physician (2.8), spouse (2.4), radiation oncologist (1.7), medical oncologist (1.5), American Cancer Society brochure (1.4), and children (1.2). The ranking of children (p = 0.08), friends (p = 0.08), parents (p = 0.09), and spouse (p = 0.13) was higher in the mastectomy group; the ranking of the radiation oncologist (p = 0.001) and ACS brochure (p = 0.03) was higher in the BCT group. The majority of patients consulted only with the surgeon (96%), primary care physician (64%), and spouse (55% overall, 75% among married patients) before making a treatment choice. Decision criteria were ranked as follows: chance for cure (4.5), physician recommendation (3.7), potential side effects (1.7), cosmetic appearance (1.3), sexual attractiveness (1.1), treatment convenience (1.0), and desire to avoid mastectomy (1.5). Desire to avoid mastectomy was higher in the BCT group (p < 0.0001); ranking of chance for cure was higher in the mastectomy group (p = 0.12). Overall satisfaction was higher in the BCT group; 87% of these patients were "very satisfied" with their decision versus 68% for the mastectomy group (p = 0.005). Review of the admitting records for 125 patients treated with mastectomy indicated that 46% had clear medical or personal contra-indications to BCT, but that the remainder might have benefitted from specialty consultation. AB - CONCLUSIONS: The surgeon's recommendation and the patient's perception of chance for cure were the most influential factors affecting treatment decision. There was a limited use of specialty consultation or written and audiovisual materials in this educated patient population. The survey results suggest potential areas of intervention to improve rates of BCT, namely use of up-front multidisciplinary evaluation, further education of primary care physicians, and greater attention to concerns of family members. IS - 1068-9265 IL - 1068-9265 PT - Journal Article ID - 9367022 [pubmed] PP - ppublish LG - English DP - 1997 Oct-Nov DC - 19980206 EZ - 1997/11/21 00:00 DA - 1997/11/21 00:01 DT - 1997/11/21 YR - 1997 ED - 19980206 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9367022 <528. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9289640 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Meijer WJ AU - van Lindert AC FA - Meijer, W J FA - van Lindert, A C TI - Risk of breast cancer in carriers of BRCA gene mutations. CM - Comment on: N Engl J Med. 1997 May 15;336(20):1465-71; PMID: 9148160 SO - New England Journal of Medicine. 337(11):788; author reply 789, 1997 Sep 11 AS - N Engl J Med. 337(11):788; author reply 789, 1997 Sep 11 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Support Techniques MH - Female MH - Humans MH - Life Expectancy MH - Mastectomy MH - Models, Theoretical MH - *Ovariectomy MH - Risk IS - 0028-4793 IL - 0028-4793 PT - Comment PT - Letter ID - 9289640 [pubmed] PP - ppublish LG - English DP - 1997 Sep 11 DC - 19970911 EZ - 1997/09/11 00:00 DA - 1997/09/11 00:01 DT - 1997/09/11 YR - 1997 ED - 19970911 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9289640 <529. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9289638 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Birkmeyer JD AU - Welch HG FA - Birkmeyer, J D FA - Welch, H G TI - Risk of breast cancer in carriers of BRCA gene mutations. CM - Comment on: N Engl J Med. 1997 May 15;336(20):1465-71; PMID: 9148160 SO - New England Journal of Medicine. 337(11):787-8; author reply 789, 1997 Sep 11 AS - N Engl J Med. 337(11):787-8; author reply 789, 1997 Sep 11 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - BRCA2 Protein MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Decision Support Techniques MH - Female MH - Genes, BRCA1 MH - Humans MH - *Life Expectancy MH - Mastectomy MH - Mutation MH - Neoplasm Proteins/ge [Genetics] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy MH - Transcription Factors/ge [Genetics] RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0028-4793 IL - 0028-4793 PT - Comment PT - Letter ID - 9289638 [pubmed] PP - ppublish LG - English DP - 1997 Sep 11 DC - 19970911 EZ - 1997/09/11 00:00 DA - 1997/09/11 00:01 DT - 1997/09/11 YR - 1997 ED - 19970911 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9289638 <530. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9289637 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Orlando R 3rd FA - Orlando, R 3rd TI - Risk of breast cancer in carriers of BRCA gene mutations. CM - Comment on: N Engl J Med. 1997 May 15;336(20):1465-71; PMID: 9148160 SO - New England Journal of Medicine. 337(11):787; author reply 789, 1997 Sep 11 AS - N Engl J Med. 337(11):787; author reply 789, 1997 Sep 11 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - BRCA2 Protein MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - Genes, BRCA1 MH - Humans MH - Life Expectancy MH - Mastectomy MH - Mutation MH - Neoplasm Proteins/ge [Genetics] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - Ovariectomy MH - Transcription Factors/ge [Genetics] RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0028-4793 IL - 0028-4793 DO - https://dx.doi.org/10.1056/NEJM199709113371113 PT - Comment PT - Letter ID - 9289637 [pubmed] ID - 10.1056/NEJM199709113371113 [doi] PP - ppublish LG - English DP - 1997 Sep 11 DC - 19970911 EZ - 1997/09/11 00:00 DA - 2001/03/28 10:01 DT - 1997/09/11 YR - 1997 ED - 19970911 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9289637 <531. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9219198 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - de Haes HC AU - Molenaar S FA - de Haes, H C FA - Molenaar, S TI - Patient participation and decision control: are patient autonomy and well-being associated?. CM - Comment on: Med Decis Making. 1997 Jul-Sep;17(3):298-306; PMID: 9219190 SO - Medical Decision Making. 17(3):353-4, 1997 Jul-Sep AS - Med Decis Making. 17(3):353-4, 1997 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Internal-External Control MH - Mastectomy, Segmental/px [Psychology] MH - *Patient Participation MH - *Patient Satisfaction MH - *Quality of Life IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9701700314 PT - Comment PT - Editorial ID - 9219198 [pubmed] ID - 10.1177/0272989X9701700314 [doi] PP - ppublish LG - English DP - 1997 Jul-Sep DC - 19970904 EZ - 1997/07/01 00:00 DA - 1997/07/01 00:01 DT - 1997/07/01 YR - 1997 ED - 19970904 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9219198 <532. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9219190 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Street RL Jr AU - Voigt B FA - Street, R L Jr FA - Voigt, B IN - Street, R L Jr. Department of Speech Communication, Texas A&M University, College Station 77843-4234, USA. r-street@tamu.edu TI - Patient participation in deciding breast cancer treatment and subsequent quality of life. CM - Comment in: Med Decis Making. 1997 Jul-Sep;17(3):353-4; PMID: 9219198 SO - Medical Decision Making. 17(3):298-306, 1997 Jul-Sep AS - Med Decis Making. 17(3):298-306, 1997 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Internal-External Control MH - Mastectomy, Segmental/px [Psychology] MH - *Mastectomy, Segmental MH - Middle Aged MH - Patient Care Team MH - *Patient Participation MH - Patient Satisfaction MH - *Quality of Life MH - Treatment Outcome AB - This investigation of patients with early breast cancer examined relationships among patient involvement in deciding treatment (i.e., whether to undergo breast removal or breast conservation), perceptions of control over treatment decisions, and subsequent health-related quality of life. It was predicted 1) that patients who more actively participated in consultations to decide treatment would perceive more decision control than would more passive patients and 2) that patients who perceived greater decision control would report better health-related quality of life following treatment than would patients perceiving less decision control. Sixty patients with stage I or II breast cancer allowed their consultations with surgeons to be audiorecorded. Following these visits, patients reported on their involvement in the consultation, optimism for the future, knowledge about treatment, and two aspects of perceived decision control, the perception of having a choice for treatment and the extent to which the doctor or patient was responsible for the decision. Six and 12 months postoperatively, 51 patients (85%) returned a follow-up survey assessing perceived decision control and health-related quality of life. The first prediction received some support. The patients who had more actively participated in their consultations, particularly in terms of offering opinions, assumed more responsibility for treatment decisions during the year following surgery than did less expressive patients. Also, the patients who reported more involvement in their consultations later believed they had had more of a choice for treatment. The second hypothesis was partially supported. Six and 12 months following treatment, the patients who believed they were more responsible for treatment decisions and believed they had more choice of treatment reported higher levels of quality of life than did the patients who perceived themselves to have less decision control. However, perceived control at the time of treatment did not predict later quality of life. Theoretical and clinical implications are discussed. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9701700306 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9219190 [pubmed] ID - 10.1177/0272989X9701700306 [doi] PP - ppublish LG - English DP - 1997 Jul-Sep DC - 19970904 EZ - 1997/07/01 00:00 DA - 2001/03/28 10:01 DT - 1997/07/01 YR - 1997 ED - 19970904 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=9219190 <533. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9275783 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Neill KM AU - Briefs BA FA - Neill, K M FA - Briefs, B A IN - Neill, K M. School of Nursing, Georgetown University Medical Center, Washington, DC, USA. TI - Factors that influence plastic surgeons' advice about reconstruction to women with breast cancer. SO - Plastic Surgical Nursing. 17(2):61-7, 1997 Summer AS - Plast Surg Nurs. 17(2):61-7, 1997 Summer NJ - Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses PI - Journal available in: Print PI - Citation processed from: Print JC - 8403490, p8m IO - Plast Surg Nurs SB - Nursing Journal CP - United States MH - *Attitude of Health Personnel MH - Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - Male MH - *Mammaplasty/px [Psychology] MH - Nursing Methodology Research MH - *Patient Education as Topic/mt [Methods] MH - *Patient Selection MH - *Physicians/px [Psychology] MH - Pilot Projects AB - The purpose of this pilot study was to describe the factors that influence the advice of plastic surgeons who offer reconstructive surgery to women with breast cancer. Answers to the following question were sought: What anatomical, technical, and personal factors are considered by plastic surgeons in their recommendations for reconstruction to women with breast cancer? Five themes emerged that explained approaches used with these patients: (1) technical issues and challenges, (2) patient-centered challenges, (3) aids to patient decision-making, (4) illusion of no loss, and (5) age. IS - 0741-5206 IL - 0741-5206 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9275783 [pubmed] PP - ppublish LG - English DP - 1997 Summer DC - 19970904 EZ - 1997/07/01 00:00 DA - 1997/07/01 00:01 DT - 1997/07/01 YR - 1997 ED - 19970904 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9275783 <534. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9219198 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - de Haes HC AU - Molenaar S FA - de Haes, H C FA - Molenaar, S TI - Patient participation and decision control: are patient autonomy and well-being associated?. CM - Comment on: Med Decis Making. 1997 Jul-Sep;17(3):298-306; PMID: 9219190 SO - Medical Decision Making. 17(3):353-4, 1997 Jul-Sep AS - Med Decis Making. 17(3):353-4, 1997 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Internal-External Control MH - Mastectomy, Segmental/px [Psychology] MH - *Patient Participation MH - *Patient Satisfaction MH - *Quality of Life IS - 0272-989X IL - 0272-989X PT - Comment PT - Editorial ID - 9219198 [pubmed] PP - ppublish LG - English DP - 1997 Jul-Sep DC - 19970904 EZ - 1997/07/01 00:00 DA - 1997/07/01 00:01 DT - 1997/07/01 YR - 1997 ED - 19970904 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9219198 <535. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9219190 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Street RL Jr AU - Voigt B FA - Street, R L Jr FA - Voigt, B IN - Street, R L Jr. Department of Speech Communication, Texas A&M University, College Station 77843-4234, USA. r-street@tamu.edu TI - Patient participation in deciding breast cancer treatment and subsequent quality of life. CM - Comment in: Med Decis Making. 1997 Jul-Sep;17(3):353-4; PMID: 9219198 SO - Medical Decision Making. 17(3):298-306, 1997 Jul-Sep AS - Med Decis Making. 17(3):298-306, 1997 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Follow-Up Studies MH - Humans MH - Internal-External Control MH - Mastectomy, Segmental/px [Psychology] MH - *Mastectomy, Segmental MH - Middle Aged MH - Patient Care Team MH - *Patient Participation MH - Patient Satisfaction MH - *Quality of Life MH - Treatment Outcome AB - This investigation of patients with early breast cancer examined relationships among patient involvement in deciding treatment (i.e., whether to undergo breast removal or breast conservation), perceptions of control over treatment decisions, and subsequent health-related quality of life. It was predicted 1) that patients who more actively participated in consultations to decide treatment would perceive more decision control than would more passive patients and 2) that patients who perceived greater decision control would report better health-related quality of life following treatment than would patients perceiving less decision control. Sixty patients with stage I or II breast cancer allowed their consultations with surgeons to be audiorecorded. Following these visits, patients reported on their involvement in the consultation, optimism for the future, knowledge about treatment, and two aspects of perceived decision control, the perception of having a choice for treatment and the extent to which the doctor or patient was responsible for the decision. Six and 12 months postoperatively, 51 patients (85%) returned a follow-up survey assessing perceived decision control and health-related quality of life. The first prediction received some support. The patients who had more actively participated in their consultations, particularly in terms of offering opinions, assumed more responsibility for treatment decisions during the year following surgery than did less expressive patients. Also, the patients who reported more involvement in their consultations later believed they had had more of a choice for treatment. The second hypothesis was partially supported. Six and 12 months following treatment, the patients who believed they were more responsible for treatment decisions and believed they had more choice of treatment reported higher levels of quality of life than did the patients who perceived themselves to have less decision control. However, perceived control at the time of treatment did not predict later quality of life. Theoretical and clinical implications are discussed. IS - 0272-989X IL - 0272-989X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 9219190 [pubmed] PP - ppublish LG - English DP - 1997 Jul-Sep DC - 19970904 EZ - 1997/07/01 00:00 DA - 2001/03/28 10:01 DT - 1997/07/01 YR - 1997 ED - 19970904 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9219190 <536. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9206919 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Gerber B AU - Krause A FA - Gerber, B FA - Krause, A IN - Gerber, B. Frauenklinik der Universitat Rostock. TI - [Quality of life in relation to patient education regarding surgical procedures in primary breast carcinoma]. [German] OT - Lebensqualitat in Abhangigkeit von der Aufklarung uber mogliche Operationsverfahren beim primaren Mammakarzinom. SO - Zentralblatt fur Gynakologie. 119(4):149-53, 1997 AS - Zentralbl Gynakol. 119(4):149-53, 1997 NJ - Zentralblatt fur Gynakologie PI - Journal available in: Print PI - Citation processed from: Print JC - 21820100r, y5s IO - Zentralbl Gynakol SB - Index Medicus CP - Germany MH - Adult MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - Chemotherapy, Adjuvant/px [Psychology] MH - Combined Modality Therapy MH - Female MH - Follow-Up Studies MH - Humans MH - Mastectomy/px [Psychology] MH - *Mastectomy, Segmental/px [Psychology] MH - Middle Aged MH - Neoplasm Staging MH - *Patient Education as Topic MH - Patient Satisfaction MH - *Quality of Life MH - Radiotherapy, Adjuvant/px [Psychology] AB - Breast conserving therapy is seen as a profit according to life quality. The patients have been subjected to the surgeon suggestions during decision-making about the primary therapy. The purpose of this study was to examine the relationship between the degree of preoperative information of breast cancer therapy and patients' choices of treatments in cases suited for breast conserving therapy. 138 recurrence free patients after breast conserving therapy (BCT) or mastectomies (ME) due to a breast cancer staged as pT1-2N0-1M0 and missing contraindication to BCT were interviewed using an observer checklist. The degrees of preoperative information, reasons for decision to mastectomy, though BCT was possible, were correlated with the postoperative life quality. Patients decided for BCT were averaging 56.0 + 12.3 years and significantly (p < 0.05) younger than patients decided for ME (60.4 + 10.5), whereas tumor size, nodal status and adjuvant therapies were comparable. The results indicate, that subjects' choice of treatment was unrelated to the amount of information. 87% (BET) respectively 78.3% (ME) patients evaluated, that preoperative information was enough (p = 0.19). The most frequent reasons for preference of mastectomy were the "perception that survival would be diminished if mastectomy was not done" (93.5%), "avoidance of radiotherapy" (60.9%) and "no partner" (34.8%). According to expectation the body image in the BCT-group (84.8%) was significantly (p = 0.0007) more positive than in the ME-group (58.9%). Nevertheless only 5 (10.9%) patients after ME have felt sorry for their earlier decision. There were no significant differences between the two groups with regard to partner- and sexual adjustment as well as physical well-being. Despite being fully informed of treatment possibilities and no medical contraindications to BCT nearly one third preferred mastectomy due to different reasons. When the patient was involved in the clinical decision-making process the mastectomy indicates not generally a loss of life quality, though nearly 40% are dissatisfied with their nude body image. IS - 0044-4197 IL - 0044-4197 PT - English Abstract PT - Journal Article ID - 9206919 [pubmed] PP - ppublish LG - German DP - 1997 DC - 19970701 EZ - 1997/01/01 00:00 DA - 1997/01/01 00:01 DT - 1997/01/01 YR - 1997 ED - 19970701 RD - 20080211 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9206919 <537. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 10167173 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Singer ME AU - Cebul RD FA - Singer, M E FA - Cebul, R D IN - Singer, M E. School of Medicine, Case Western Reserve University, USA. TI - BRCA1: to test or not to test, that is the question. SO - Health Matrix. 7(1):163-85, 1997 Winter AS - Health Matrix. 7(1):163-85, 1997 Winter NJ - Health matrix (Cleveland, Ohio : 1991) PI - Journal available in: Print PI - Citation processed from: Print JC - 9311154, hem, bld, 8405332 IO - Health Matrix Clevel OI - Source: KIE. 54782 SB - Bioethics Journals SB - Health Administration Journals CP - United States MH - Adult MH - Antineoplastic Agents, Hormonal/tu [Therapeutic Use] MH - *Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - Genetic Testing/ec [Economics] MH - Genetic Testing/px [Psychology] MH - *Genetic Testing MH - Humans MH - Insurance, Health MH - Jews MH - Mastectomy MH - *Patient Participation MH - Prejudice MH - Risk Factors MH - Tamoxifen/tu [Therapeutic Use] MH - Uncertainty MH - United States KW - Genetics and Reproduction NT - 71 fn. NT - KIE BoB Subject Heading: genetic screening NT - Full author name: Singer, Mendel E NT - Full author name: Cebul, Randall D RN - 0 (Antineoplastic Agents, Hormonal) RN - 094ZI81Y45 (Tamoxifen) IS - 0748-383X IL - 0748-383X PT - Journal Article ID - 10167173 [pubmed] PP - ppublish LG - English DP - 1997 Winter DC - 19970617 EZ - 1997/01/01 00:00 DA - 1997/12/03 00:01 DT - 1997/01/01 00:00 YR - 1997 ED - 19970617 RD - 20131121 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=10167173 <538. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9104377 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fallowfield L FA - Fallowfield, L IN - Fallowfield, L. Department of Oncology, University College, London Medical School, Bland Sutton Institute, UK. TI - Offering choice of surgical treatment to women with breast cancer. [Review] [28 refs] SO - Patient Education & Counseling. 30(3):209-14, 1997 Mar AS - Patient Educ Couns. 30(3):209-14, 1997 Mar NJ - Patient education and counseling PI - Journal available in: Print PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Humans MH - Mastectomy/px [Psychology] MH - Patient Education as Topic MH - *Patient Participation AB - Much has been written about the psychosocial and sexual dysfunction associated with the diagnosis and treatment of breast cancer. Hopes that breast conserving techniques would lead to a reduction in some of the psychosocial morbidity experienced, have not materialised. Most of the methodologically sound studies reported to date demonstrate few differences in quality of life domains between women whatever their primary surgical treatment. Some researchers suggested that if women were offered an opportunity to select the surgical option they preferred, then two things would occur: (1) women would choose breast-conserving techniques, and (2) choice in itself would prevent psychosocial morbidity. Despite strong support for both of these assumptions, neither have been borne out. Significant numbers of women, when offered choice, opt for mastectomy and choice in itself does not convey protection from psychological morbidity. The majority of women seem to welcome being given clear information about the options available, together with the reasons as to why a clinician would advise one policy rather than another. However, fewer women than expected wish to take a major role in decision-making about their breast cancer treatment. [References: 28] IS - 0738-3991 IL - 0738-3991 DI - S0738399196009470 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review ID - 9104377 [pubmed] ID - S0738399196009470 [pii] PP - ppublish LG - English DP - 1997 Mar DC - 19970523 EZ - 1997/03/01 00:00 DA - 1997/03/01 00:01 DT - 1997/03/01 YR - 1997 ED - 19970523 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9104377 <539. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9148160 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Schrag D AU - Kuntz KM AU - Garber JE AU - Weeks JC FA - Schrag, D FA - Kuntz, K M FA - Garber, J E FA - Weeks, J C IN - Schrag, D. Center for Outcomes and Policy Research, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA. TI - Decision analysis--effects of prophylactic mastectomy and oophorectomy on life expectancy among women with BRCA1 or BRCA2 mutations.[Erratum appears in N Engl J Med 1997 Aug 7;337(6):434] CM - Comment in: N Engl J Med. 1997 May 15;336(20):1448-9; PMID: 9145684 CM - Comment in: N Engl J Med. 1997 Sep 11;337(11):787; author reply 789; PMID: 9289637 CM - Comment in: N Engl J Med. 1997 Sep 11;337(11):788; author reply 789; PMID: 9289640 CM - Comment in: N Engl J Med. 1997 Sep 11;337(11):787-8; author reply 789; PMID: 9289638 SO - New England Journal of Medicine. 336(20):1465-71, 1997 May 15 AS - N Engl J Med. 336(20):1465-71, 1997 May 15 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - Adult MH - BRCA2 Protein MH - Breast Neoplasms/ge [Genetics] MH - *Breast Neoplasms/pc [Prevention & Control] MH - *Decision Support Techniques MH - Female MH - *Genes, BRCA1 MH - Humans MH - Life Expectancy MH - *Mastectomy MH - Middle Aged MH - Mutation MH - *Neoplasm Proteins/ge [Genetics] MH - Ovarian Neoplasms/ge [Genetics] MH - *Ovarian Neoplasms/pc [Prevention & Control] MH - *Ovariectomy MH - Primary Prevention MH - Probability MH - *Transcription Factors/ge [Genetics] AB - BACKGROUND: Women with BRCA1 or BRCA2 mutations have an increased risk of breast cancer and ovarian cancer. Prophylactic mastectomy and oophorectomy are often considered as ways of reducing these risks, but the effect of the procedures on life expectancy has not been established. AB - METHODS: In a decision analysis, we compared prophylactic mastectomy and prophylactic oophorectomy with no prophylactic surgery among women who carry mutations in the BRCA1 or BRCA2 gene. We used available data about the incidence of cancer, the prognosis for women with cancer, and the efficacy of prophylactic mastectomy and oophorectomy in preventing breast and ovarian cancer to estimate the effects of these interventions on life expectancy among women with different levels of risk of cancer. AB - RESULTS: We calculated that, on average, 30-year-old women who carry BRCA1 or BRCA2 mutations gain from 2.9 to 5.3 years of life expectancy from prophylactic mastectomy and from 0.3 to 1.7 years of life expectancy from prophylactic oophorectomy, depending on their cumulative risk of cancer. Gains in life expectancy decline with age at the time of prophylactic surgery and are minimal for 60-year-old women. Among 30-year-old women, oophorectomy may be delayed 10 years with little loss of life expectancy. AB - CONCLUSIONS: On the basis of a range of estimates of the incidence of cancer, prognosis, and efficacy of prophylactic surgery, our model suggests that prophylactic mastectomy provides substantial gains in life expectancy and prophylactic oophorectomy more limited gains for young women with BRCA1 or BRCA2 mutations. RN - 0 (BRCA2 Protein) RN - 0 (Neoplasm Proteins) RN - 0 (Transcription Factors) IS - 0028-4793 IL - 0028-4793 DO - https://dx.doi.org/10.1056/NEJM199705153362022 PT - Comparative Study PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 9148160 [pubmed] ID - 10.1056/NEJM199705153362022 [doi] PP - ppublish LG - English DP - 1997 May 15 DC - 19970515 EZ - 1997/05/15 00:00 DA - 1997/05/15 00:01 DT - 1997/05/15 YR - 1997 ED - 19970515 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9148160 <540. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9128616 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - O'Connor AM AU - Llewellyn-Thomas HA AU - Sawka C AU - Pinfold SP AU - To T AU - Harrison DE FA - O'Connor, A M FA - Llewellyn-Thomas, H A FA - Sawka, C FA - Pinfold, S P FA - To, T FA - Harrison, D E IN - O'Connor, A M. Clinical Epidemiology Unit, Ottawa Civic Hospital, Ontario, Canada. TI - Physicians' opinions about decision aids for patients considering systemic adjuvant therapy for axillary-node negative breast cancer. SO - Patient Education & Counseling. 30(2):143-53, 1997 Feb AS - Patient Educ Couns. 30(2):143-53, 1997 Feb NJ - Patient education and counseling PI - Journal available in: Print PI - Citation processed from: Print JC - pec, 8406280 IO - Patient Educ Couns SB - Nursing Journal CP - Ireland MH - Adult MH - Aged MH - *Attitude of Health Personnel MH - Axilla MH - *Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - Cross-Sectional Studies MH - *Decision Support Techniques MH - Female MH - Humans MH - Lymph Nodes/pa [Pathology] MH - Male MH - Middle Aged MH - *Patient Education as Topic/mt [Methods] MH - *Physicians/px [Psychology] MH - Surveys and Questionnaires AB - PURPOSE: To examine variations in physicians' opinions about the appropriateness and content of decision aids for women with breast cancer and criteria for their evaluation. AB - METHODS: Cross-sectional survey of all 144 Ontario oncologists by Dillman's mailed survey design. The response rate was 87%. AB - RESULTS: The predominant current practice pattern was to spontaneously inform patients about the treatment recommendations, degree of certainty regarding the recommendations, treatment regime, benefits and side effects. Most respondents (94%) endorsed patient decision aids, particularly when there was high uncertainty about providing adjuvant treatment. Over three-quarters endorsed measuring the following outcomes of decision aids: patients' clarity of trade-offs involved (e.g. survival vs. side effects); comprehension of treatment alternatives, risks and benefits; accuracy of expectations; decision satisfaction; anxiety; commitment to the decision; length of time to complete the decision aid; and decision uncertainty. The least support was for the use of the decision itself as an outcome measure. AB - CONCLUSIONS: There is considerable consensus regarding the indications for, content and criteria for evaluating decision aids which should be considered when developing aids relevant to the needs of clinicians and patients. IS - 0738-3991 IL - 0738-3991 DI - S0738-3991(96)00948-2 PT - Journal Article ID - 9128616 [pubmed] ID - S0738-3991(96)00948-2 [pii] PP - ppublish LG - English DP - 1997 Feb DC - 19970515 EZ - 1997/02/01 00:00 DA - 1997/02/01 00:01 DT - 1997/02/01 YR - 1997 ED - 19970515 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9128616 <541. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9087469 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Col NF AU - Eckman MH AU - Karas RH AU - Pauker SG AU - Goldberg RJ AU - Ross EM AU - Orr RK AU - Wong JB FA - Col, N F FA - Eckman, M H FA - Karas, R H FA - Pauker, S G FA - Goldberg, R J FA - Ross, E M FA - Orr, R K FA - Wong, J B IN - Col, N F. Division of Clinical Decision Making, Informatics, and Telemedicine, Department of Medicine, New England Medical Center and Tufts University School of Medicine, Boston, Mass 02111, USA. nananda.col@es.nemc.org TI - Patient-specific decisions about hormone replacement therapy in postmenopausal women. CM - Comment in: JAMA. 1997 Aug 13;278(6):475; author reply 476; PMID: 9256216 CM - Comment in: JAMA. 1997 Aug 13;278(6):475; author reply 476; PMID: 9256217 SO - JAMA. 277(14):1140-7, 1997 Apr 09 AS - JAMA. 277(14):1140-7, 1997 Apr 09 NJ - JAMA PI - Journal available in: Print PI - Citation processed from: Print JC - 7501160 IO - JAMA SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - African Continental Ancestry Group MH - Aged MH - Breast Neoplasms/ep [Epidemiology] MH - Coronary Disease/ep [Epidemiology] MH - *Decision Support Techniques MH - Endometrial Neoplasms/ep [Epidemiology] MH - Estrogen Replacement Therapy/ae [Adverse Effects] MH - Estrogen Replacement Therapy/sn [Statistics & Numerical Data] MH - *Estrogen Replacement Therapy MH - European Continental Ancestry Group MH - Female MH - Hip Fractures/ep [Epidemiology] MH - Humans MH - Life Expectancy MH - Middle Aged MH - Models, Theoretical MH - Postmenopause MH - Risk MH - Risk Factors MH - Sensitivity and Specificity AB - OBJECTIVE: To examine the effect of hormone replacement therapy on life expectancy in postmenopausal women with different risk profiles for heart disease, breast cancer, and hip fracture. AB - DESIGN: Decision analysis using a Markov model. Published regression models were used to link risk factors to disease incidence and to estimate the lifetime risks of developing coronary heart disease (CHD), breast cancer, hip fracture, and endometrial cancer. The impact of hormone therapy on disease incidence was estimated from published epidemiologic studies. AB - SETTING: Mathematical model applicable to primary care. AB - INTERVENTIONS: Treatment with hormone replacement therapy or no hormone replacement therapy. AB - MAIN OUTCOME MEASURE: Life expectancy. AB - RESULTS: Hormone replacement therapy should increase life expectancy for nearly all postmenopausal women, with some gains exceeding 3 years, depending mainly on an individual's risk factors for CHD and breast cancer. For women with at least 1 risk factor for CHD, hormone therapy should extend life expectancy, even for women having first-degree relatives with breast cancer. Women without any risk factors for CHD or hip fracture, but who have 2 first-degree relatives with breast cancer, however, should not receive hormone therapy. AB - CONCLUSIONS: The benefit of hormone replacement therapy in reducing the likelihood of developing CHD appears to outweigh the risk of breast cancer for nearly all women in whom this treatment might be considered. Our analysis supports the broader use of hormone replacement therapy. IS - 0098-7484 IL - 0098-7484 PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 9087469 [pubmed] PP - ppublish GI - No: 1 PO1 HS 06503 Organization: (HS) *AHRQ HHS* Country: United States No: LM 07092 Organization: (LM) *NLM NIH HHS* Country: United States LG - English DP - 1997 Apr 09 DC - 19970417 EZ - 1997/04/09 00:00 DA - 1997/04/09 00:01 DT - 1997/04/09 YR - 1997 ED - 19970417 RD - 20161017 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=9087469 <542. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 9005128 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cataliotti L AU - Distante V AU - Rontini M AU - Ponzano C AU - Manetti A AU - Falli F FA - Cataliotti, L FA - Distante, V FA - Rontini, M FA - Ponzano, C FA - Manetti, A FA - Falli, F IN - Cataliotti, L. Istituto di Clinica Chirurgica I, Universita degli Studi di Firenze. TI - [Role of axillary dissection in breast carcinoma]. [Italian] OT - Ruolo della dissezione ascellare nel carcinoma mammario. SO - Chirurgia Italiana. 47(4):23-31, 1995 AS - Chir Ital. 47(4):23-31, 1995 NJ - Chirurgia italiana PI - Journal available in: Print PI - Citation processed from: Print JC - czz, 0151753 IO - Chir Ital SB - Index Medicus CP - Italy MH - Adult MH - Aged MH - Axilla MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Data Interpretation, Statistical MH - Female MH - Follow-Up Studies MH - Humans MH - *Lymph Node Excision MH - Mammography MH - Middle Aged MH - Prognosis MH - Time Factors AB - Between 1986 and 1995, 965 patients with T1 breast cancer were treated with wide excision (796 pts) or mastectomy (138 pts). Axillary dissection was performed in 934 patients. Nodal positivity was 8.7% for T1a, 15.6% for T1b and 37.7% for T1c. 68.5% of cases had one to three positive nodes, 18.3% four to ten and 13% more than ten nodes. No differences were observed in the frequency of lymph nodes involved according to the age of patients, menopausal status, pattern at mammography, histology and receptor status. Favourable histology (tubular, cribriform, papillary, colloid) shows a significant difference when compared with all the others histotypes. On the basis of data collected it is impossible to anticipate the axillary status and avoid axillary dissection. IS - 0009-4773 IL - 0009-4773 PT - Comparative Study PT - English Abstract PT - Journal Article ID - 9005128 [pubmed] PP - ppublish LG - Italian DP - 1995 DC - 19970124 EZ - 1995/01/01 00:00 DA - 1995/01/01 00:01 DT - 1995/01/01 YR - 1995 ED - 19970124 RD - 20091111 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=9005128 <543. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8821407 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Blichert-Toft M AU - Mouridsen H AU - Andersen KW FA - Blichert-Toft, M FA - Mouridsen, H FA - Andersen, K W IN - Blichert-Toft, M. Danish Breast Cancer Cooperative Group, Rigshopitalet, Copenhagen, Denmark. TI - Clinical trials. [Review] [24 refs] SO - Seminars in Surgical Oncology. 12(1):32-8, 1996 Jan-Feb AS - Semin Surg Oncol. 12(1):32-8, 1996 Jan-Feb NJ - Seminars in surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - sso, 8503713 IO - Semin Surg Oncol OI - Source: KIE. 63999 OI - Source: NRCBL. 18.2 SB - Bioethics Journals SB - Index Medicus CP - United States MH - Attitude of Health Personnel MH - Breast Neoplasms/th [Therapy] MH - Data Interpretation, Statistical MH - Denmark MH - Disclosure MH - Female MH - Humans MH - Informed Consent MH - Patient Selection MH - Physician's Role MH - Prognosis MH - Random Allocation MH - *Randomized Controlled Trials as Topic MH - Research Subjects MH - Therapeutic Human Experimentation KW - Biomedical and Behavioral Research AB - The randomized clinical trial is a scientific method for solving clinical problems. The method is typically employed before a new type of treatment is offered on a major scale in order to safeguard patients against a less curative therapy. Especially with regard to cancer treatment, randomized studies are conducted in increasing numbers. However, there remains a considerable discrepancy between the actual number of patients entered in randomized trials and the eligible number available. The demand of obtaining informed consent is a major reason for not entering patients into randomized studies. The critical item is whether information about randomization as a method for allocation should be disclosed to the patient. The doctor feels embarrassed not to be able to advise and support the patient in decision making about treatment and finds his or her role as the caring doctor replaced by the roulette. The requirement to seek informed consent has increased the rate of denial to participate in randomized trials from a few percent, up to about 50% or even higher. [References: 24] NT - KIE BoB Subject Heading: human experimentation/research design NT - Full author name: Blichert-Toft, Mogens NT - Full author name: Mouridsen, Henning NT - Full author name: Andersen, Knud West IS - 8756-0437 IL - 1098-2388 DI - 10.1002/(SICI)1098-2388(199601/02)12:1<32::AID-SSU5>3.0.CO;2-7 DO - https://dx.doi.org/10.1002/(SICI)1098-2388(199601/02)12:1<32::AID-SSU5>3.0.CO;2-7 PT - Journal Article PT - Review ID - 8821407 [pubmed] ID - 10.1002/(SICI)1098-2388(199601/02)12:1<32::AID-SSU5>3.0.CO;2-7 [pii] ID - 10.1002/(SICI)1098-2388(199601/02)12:1<32::AID-SSU5>3.0.CO;2-7 [doi] PP - ppublish LG - English DP - 1996 Jan-Feb DC - 19961126 EZ - 1996/01/01 00:00 DA - 2000/06/22 10:00 DT - 1996/01/01 YR - 1996 ED - 19961126 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8821407 <544. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8717597 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stalmeier PF AU - Bezembinder TG AU - Unic IJ FA - Stalmeier, P F FA - Bezembinder, T G FA - Unic, I J IN - Stalmeier, P F. Nijmegen Institute for Cognition and Information (NICI), Department of Mathematical Psychology, University of Nijmegen, The Netherlands. TI - Proportional heuristics in time tradeoff and conjoint measurement. SO - Medical Decision Making. 16(1):36-44, 1996 Jan-Mar AS - Med Decis Making. 16(1):36-44, 1996 Jan-Mar NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - Data Interpretation, Statistical MH - *Decision Support Techniques MH - Effect Modifier, Epidemiologic MH - Female MH - Genetic Counseling MH - Health Status MH - Humans MH - Linear Models MH - Mastectomy MH - Neoplasm Metastasis MH - *Quality-Adjusted Life Years MH - Time Factors AB - The time-tradeoff (TTO) test is widely used to measure quality of life for different health states. Subjects are asked to equate the value of living a given period in an inferior health state to the value of living a shorter period in good health. Applications of TTOs have been criticized based on the fact that the value of future life duration is taken as the future life duration itself. The authors show that for a health state in which a subject does not want to live longer than a specified amount of time, subjects' responses do not comply with the assumption that the value of the period in inferior health is equated to the value of the shorter period in good health. Actually, preference reversals with respect to such a health state point to the use of a proportional heuristic in the TTO test. Comparisons of the TTO test in these subjects with category scaling and difference measurements also favor a proportional interpretation of the TTO test. In tests based on conjoint measurement, these subjects also appear to use a proportional heuristic. Consequences of the use of the TTO test and conjoint measurement in quality-of-life models are discussed. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9601600111 PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 8717597 [pubmed] ID - 10.1177/0272989X9601600111 [doi] PP - ppublish LG - English DP - 1996 Jan-Mar DC - 19961016 EZ - 1996/01/01 00:00 DA - 1996/01/01 00:01 DT - 1996/01/01 YR - 1996 ED - 19961016 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=8717597 <545. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8717597 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Stalmeier PF AU - Bezembinder TG AU - Unic IJ FA - Stalmeier, P F FA - Bezembinder, T G FA - Unic, I J IN - Stalmeier, P F. Nijmegen Institute for Cognition and Information (NICI), Department of Mathematical Psychology, University of Nijmegen, The Netherlands. TI - Proportional heuristics in time tradeoff and conjoint measurement. SO - Medical Decision Making. 16(1):36-44, 1996 Jan-Mar AS - Med Decis Making. 16(1):36-44, 1996 Jan-Mar NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Choice Behavior MH - Data Interpretation, Statistical MH - *Decision Support Techniques MH - Effect Modifier, Epidemiologic MH - Female MH - Genetic Counseling MH - Health Status MH - Humans MH - Linear Models MH - Mastectomy MH - Neoplasm Metastasis MH - *Quality-Adjusted Life Years MH - Time Factors AB - The time-tradeoff (TTO) test is widely used to measure quality of life for different health states. Subjects are asked to equate the value of living a given period in an inferior health state to the value of living a shorter period in good health. Applications of TTOs have been criticized based on the fact that the value of future life duration is taken as the future life duration itself. The authors show that for a health state in which a subject does not want to live longer than a specified amount of time, subjects' responses do not comply with the assumption that the value of the period in inferior health is equated to the value of the shorter period in good health. Actually, preference reversals with respect to such a health state point to the use of a proportional heuristic in the TTO test. Comparisons of the TTO test in these subjects with category scaling and difference measurements also favor a proportional interpretation of the TTO test. In tests based on conjoint measurement, these subjects also appear to use a proportional heuristic. Consequences of the use of the TTO test and conjoint measurement in quality-of-life models are discussed. IS - 0272-989X IL - 0272-989X PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 8717597 [pubmed] PP - ppublish LG - English DP - 1996 Jan-Mar DC - 19961016 EZ - 1996/01/01 00:00 DA - 1996/01/01 00:01 DT - 1996/01/01 YR - 1996 ED - 19961016 RD - 20111117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8717597 <546. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8768489 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Pierce PF FA - Pierce, P F IN - Pierce, P F. University of Michigan, School of Nursing, Ann Arbor 48109, USA. TI - When the patient chooses: describing unaided decisions in health care. [Review] [30 refs] SO - Human Factors. 38(2):278-87, 1996 Jun AS - Hum Factors. 38(2):278-87, 1996 Jun NJ - Human factors PI - Journal available in: Print PI - Citation processed from: Print JC - ge5, 0374660 IO - Hum Factors SB - Index Medicus SB - National Aeronautics and Space Administration (NASA) Journals CP - United States MH - Arrhythmias, Cardiac/px [Psychology] MH - Arrhythmias, Cardiac/th [Therapy] MH - *Decision Making MH - Female MH - Humans MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Models, Psychological MH - *Patient Participation MH - Professional-Patient Relations AB - Patients make health care decisions in a complex and alien environment with little, if any, insightful aid from health care professionals; such professionals may be well intentioned but naive about how to provide decisional support. The search for information is unstructured, and once information is obtained, it is not easily understood by the layperson who may have difficulty understanding ambiguous and uncertain information. This paper addresses issues and concerns pertaining to the representation of unaided decision making in clinical practice among patients in two clinical contexts (breast cancer and cardiovascular disease). An analysis of qualitative clinical interviews provides indicators of naturalistic rule-based approaches patients use when making a medical decision. The relative salience of the alternatives plays a key role in discriminating rapid, intuitive decisions from those that are more deliberative. Empirical descriptions of real-world decision-making processes support a theoretical model of unaided decisions in health care. [References: 30] IS - 0018-7208 IL - 0018-7208 DO - https://dx.doi.org/10.1177/001872089606380208 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PT - Review ID - 8768489 [pubmed] ID - 10.1177/001872089606380208 [doi] PP - ppublish GI - No: SF31 NU05550-03 Organization: (NU) *BHP HRSA HHS* Country: United States LG - English DP - 1996 Jun DC - 19960919 EZ - 1996/06/01 00:00 DA - 1996/06/01 00:01 DT - 1996/06/01 YR - 1996 ED - 19960919 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=8768489 <547. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8768489 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Pierce PF FA - Pierce, P F IN - Pierce, P F. University of Michigan, School of Nursing, Ann Arbor 48109, USA. TI - When the patient chooses: describing unaided decisions in health care. [Review] [30 refs] SO - Human Factors. 38(2):278-87, 1996 Jun AS - Hum Factors. 38(2):278-87, 1996 Jun NJ - Human factors PI - Journal available in: Print PI - Citation processed from: Print JC - ge5, 0374660 IO - Hum Factors SB - Index Medicus SB - National Aeronautics and Space Administration (NASA) Journals CP - United States MH - Arrhythmias, Cardiac/px [Psychology] MH - Arrhythmias, Cardiac/th [Therapy] MH - *Decision Making MH - Female MH - Humans MH - Mastectomy/mt [Methods] MH - Mastectomy/px [Psychology] MH - Models, Psychological MH - *Patient Participation MH - Professional-Patient Relations AB - Patients make health care decisions in a complex and alien environment with little, if any, insightful aid from health care professionals; such professionals may be well intentioned but naive about how to provide decisional support. The search for information is unstructured, and once information is obtained, it is not easily understood by the layperson who may have difficulty understanding ambiguous and uncertain information. This paper addresses issues and concerns pertaining to the representation of unaided decision making in clinical practice among patients in two clinical contexts (breast cancer and cardiovascular disease). An analysis of qualitative clinical interviews provides indicators of naturalistic rule-based approaches patients use when making a medical decision. The relative salience of the alternatives plays a key role in discriminating rapid, intuitive decisions from those that are more deliberative. Empirical descriptions of real-world decision-making processes support a theoretical model of unaided decisions in health care. [References: 30] IS - 0018-7208 IL - 0018-7208 PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PT - Review ID - 8768489 [pubmed] PP - ppublish GI - No: SF31 NU05550-03 Organization: (NU) *BHP HRSA HHS* Country: United States LG - English DP - 1996 Jun DC - 19960919 EZ - 1996/06/01 00:00 DA - 1996/06/01 00:01 DT - 1996/06/01 YR - 1996 ED - 19960919 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8768489 <548. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8726184 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Weiss SM AU - Wengert PA Jr AU - Martinez EM AU - Sewall W AU - Kopp E FA - Weiss, S M FA - Wengert, P A Jr FA - Martinez, E M FA - Sewall, W FA - Kopp, E IN - Weiss, S M. Department of Surgery, Polyclinic Medical Center, Harrisburg, Pennsylvania 17110, USA. TI - Patient satisfaction with decision-making for breast cancer therapy. SO - Annals of Surgical Oncology. 3(3):285-9, 1996 May AS - Ann Surg Oncol. 3(3):285-9, 1996 May NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/su [Surgery] MH - *Decision Making MH - Female MH - Humans MH - Mastectomy/mt [Methods] MH - Patient Education as Topic MH - *Patient Participation MH - *Patient Satisfaction AB - BACKGROUND: Many sources have suggested that mastectomy is inappropriately performed too frequently for breast cancer, leading to excessive patient dissatisfaction and unnecessary mutilation. Hurried decision-making based on inadequate information has been proposed as an explanation. AB - METHODS: After confirming the diagnosis of breast cancer, patients were informed of the diagnosis, prognosis, and treatment options according to a standard protocol. The protocol was similar to that used by many surgeons in similar circumstances. Six months after completion of either mastectomy or breast conservation therapy, patients were surveyed about their satisfaction with the decision-making process and choice of treatment. AB - RESULTS: The majority of patients, whether they had undergone mastectomy or breast conservation, thought they had been adequately informed of treatment options and that they had made the appropriate choice of therapy. A significant percentage of mastectomy patients found that procedure more disfiguring than anticipated, but still thought they had made the appropriate choice of therapy. Despite having been informed to the contrary, most patients said their chosen treatment provided the best chance for cure. AB - CONCLUSIONS: When informed of the diagnosis and treatment options in an unhurried, supportive setting, and when encouraged to seek further consultations as desired, breast cancer patients make appropriate therapeutic choices about mastectomy or breast conservation therapy. IS - 1068-9265 IL - 1068-9265 PT - Journal Article ID - 8726184 [pubmed] PP - ppublish LG - English DP - 1996 May DC - 19960917 EZ - 1996/05/01 00:00 DA - 2001/03/28 10:01 DT - 1996/05/01 YR - 1996 ED - 19960917 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8726184 <549. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8646518 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Kotwall CA AU - Maxwell JG AU - Covington DL AU - Churchill P AU - Smith SE AU - Covan EK FA - Kotwall, C A FA - Maxwell, J G FA - Covington, D L FA - Churchill, P FA - Smith, S E FA - Covan, E K IN - Kotwall, C A. Department of Surgery, School of Medicine, University of North Carolina at Chapel Hill, USA. TI - Clinicopathologic factors and patient perceptions associated with surgical breast-conserving treatment. SO - Annals of Surgical Oncology. 3(2):169-75, 1996 Mar AS - Ann Surg Oncol. 3(2):169-75, 1996 Mar NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - *Mastectomy, Segmental MH - Middle Aged MH - *Patient Compliance MH - Patient Education as Topic MH - Retrospective Studies MH - *Self Concept MH - Treatment Outcome AB - 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. AB - 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. AB - 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). AB - 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. IS - 1068-9265 IL - 1068-9265 PT - Journal Article ID - 8646518 [pubmed] PP - ppublish LG - English DP - 1996 Mar DC - 19960719 EZ - 1996/03/01 00:00 DA - 1996/03/01 00:01 DT - 1996/03/01 YR - 1996 ED - 19960719 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8646518 <550. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8577618 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Coleman EA AU - Coon SK AU - Thompson PJ AU - Lemon SJ AU - Depuy RS FA - Coleman, E A FA - Coon, S K FA - Thompson, P J FA - Lemon, S J FA - Depuy, R S IN - Coleman, E A. College of Nursing, University of Arkansas for Medical Sciences (UAMS), Little Rock, USA. TI - Impact of silicone implants on the lives of women with breast cancer. SO - Oncology Nursing Forum. 22(10):1493-500, 1995 Nov-Dec AS - Oncol Nurs Forum. 22(10):1493-500, 1995 Nov-Dec NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Print JC - 7809033, pad IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Aged MH - Anger MH - Attitude to Health MH - *Breast Implants/ae [Adverse Effects] MH - *Breast Neoplasms/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - Mammaplasty/nu [Nursing] MH - *Mammaplasty MH - *Mastectomy/rh [Rehabilitation] MH - Middle Aged MH - Patient Education as Topic MH - *Patient Satisfaction MH - Physician-Patient Relations MH - *Silicones MH - Truth Disclosure MH - United States AB - PURPOSE/OBJECTIVES: To describe the impact of silicone implants on the lives of women with breast cancer. AB - DESIGN: Qualitative analysis of telephone interview data. AB - SAMPLE: 120 women from across the United States who have reported to the Food and Drug Administration problems with breast implants following mastectomies. AB - METHODS: Telephone interviews were used to gather responses to 110 questions. Qualitative analysis of narrative data was linked with quantitative data. AB - MAIN RESEARCH VARIABLES: Concerns and feelings about breast implants; potential problems with silicone implants; source of information about problems; how they coped with the silicone implant controversy; problems related to their breast implants; the effect of health problems on day-to-day activities, relationships with significant others, work, and any other important aspects of their lives; and advice they would give other women regarding breast implant surgery. By linking the qualitative analysis of narrative data with quantitative data, the investigators sought to answer the following research question: Do the patterns of responses differ based on specific systemic physical problems, reported localized breast problems, or implant problems? AB - FINDINGS: The women reported poorer quality of life and feelings of worry and anger because of health problems. They perceived they had received incomplete information and often had complaints dismissed by their healthcare providers. Most of them would not recommend silicone implants for patients undergoing mastectomy. The women's levels of satisfaction were directly associated with their feelings of being informed and the type of health problems they experienced. AB - CONCLUSIONS: Women need reconstruction options following mastectomy, however, use of silicone implants can result in additional health problems and decreased quality of life as a result of those problems. AB - IMPLICATIONS FOR NURSING PRACTICE: Nurses can assume the role of breast health educator, which includes counseling women with breast cancer about breast implants and other reconstructive options. Study results will help health providers care both for those patients considering treatment options and those coping with the problems and concerns related to their breast implants. Women should be told the inherent risks and complications associated with breast implants and also told when "we don't know." RN - 0 (Silicones) IS - 0190-535X IL - 0190-535X PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 8577618 [pubmed] PP - ppublish LG - English DP - 1995 Nov-Dec DC - 19960314 EZ - 1995/11/01 00:00 DA - 1995/11/01 00:01 DT - 1995/11/01 YR - 1995 ED - 19960314 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8577618 <551. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8558224 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hillner BE AU - Desch CE AU - Carlson RW AU - Smith TJ AU - Esserman L AU - Bear HD FA - Hillner, B E FA - Desch, C E FA - Carlson, R W FA - Smith, T J FA - Esserman, L FA - Bear, H D IN - Hillner, B E. Massey Cancer Center, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0170, USA. TI - Trade-offs between survival and breast preservation for three initial treatments of ductal carcinoma-in-situ of the breast. SO - Journal of Clinical Oncology. 14(1):70-7, 1996 Jan AS - J Clin Oncol. 14(1):70-7, 1996 Jan NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma in Situ/mo [Mortality] MH - Carcinoma in Situ/rt [Radiotherapy] MH - Carcinoma in Situ/su [Surgery] MH - *Carcinoma in Situ/th [Therapy] MH - Carcinoma, Ductal, Breast/mo [Mortality] MH - Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - *Carcinoma, Ductal, Breast/th [Therapy] MH - Cohort Studies MH - Combined Modality Therapy MH - Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Humans MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - Models, Statistical MH - Neoplasm Recurrence, Local/pc [Prevention & Control] MH - Neoplasms, Second Primary/pc [Prevention & Control] MH - Predictive Value of Tests MH - Probability MH - Prognosis MH - Quality of Life MH - Radiography MH - Survival Rate AB - PURPOSE: To assess the trade-offs between survival and breast preservation of currently accepted approaches for ductal carcinoma-in-situ (DCIS) of the breast. AB - PATIENTS AND METHODS: Decision analysis was performed using the Markov model of hypothetical cohorts of 55-year-old white women with nonpalpable mammographic abnormalities found to be DCIS. Strategies were breast-conserving surgery (BCS), BCS with 50-Gy radiation (RT) or initial mastectomy. Recurrence rates were derived from the published literature. Main outcomes were overall, breast cancer-free, and event-free survival plus years of both breasts preserved. AB - RESULTS: Using the conditions defined in this model, the actuarial survival rates at 10 and 20 years were 91.7% and 74.1% for the initial mastectomy strategy, 91.0% and 72.1% for BCS plus RT, and 89.6% and 68.2% for BCS alone. At 20 years, the initial mastectomy strategy also had a greater breast cancer-free survival rate of 74.5%, compared with 63.3% for BCS plus RT, or 46.8% for BCS alone. However, BCS alone had the highest survival rate with both breasts preserved (64.2%) compared with BCS plus RT (56.0%) or initial mastectomy (0%). Of the breast-conserving strategies at 20 years, the breast event-free survival rate (no invasive cancer or DCIS) was greater for BCS plus RT (47.2%) compared with BCS alone (28.4%). Using just survival as the primary end point, mastectomy is the optimal strategy by a small margin. However, if quality-adjusted survival is at issue, mastectomy is the choice only if the yearly reduction in quality of life due to mastectomy is less than 1%. AB - CONCLUSION: BCS with or without radiation compared with mastectomy as initial management of DCIS of the breast trades a slight decrease in survival rates for the value of breast preservation. This model should aid clinicians in matching treatments to their patients' preferences. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/JCO.1996.14.1.70 PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 8558224 [pubmed] ID - 10.1200/JCO.1996.14.1.70 [doi] PP - ppublish LG - English DP - 1996 Jan DC - 19960223 EZ - 1996/01/01 00:00 DA - 1996/01/01 00:01 DT - 1996/01/01 YR - 1996 ED - 19960223 RD - 20170210 UP - 20170213 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=8558224 <552. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8558224 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hillner BE AU - Desch CE AU - Carlson RW AU - Smith TJ AU - Esserman L AU - Bear HD FA - Hillner, B E FA - Desch, C E FA - Carlson, R W FA - Smith, T J FA - Esserman, L FA - Bear, H D IN - Hillner, B E. Massey Cancer Center, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0170, USA. TI - Trade-offs between survival and breast preservation for three initial treatments of ductal carcinoma-in-situ of the breast. SO - Journal of Clinical Oncology. 14(1):70-7, 1996 Jan AS - J Clin Oncol. 14(1):70-7, 1996 Jan NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Print JC - jco, 8309333 IO - J. Clin. Oncol. SB - Index Medicus CP - United States MH - Aged MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/su [Surgery] MH - *Breast Neoplasms/th [Therapy] MH - Carcinoma in Situ/mo [Mortality] MH - Carcinoma in Situ/rt [Radiotherapy] MH - Carcinoma in Situ/su [Surgery] MH - *Carcinoma in Situ/th [Therapy] MH - Carcinoma, Ductal, Breast/mo [Mortality] MH - Carcinoma, Ductal, Breast/rt [Radiotherapy] MH - Carcinoma, Ductal, Breast/su [Surgery] MH - *Carcinoma, Ductal, Breast/th [Therapy] MH - Cohort Studies MH - Combined Modality Therapy MH - Decision Support Techniques MH - Disease-Free Survival MH - Female MH - Humans MH - Markov Chains MH - Mastectomy MH - Middle Aged MH - Models, Statistical MH - Neoplasm Recurrence, Local/pc [Prevention & Control] MH - Neoplasms, Second Primary/pc [Prevention & Control] MH - Predictive Value of Tests MH - Probability MH - Prognosis MH - Quality of Life MH - Radiography MH - Survival Rate AB - PURPOSE: To assess the trade-offs between survival and breast preservation of currently accepted approaches for ductal carcinoma-in-situ (DCIS) of the breast. AB - PATIENTS AND METHODS: Decision analysis was performed using the Markov model of hypothetical cohorts of 55-year-old white women with nonpalpable mammographic abnormalities found to be DCIS. Strategies were breast-conserving surgery (BCS), BCS with 50-Gy radiation (RT) or initial mastectomy. Recurrence rates were derived from the published literature. Main outcomes were overall, breast cancer-free, and event-free survival plus years of both breasts preserved. AB - RESULTS: Using the conditions defined in this model, the actuarial survival rates at 10 and 20 years were 91.7% and 74.1% for the initial mastectomy strategy, 91.0% and 72.1% for BCS plus RT, and 89.6% and 68.2% for BCS alone. At 20 years, the initial mastectomy strategy also had a greater breast cancer-free survival rate of 74.5%, compared with 63.3% for BCS plus RT, or 46.8% for BCS alone. However, BCS alone had the highest survival rate with both breasts preserved (64.2%) compared with BCS plus RT (56.0%) or initial mastectomy (0%). Of the breast-conserving strategies at 20 years, the breast event-free survival rate (no invasive cancer or DCIS) was greater for BCS plus RT (47.2%) compared with BCS alone (28.4%). Using just survival as the primary end point, mastectomy is the optimal strategy by a small margin. However, if quality-adjusted survival is at issue, mastectomy is the choice only if the yearly reduction in quality of life due to mastectomy is less than 1%. AB - CONCLUSION: BCS with or without radiation compared with mastectomy as initial management of DCIS of the breast trades a slight decrease in survival rates for the value of breast preservation. This model should aid clinicians in matching treatments to their patients' preferences. IS - 0732-183X IL - 0732-183X DO - https://dx.doi.org/10.1200/jco.1996.14.1.70 PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 8558224 [pubmed] ID - 10.1200/jco.1996.14.1.70 [doi] PP - ppublish LG - English DP - 1996 Jan DC - 19960223 EZ - 1996/01/01 00:00 DA - 1996/01/01 00:01 DT - 1996/01/01 YR - 1996 ED - 19960223 RD - 20161123 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=8558224 <553. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 7554855 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Bohren BF AU - Hadzikadic M AU - Hanley EN Jr FA - Bohren, B F FA - Hadzikadic, M FA - Hanley, E N Jr IN - Bohren, B F. Department of Orthopaeduic Surgery, Carolinas Medical Center, Charlotte, North Carolina 28232, USA. TI - Extracting knowledge from large medical databases: an automated approach. SO - Computers & Biomedical Research. 28(3):191-210, 1995 Jun AS - Comput Biomed Res. 28(3):191-210, 1995 Jun NJ - Computers and biomedical research, an international journal PI - Journal available in: Print PI - Citation processed from: Print JC - dof, 0100331 IO - Comput. Biomed. Res. SB - Index Medicus CP - United States MH - Algorithms MH - Artificial Intelligence MH - Automation MH - Breast Neoplasms MH - Database Management Systems/cl [Classification] MH - Database Management Systems/og [Organization & Administration] MH - *Database Management Systems MH - Decision Making MH - Decision Support Techniques MH - Decision Trees MH - Female MH - Forecasting MH - Humans MH - *Information Systems MH - Low Back Pain MH - Medical Records MH - Outcome Assessment (Health Care) MH - Pattern Recognition, Automated MH - Wounds and Injuries AB - Tools which can uncover patterns in patients' records and then make predictions based on that knowledge are and will continue to be high priority in many medical informatics groups. These tools are impacting the performance of outcome studies by discovering patterns which can then be verified with standard statistical tools. This paper demonstrates INC2.5, a general classification system, as a tool for assisting physicians in the decision making process. INC2.5 gathers information from patient records and builds a decision tree which is used to assist physicians in predicting the outcome of new patients. The decision tree will also reveal any patterns which the system found in the data. Successful results of such a system can be used to enhance outcome studies as well as to spread clinical information to areas with fewer resources. IS - 0010-4809 IL - 0010-4809 DI - S0010480985710130 PT - Journal Article ID - 7554855 [pubmed] ID - S0010480985710130 [pii] PP - ppublish LG - English DP - 1995 Jun DC - 19951113 EZ - 1995/06/01 00:00 DA - 2001/03/28 10:01 DT - 1995/06/01 YR - 1995 ED - 19951113 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7554855 <554. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 7564937 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chapman GB AU - Elstein AS AU - Hughes KK FA - Chapman, G B FA - Elstein, A S FA - Hughes, K K IN - Chapman, G B. Department of Medical Education, University of Illinois at Chicago 60612, USA. TI - Effects of patient education on decisions about breast cancer treatments: a preliminary report. SO - Medical Decision Making. 15(3):231-9, 1995 Jul-Sep AS - Med Decis Making. 15(3):231-9, 1995 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adolescent MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Educational Measurement MH - Female MH - Humans MH - Mammaplasty MH - Mastectomy MH - Middle Aged MH - Pamphlets MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Prostheses and Implants MH - *Teaching Materials MH - Videotape Recording AB - The authors examined the effects of materials for educating patients about treatment options for breast cancer on knowledge about the disease, preferences for alternative treatments, and how changes in knowledge and preferences were related. Eighty-two undergraduate students acted as advisors to a hypothetical patient. They completed a knowledge test and rated their preferences for three options--breast-sparing surgery with radiation, mastectomy followed by reconstructive surgery, and mastectomy followed by use of a breast prosthesis--before and after viewing a videotape or a booklet version of the educational materials. Both formats increased knowledge scores. Treatment preferences were not affected by reading the booklet, but viewing the videotape resulted in a preference shift toward breast-sparing surgery. This media difference may be due to features of the video that were not reproduced in the booklet, such as interviews with other patients. Knowledge gains were uncorrelated with preference changes. IS - 0272-989X IL - 0272-989X DO - https://dx.doi.org/10.1177/0272989X9501500306 PT - Clinical Trial PT - Comparative Study PT - Controlled Clinical Trial PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 7564937 [pubmed] ID - 10.1177/0272989X9501500306 [doi] PP - ppublish GI - No: LM4583 Organization: (LM) *NLM NIH HHS* Country: United States LG - English DP - 1995 Jul-Sep DC - 19951106 EZ - 1995/07/01 00:00 DA - 1995/07/01 00:01 DT - 1995/07/01 YR - 1995 ED - 19951106 RD - 20170214 UP - 20170215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medc&AN=7564937 <555. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 7564937 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Chapman GB AU - Elstein AS AU - Hughes KK FA - Chapman, G B FA - Elstein, A S FA - Hughes, K K IN - Chapman, G B. Department of Medical Education, University of Illinois at Chicago 60612, USA. TI - Effects of patient education on decisions about breast cancer treatments: a preliminary report. SO - Medical Decision Making. 15(3):231-9, 1995 Jul-Sep AS - Med Decis Making. 15(3):231-9, 1995 Jul-Sep NJ - Medical decision making : an international journal of the Society for Medical Decision Making PI - Journal available in: Print PI - Citation processed from: Print JC - ma8, 8109073 IO - Med Decis Making SB - Index Medicus CP - United States MH - Adolescent MH - Adult MH - *Breast Neoplasms/px [Psychology] MH - *Breast Neoplasms/th [Therapy] MH - *Decision Making MH - Educational Measurement MH - Female MH - Humans MH - Mammaplasty MH - Mastectomy MH - Middle Aged MH - Pamphlets MH - *Patient Education as Topic/mt [Methods] MH - Patient Participation MH - Prostheses and Implants MH - *Teaching Materials MH - Videotape Recording AB - The authors examined the effects of materials for educating patients about treatment options for breast cancer on knowledge about the disease, preferences for alternative treatments, and how changes in knowledge and preferences were related. Eighty-two undergraduate students acted as advisors to a hypothetical patient. They completed a knowledge test and rated their preferences for three options--breast-sparing surgery with radiation, mastectomy followed by reconstructive surgery, and mastectomy followed by use of a breast prosthesis--before and after viewing a videotape or a booklet version of the educational materials. Both formats increased knowledge scores. Treatment preferences were not affected by reading the booklet, but viewing the videotape resulted in a preference shift toward breast-sparing surgery. This media difference may be due to features of the video that were not reproduced in the booklet, such as interviews with other patients. Knowledge gains were uncorrelated with preference changes. IS - 0272-989X IL - 0272-989X PT - Clinical Trial PT - Comparative Study PT - Controlled Clinical Trial PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. ID - 7564937 [pubmed] PP - ppublish GI - No: LM4583 Organization: (LM) *NLM NIH HHS* Country: United States LG - English DP - 1995 Jul-Sep DC - 19951106 EZ - 1995/07/01 00:00 DA - 1995/07/01 00:01 DT - 1995/07/01 YR - 1995 ED - 19951106 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7564937 <556. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 7863336 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Marshall E FA - Marshall, E TI - Clinical trials. Fisher clashes with NCI--again. SO - Science. 267(5200):954, 1995 Feb 17 AS - Science. 267(5200):954, 1995 Feb 17 NJ - Science (New York, N.Y.) PI - Journal available in: Print PI - Citation processed from: Print JC - 0404511, uj7 IO - Science SB - Index Medicus SB - History of Medicine Journals CP - United States MH - Breast Neoplasms/su [Surgery] MH - *Clinical Trials as Topic/st [Standards] MH - Data Interpretation, Statistical MH - Female MH - History, 20th Century MH - Humans MH - Mastectomy, Segmental MH - Mastectomy, Simple MH - *National Institutes of Health (U.S.) MH - *Publishing MH - United States PN - Fisher B IS - 0036-8075 IL - 0036-8075 PT - Biography PT - Historical Article PT - News ID - 7863336 [pubmed] PP - ppublish LG - English DP - 1995 Feb 17 DC - 19950323 EZ - 1995/02/17 00:00 DA - 1995/02/17 00:01 DT - 1995/02/17 YR - 1995 ED - 19950323 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7863336 <557. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 7850551 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Osteen RT AU - Winchester DP AU - Hussey DH AU - Clive RE AU - Friedman MA AU - Cady B AU - Chmiel JS AU - Kraybill WG AU - Urist MM AU - Doggett RL FA - Osteen, R T FA - Winchester, D P FA - Hussey, D H FA - Clive, R E FA - Friedman, M A FA - Cady, B FA - Chmiel, J S FA - Kraybill, W G FA - Urist, M M FA - Doggett, R L IN - Osteen, R T. Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115. TI - Insurance coverage of patients with breast cancer in the 1991 commission on cancer patient care evaluation study. SO - Annals of Surgical Oncology. 1(6):462-7, 1994 Nov AS - Ann Surg Oncol. 1(6):462-7, 1994 Nov NJ - Annals of surgical oncology PI - Journal available in: Print PI - Citation processed from: Print JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States MH - Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] MH - Biopsy, Needle/sn [Statistics & Numerical Data] MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/ec [Economics] MH - Breast Neoplasms/pc [Prevention & Control] MH - Breast Neoplasms/th [Therapy] MH - Combined Modality Therapy MH - Data Interpretation, Statistical MH - Health Maintenance Organizations/sn [Statistics & Numerical Data] MH - Humans MH - *Insurance, Health/sn [Statistics & Numerical Data] MH - Mammography/sn [Statistics & Numerical Data] MH - Mass Screening/sn [Statistics & Numerical Data] MH - Mastectomy/sn [Statistics & Numerical Data] MH - Medicaid/sn [Statistics & Numerical Data] MH - *Medically Uninsured/sn [Statistics & Numerical Data] MH - Medicare/sn [Statistics & Numerical Data] MH - Neoplasm Metastasis MH - Neoplasm Staging MH - Program Evaluation MH - *Quality of Health Care MH - *Registries MH - Societies, Medical MH - United States AB - BACKGROUND: Trends in the care of patients with cancer are monitored annually by the Commission on Cancer of the American College of Surgeons. In 1991 a patient care evaluation study of breast cancer was conducted, which among other questions examined the correlation of health insurance with type or quality of care delivered for breast cancer on a national basis. AB - METHODS: The tumor registry system of the American College of Surgeons was used to obtain data on patients with breast cancer diagnosed in 1983 and 1990. Trends in diagnosis and treatment were correlated with the type of insurance or lack of insurance. AB - RESULTS: Data were obtained from hospitals in 50 states on a total of 41,651 patients. The largest number of patients were covered by Medicare. Fewer than 5% were considered medically indigent. Medically indigent patients presented with higher stage disease and did not participate in a trend toward downstaging, which occurred between the two study years. The treatment of medically indigent patients appeared to be appropriate and comparable with better insured patients. Insurance type (health maintenance organization vs. private) did not affect stage, treatment, or outcome. Decisions to use controversial therapies, such as chemotherapy for stage I disease, did not appear to be financially driven. AB - CONCLUSION: A nationwide pattern of care study for breast cancer indicates that medically indigent patients present with more advanced disease compared with better insured patients, but once the diagnosis is made, treatment and outcome have little to do with insurance type. IS - 1068-9265 IL - 1068-9265 PT - Journal Article ID - 7850551 [pubmed] PP - ppublish LG - English DP - 1994 Nov DC - 19950315 EZ - 1994/11/01 00:00 DA - 1994/11/01 00:01 DT - 1994/11/01 YR - 1994 ED - 19950315 RD - 20070718 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=7850551 <558. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8065416 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Heitjan DF FA - Heitjan, D F TI - The NSABP trials. SO - New England Journal of Medicine. 331(12):809-10, 1994 Sep 22 AS - N Engl J Med. 331(12):809-10, 1994 Sep 22 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Clinical Trials as Topic MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Mastectomy MH - Mastectomy, Segmental MH - Research Design IS - 0028-4793 IL - 0028-4793 PT - Letter ID - 8065416 [pubmed] PP - ppublish LG - English DP - 1994 Sep 22 DC - 19940922 EZ - 1994/09/22 00:00 DA - 1994/09/22 00:01 DT - 1994/09/22 YR - 1994 ED - 19940922 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8065416 <559. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8063085 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fawzy FI AU - Fawzy NW FA - Fawzy, F I FA - Fawzy, N W IN - Fawzy, F I. Department of Psychiatry, UCLA School of Medicine. TI - A structured psychoeducational intervention for cancer patients. SO - General Hospital Psychiatry. 16(3):149-92, 1994 May AS - Gen Hosp Psychiatry. 16(3):149-92, 1994 May NJ - General hospital psychiatry PI - Journal available in: Print PI - Citation processed from: Print JC - fnk, 7905527 IO - Gen Hosp Psychiatry SB - Index Medicus CP - United States MH - *Adaptation, Psychological MH - Affect MH - Avoidance Learning MH - Behavior Therapy MH - Body Image MH - Breast Neoplasms/di [Diagnosis] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Communication MH - Comprehensive Health Care MH - Female MH - Humans MH - Interpersonal Relations MH - *Manuals as Topic MH - Mastectomy/px [Psychology] MH - Models, Educational MH - Models, Psychological MH - *Patient Education as Topic/mt [Methods] MH - Physician-Patient Relations MH - Quality of Life MH - Self-Help Groups/og [Organization & Administration] MH - Social Support MH - Stress, Psychological/pc [Prevention & Control] MH - Stress, Psychological/px [Psychology] MH - *Teaching Materials IS - 0163-8343 IL - 0163-8343 PT - Journal Article ID - 8063085 [pubmed] PP - ppublish LG - English DP - 1994 May DC - 19940922 EZ - 1994/05/01 00:00 DA - 1994/05/01 00:01 DT - 1994/05/01 YR - 1994 ED - 19940922 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8063085 <560. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8032564 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Thomas P FA - Thomas, P IN - Thomas, P. Whipps Cross Hospital, London. TI - Decision making in surgery: management of symptomatic early breast carcinoma. SO - British Journal of Hospital Medicine. 51(6):287-9, 1994 Mar 16-Apr 5 AS - Br J Hosp Med. 51(6):287-9, 1994 Mar 16-Apr 5 NJ - British journal of hospital medicine PI - Journal available in: Print PI - Citation processed from: Print JC - bz5, 0171545 IO - Br J Hosp Med SB - Index Medicus CP - England MH - Antineoplastic Agents/tu [Therapeutic Use] MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/th [Therapy] MH - Chemotherapy, Adjuvant MH - Combined Modality Therapy MH - *Decision Support Techniques MH - Female MH - Humans MH - Lymph Node Excision MH - Mastectomy/mt [Methods] MH - Neoplasm Staging MH - Patient Education as Topic AB - The initial advice given to a patient with a proven breast carcinoma needs to be informed and sensitive. Breast specialists still have firm and differing views of the management of early breast carcinoma and, although a consensus approach is nearer now than it used to be, there is still sufficient variation to make it difficult for the surgical trainee. RN - 0 (Antineoplastic Agents) IS - 0007-1064 IL - 0007-1064 PT - Journal Article ID - 8032564 [pubmed] PP - ppublish LG - English DP - 1994 Mar 16-Apr 5 DC - 19940816 EZ - 1994/03/05 00:00 DA - 1994/03/05 00:01 DT - 1994/03/05 YR - 1994 ED - 19940816 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8032564 <561. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8159206 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Fisher B AU - Redmond CK FA - Fisher, B FA - Redmond, C K TI - Fraud in breast-cancer trials. CM - Comment in: N Engl J Med. 1994 May 19;330(20):1448-50; PMID: 8159201 SO - New England Journal of Medicine. 330(20):1458-60, 1994 May 19 AS - N Engl J Med. 330(20):1458-60, 1994 May 19 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - *Clinical Trials as Topic/st [Standards] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Mastectomy, Segmental MH - Medical Audit MH - Medical Records/sn [Statistics & Numerical Data] MH - *Scientific Misconduct IS - 0028-4793 IL - 0028-4793 DO - https://dx.doi.org/10.1056/NEJM199405193302015 PT - Letter ID - 8159206 [pubmed] ID - 10.1056/NEJM199405193302015 [doi] PP - ppublish LG - English DP - 1994 May 19 DC - 19940519 EZ - 1994/05/19 00:00 DA - 1994/05/19 00:01 DT - 1994/05/19 YR - 1994 ED - 19940519 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8159206 <562. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8159201 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Angell M AU - Kassirer JP FA - Angell, M FA - Kassirer, J P TI - Setting the record straight in the breast-cancer trials. CM - Comment in: N Engl J Med. 1994 May 19;330(20):1461; PMID: 8159210 CM - Comment in: N Engl J Med. 1994 May 19;330(20):1461; PMID: 8159209 CM - Comment in: N Engl J Med. 1994 May 19;330(20):1462; PMID: 8159212 CM - Comment in: N Engl J Med. 1995 Jan 5;332(1):64; PMID: 7990882 CM - Comment in: N Engl J Med. 1994 May 19;330(20):1462; PMID: 8159211 CM - Comment on: N Engl J Med. 1994 May 19;330(20):1460; PMID: 8159207 CM - Comment on: N Engl J Med. 1994 May 19;330(20):1460-1; PMID: 8159208 CM - Comment on: N Engl J Med. 1994 May 19;330(20):1458-60; PMID: 8159206 SO - New England Journal of Medicine. 330(20):1448-50, 1994 May 19 AS - N Engl J Med. 330(20):1448-50, 1994 May 19 NJ - The New England journal of medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0255562, now IO - N. Engl. J. Med. SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/su [Surgery] MH - Canada MH - Clinical Trials as Topic/st [Standards] MH - *Clinical Trials as Topic/sn [Statistics & Numerical Data] MH - Data Interpretation, Statistical MH - Female MH - Humans MH - Mastectomy, Segmental MH - *Scientific Misconduct MH - United States IS - 0028-4793 IL - 0028-4793 DO - https://dx.doi.org/10.1056/NEJM199405193302010 PT - Comment PT - Editorial ID - 8159201 [pubmed] ID - 10.1056/NEJM199405193302010 [doi] PP - ppublish LG - English DP - 1994 May 19 DC - 19940519 EZ - 1994/05/19 00:00 DA - 1994/05/19 00:01 DT - 1994/05/19 YR - 1994 ED - 19940519 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8159201 <563. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 1307183 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lantieri L AU - Raulo Y AU - Baruch J FA - Lantieri, L FA - Raulo, Y FA - Baruch, J IN - Lantieri, L. Service de Chirurgie Plastique, Hopital Henri Mondor, Creteil. TI - [Effect of inadequate filling of deflation of inflatable breast prostheses. Statistical study of 535 inflatable prostheses]. [French] OT - Influence de l'insuffisance de remplissage sur le degonflement des protheses mammaires gonflables. Etude statistique sur 535 protheses gonflables. SO - Annales de Chirurgie Plastique et Esthetique. 37(5):534-40, 1992 Oct AS - Ann Chir Plast Esthet. 37(5):534-40, 1992 Oct NJ - Annales de chirurgie plastique et esthetique PI - Journal available in: Print PI - Citation processed from: Print JC - 529, 8305839 IO - Ann Chir Plast Esthet SB - Index Medicus CP - France MH - Adolescent MH - Adult MH - Data Interpretation, Statistical MH - Esthetics MH - Female MH - Humans MH - *Mammaplasty MH - Middle Aged MH - *Prostheses and Implants/ae [Adverse Effects] MH - Silicones AB - This study was based on a series of 535 inflatable prostheses used for breast reconstruction or augmentation with a mean follow-up of 5.15 years. The authors specifically analysed the statistical correlation between underinflation and deflation due to late rupture. They demonstrated a statistically significant difference between the initial filling of the prostheses which subsequently deflated and the initial filling of all prostheses of the series. The mean filling of prostheses which subsequently deflated was 89% while the mean filling of all prosthesis in the series was 100%. The various pathologies are analysed according to the cosmetic or reconstructive indications. The two series, cosmetic and reconstructive, were homogeneous in terms of filling volume and deflation; the only difference concerned the age distribution. Patients undergoing breast reconstruction with a prosthesis were older than patients undergoing augmentation surgery for small breasts. The authors discuss the advantages and disadvantages of this type of prosthesis. RN - 0 (Silicones) IS - 0294-1260 IL - 0294-1260 PT - English Abstract PT - Journal Article ID - 1307183 [pubmed] PP - ppublish LG - French DP - 1992 Oct DC - 19930823 EZ - 1992/10/01 00:00 DA - 1992/10/01 00:01 DT - 1992/10/01 YR - 1992 ED - 19930823 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=1307183 <564. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 8321703 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Hughes KK FA - Hughes, K K IN - Hughes, K K. Department of Administrative Studies in Nursing, University of Illinois College of Nursing, Chicago. TI - Decision making by patients with breast cancer: the role of information in treatment selection. SO - Oncology Nursing Forum. 20(4):623-8, 1993 May AS - Oncol Nurs Forum. 20(4):623-8, 1993 May NJ - Oncology nursing forum PI - Journal available in: Print PI - Citation processed from: Print JC - 7809033, pad IO - Oncol Nurs Forum SB - Index Medicus SB - Nursing Journal CP - United States MH - Adult MH - Aged MH - Aged, 80 and over MH - Breast Neoplasms/pa [Pathology] MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/th [Therapy] MH - Choice Behavior MH - Combined Modality Therapy MH - Decision Theory MH - Female MH - Humans MH - *Mastectomy, Modified Radical/px [Psychology] MH - *Mastectomy, Segmental/px [Psychology] MH - Memory MH - Middle Aged MH - Neoplasm Staging MH - *Patient Education as Topic MH - *Patient Participation MH - Retrospective Studies AB - In recent years, patients have become more involved in the clinical decision-making process, yet the nature of this process, including the role of information, is poorly understood. The purpose of this exploratory study was to examine the relationship between information about breast cancer treatment alternatives and patients' choices of treatments. The target population was all patients with breast cancer in the process of deciding between breast conservation (lumpectomy plus irradiation) and more traditional management (modified radical mastectomy, with or without reconstruction). A convenience sample of 71 female patients with stage I or II breast cancer was drawn from a breast clinic affiliated with a 1,000-bed tertiary medical center. The amount of information provided to each subject and the nature of its presentation were recorded using an observer checklist. Recall of information and final treatment selection were ascertained during telephone interviews conducted six to eight weeks after surgery. The results indicate that subjects' choice of treatment was unrelated to the amount of information they received during the clinic visit. Manner of presentation also did not influence treatment selection. However, treatment selection was related to the amount of information subjects received prior to their clinic visit (p < 0.01). The results also indicate that patients' recall of information about treatments and associated risks is exceedingly poor. Clinical and legal implications are discussed and recommendations for further research are offered in this article. IS - 0190-535X IL - 0190-535X PT - Journal Article ID - 8321703 [pubmed] PP - ppublish LG - English DP - 1993 May DC - 19930803 EZ - 1993/05/01 00:00 DA - 1993/05/01 00:01 DT - 1993/05/01 YR - 1993 ED - 19930803 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=8321703 <565. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 1454382 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Wilder-Smith CH AU - Schuler L FA - Wilder-Smith, C H FA - Schuler, L IN - Wilder-Smith, C H. Department of Medicine, Inselspital, University of Berne, Switzerland. TI - Postoperative analgesia: pain by choice? The influence of patient attitudes and patient education. SO - Pain. 50(3):257-62, 1992 Sep AS - Pain. 50(3):257-62, 1992 Sep NJ - Pain PI - Journal available in: Print PI - Citation processed from: Print JC - opf, 7508686 IO - Pain SB - Index Medicus CP - United States MH - Adult MH - *Analgesia MH - *Attitude to Health MH - Choice Behavior MH - Curettage MH - Female MH - Humans MH - Hysterectomy MH - Laparoscopy MH - Mastectomy MH - Middle Aged MH - *Pain, Postoperative MH - *Patient Education as Topic MH - *Patients MH - *Postoperative Care MH - Prospective Studies AB - Postoperative pain control can be unsatisfactory for a variety of reasons, including patients' attitudes towards pain treatment itself. To assess patients' expectations and their influence on postoperative analgesia, as well as the prevalence of pain following common gynaecological surgery, a prospective study was performed in 166 patients with either abdominal hysterectomy, mastectomy, laparoscopy or uterine curettage. After a first postoperative period with routine on-demand analgesia, a nurse specialised in pain treatment discussed the purposes and risks of pain treatment with the patients and cared for these patients in the second, subsequent study period. Following this discussion, 30 of 40 patients refusing analgesics in the first study period agreed to be given pain medication. In the groups with hysterectomy or mastectomy, pain control improved in the second postoperative period, even though the doses of analgesics administered were generally lower. Education of patients regarding the aims and risks of pain therapy is an essential part of pain control and can lead to an improvement of postoperative analgesia. IS - 0304-3959 IL - 0304-3959 DI - 0304-3959(92)90029-B PT - Journal Article ID - 1454382 [pubmed] ID - 0304-3959(92)90029-B [pii] PP - ppublish LG - English DP - 1992 Sep DC - 19930106 EZ - 1992/09/01 00:00 DA - 1992/09/01 00:01 DT - 1992/09/01 YR - 1992 ED - 19930106 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=1454382 <566. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 1444204 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Eskelinen M AU - Hippelainen M AU - Carlsson L AU - Jonsson P AU - Alhava E FA - Eskelinen, M FA - Hippelainen, M FA - Carlsson, L FA - Jonsson, P FA - Alhava, E IN - Eskelinen, M. Department of Surgery, University of Kuopio, Finland. TI - A decision support system for predicting a recurrence of breast cancer; a prospective study of serum tumour markers TAG 12, CA 15-3 and MCA. SO - Anticancer Research. 12(5):1439-42, 1992 Sep-Oct AS - Anticancer Res. 12(5):1439-42, 1992 Sep-Oct NJ - Anticancer research PI - Journal available in: Print PI - Citation processed from: Print JC - 59l, 8102988 IO - Anticancer Res. SB - Index Medicus CP - Greece MH - *Antigens, Neoplasm/bl [Blood] MH - *Antigens, Tumor-Associated, Carbohydrate/bl [Blood] MH - *Biomarkers, Tumor/bl [Blood] MH - *Breast Neoplasms/bl [Blood] MH - Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - Female MH - Humans MH - Lymphatic Metastasis MH - Mastectomy MH - Mastectomy, Segmental MH - Middle Aged MH - Neoplasm Metastasis MH - Prognosis MH - Prospective Studies MH - Recurrence AB - The aim of the present study was to evaluate the clinical value of the preoperative serum tumour markers TAG 12, CA 15-3 and MCA in predicting a recurrence of breast cancer patients. The sensitivity of the TAG 12 test was 54%, that of the CA 15-3 test 15% and that of the MCA test 15% in predicting a recurrence of breast cancer. The most important predictor of breast cancer recurrence was TAG 12. In order to evaluate the contributions of different tumour marker serum test, a stepwise discriminant analysis was carried out. The discriminant function (DF) is DF = TAG 12 x 0.061 - CA 15-3 x 0.1336 - 0.396. The sensitivity of the DF in detecting recurrence of breast cancer was 63% with a specificity of 90% and an efficiency of 75%. In conclusion, the results indicate that a new tumour marker TAG 12 is superior to CA 15-3 and MCA in predicting breast cancer recurrence. In this study the discriminant function including TAG 12 and CA 15-3 was superior to single preoperative tumour marker tests. The results speak for the use of a decision support system to aid in predicting a recurrence of breast cancer. RN - 0 (Antigens, Neoplasm) RN - 0 (Antigens, Tumor-Associated, Carbohydrate) RN - 0 (Biomarkers, Tumor) RN - 0 (TAG 12) RN - 0 (mucinous carcinoma-associated antigen) IS - 0250-7005 IL - 0250-7005 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 1444204 [pubmed] PP - ppublish LG - English DP - 1992 Sep-Oct DC - 19921216 EZ - 1992/09/01 00:00 DA - 1992/09/01 00:01 DT - 1992/09/01 YR - 1992 ED - 19921216 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=1444204 <567. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 1835623 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Verhoef LC AU - Stalpers LJ AU - Verbeek AL AU - Wobbes T AU - van Daal WA FA - Verhoef, L C FA - Stalpers, L J FA - Verbeek, A L FA - Wobbes, T FA - van Daal, W A IN - Verhoef, L C. Institute for Radiotherapy, Radboud University Hospital, Nijmegen, The Netherlands. TI - Breast-conserving treatment or mastectomy in early breast cancer: a clinical decision analysis with special reference to the risk of local recurrence. SO - European Journal of Cancer. 27(9):1132-7, 1991 AS - Eur J Cancer. 27(9):1132-7, 1991 NJ - European journal of cancer (Oxford, England : 1990) PI - Journal available in: Print PI - Citation processed from: Print JC - arv, 9005373 IO - Eur. J. Cancer SB - Index Medicus CP - England MH - Adult MH - Age Factors MH - Aged MH - Breast/su [Surgery] MH - *Breast Neoplasms/mo [Mortality] MH - Breast Neoplasms/su [Surgery] MH - *Decision Support Techniques MH - Female MH - Humans MH - Mastectomy/mt [Methods] MH - *Mastectomy/mo [Mortality] MH - Middle Aged MH - *Neoplasm Recurrence, Local/mo [Mortality] MH - Postoperative Period MH - Prognosis MH - Quality of Life MH - Risk Factors MH - Sensitivity and Specificity AB - A clinical decision analysis was performed to judge the impact of local recurrences after breast-conserving treatment (BCT) on the (quality-adjusted) life expectancy of breast cancer patients. A life-long follow-up of two patient groups, one of which had undergone mastectomy and one BCT, was simulated by a Markov model of medical prognosis. Data used in the model originated from the literature. Since results in the source papers were not split according to stage, we performed two analyses: one with data from all source studies (T1 and T2) and one with data from source studies, concerning only T1 patients. In both analyses, the conclusion was that BCT yields better quality-adjusted life expectancy than mastectomy. Sensitivity analysis, however, identified subgroups of patients who should preferably undergo mastectomy. These subgroups are: patients preferring mastectomy to BCT, patients with a high risk of local recurrence, young patients and patients at high age, if they also have a high local recurrence risk. For these groups, patient preferences should play a major role in recommending treatment. IS - 0959-8049 IL - 0959-8049 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 1835623 [pubmed] PP - ppublish LG - English DP - 1991 DC - 19920109 EZ - 1991/01/01 00:00 DA - 1991/01/01 00:01 DT - 1991/01/01 YR - 1991 ED - 19920109 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=1835623 <568. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 1913500 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Brown HG FA - Brown, H G IN - Brown, H G. Jonsson Comprehensive Cancer Center, Division of Cancer Control, Los Angeles, California 90024. TI - Patient issues in breast reconstruction. [Review] [6 refs] SO - Cancer. 68(5 Suppl):1167-9, 1991 Sep 01 AS - Cancer. 68(5 Suppl):1167-9, 1991 Sep 01 NJ - Cancer PI - Journal available in: Print PI - Citation processed from: Print JC - 0374236, clz IO - Cancer SB - Core Clinical Journals (AIM) SB - Index Medicus CP - United States MH - *Breast Neoplasms/px [Psychology] MH - Breast Neoplasms/su [Surgery] MH - *Choice Behavior MH - Female MH - *Health Knowledge, Attitudes, Practice MH - Humans MH - *Mammaplasty/px [Psychology] MH - Mammaplasty/st [Standards] MH - Patient Education as Topic/mt [Methods] MH - Teaching Materials AB - Breast reconstruction is not a new idea. Techniques have been developing since the late 1800s. The state of the art is such that the knowledge of its availability and success has significant effect on the willingness of women to seek earlier diagnosis and treatment. However, reconstruction is not for everyone. This paper examines the issues about knowledge, attitudes, and practices that either result in electing for or against reconstruction. Some issues involved are financial, others have to do with cosmetic appearance, and still others involve the medical and psychological affects. Identifying and understanding the issues from the point of view of the patient is important in providing support for the patient with breast cancer. [References: 6] IS - 0008-543X IL - 0008-543X PT - Journal Article PT - Review ID - 1913500 [pubmed] PP - ppublish LG - English DP - 1991 Sep 01 DC - 19911108 EZ - 1991/09/01 00:00 DA - 1991/09/01 00:01 DT - 1991/09/01 YR - 1991 ED - 19911108 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=1913500 <569. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 2361056 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Suominen T FA - Suominen, T TI - [Women's experience of care following breast surgery]. [Finnish] OT - Rintaleikattujen naisten hoitokokemuksia. SO - Hoitotiede. 2(2):146-51, 1990 AS - Hoitotiede. 2(2):146-51, 1990 NJ - Hoitotiede PI - Journal available in: Print PI - Citation processed from: Print JC - aoy, 9104138, 9104138 IO - Hoitotiede SB - Nursing Journal CP - Finland MH - *Adaptation, Psychological MH - Adult MH - Aged MH - Consumer Behavior MH - Data Interpretation, Statistical MH - Family/px [Psychology] MH - Female MH - Humans MH - Mastectomy/nu [Nursing] MH - *Mastectomy/px [Psychology] MH - Middle Aged MH - *Self Care MH - Social Support MH - Surveys and Questionnaires AB - The purpose of this study was women's readiness and possibility of self-care after breast operation, and experiences and expectations which they had about their guidance with knowledge and skills and support during the care. A questionnaire was developed and sent to the subjects. The sample consisted of 109 women with breast cancer within the last three years. The statistical analysis of data was based on percentual distributions with correlations, cross tabulation and log-linear models. The patients described that they have good readiness to take part in their own care, but at all stages of care they got support and information insufficiently. Relatives were not supported enough. The action organised by cancer association was mainly considered positive. IS - 0786-5686 IL - 0786-5686 PT - English Abstract PT - Journal Article ID - 2361056 [pubmed] PP - ppublish LG - Finnish DP - 1990 DC - 19900806 EZ - 1990/01/01 00:00 DA - 1990/01/01 00:01 DT - 1990/01/01 YR - 1990 ED - 19900806 RD - 20151119 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=2361056 <570. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 2696036 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Cuzick J FA - Cuzick, J IN - Cuzick, J. Imperial Cancer Research Fund, Lincoln's Inn Fields, London, Great Britain. TI - Overview of adjuvant radiotherapy for breast cancer. SO - Recent Results in Cancer Research. 115:220-5, 1989 AS - Recent Results Cancer Res. 115:220-5, 1989 NJ - Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer PI - Journal available in: Print PI - Citation processed from: Print JC - r1y, 0044671 IO - Recent Results Cancer Res. SB - Index Medicus CP - Germany MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Combined Modality Therapy MH - Data Collection/st [Standards] MH - Data Interpretation, Statistical MH - Humans MH - Mastectomy MH - Meta-Analysis as Topic MH - Randomized Controlled Trials as Topic MH - Survival Rate IS - 0080-0015 IL - 0080-0015 PT - Clinical Trial PT - Journal Article PT - Randomized Controlled Trial ID - 2696036 [pubmed] PP - ppublish LG - English DP - 1989 DC - 19900320 EZ - 1989/01/01 00:00 DA - 1989/01/01 00:01 DT - 1989/01/01 YR - 1989 ED - 19900320 RD - 20150828 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=2696036 <571. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 2693454 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rolland C AU - Guidoin R AU - Marceau D AU - Ledoux R FA - Rolland, C FA - Guidoin, R FA - Marceau, D FA - Ledoux, R IN - Rolland, C. Biomaterials Unit, St-Francois d'Assise Hospital, Quebec City, Canada. TI - Nondestructive investigations on ninety-seven surgically excised mammary prostheses. SO - Journal of Biomedical Materials Research. 23(A3 Suppl):285-98, 1989 Dec AS - J Biomed Mater Res. 23(A3 Suppl):285-98, 1989 Dec NJ - Journal of biomedical materials research PI - Journal available in: Print PI - Citation processed from: Print JC - hjj, 0112726 IO - J. Biomed. Mater. Res. SB - Index Medicus CP - United States MH - Adult MH - *Biocompatible Materials MH - *Breast/su [Surgery] MH - Data Interpretation, Statistical MH - Electron Probe Microanalysis MH - Female MH - Foreign-Body Reaction/et [Etiology] MH - Foreign-Body Reaction/me [Metabolism] MH - Foreign-Body Reaction/pa [Pathology] MH - Humans MH - Medical Records MH - Microscopy, Electron, Scanning MH - Minerals/an [Analysis] MH - Prostheses and Implants/ae [Adverse Effects] MH - *Prostheses and Implants MH - Prosthesis Failure MH - *Silicones MH - Spectrophotometry, Infrared MH - Surface Properties MH - X-Ray Diffraction AB - The information contained in the medical files of 68 patients having undergone surgical excision of a total of 97 internal mammary prostheses allowed us to define a typical patient profile at time of first implantation. Age: 33 years 11 months, height: 1.59 m, weight: 51.5 kg, two children. Twenty-one percent of these patients had the operation done subsequent to a mastectomy, while 79% requested it for cosmetic reasons. The duration of implantation was less than 55 months for 76% of the prostheses received after excision. The most frequent evolutive complications were the formation of a fibrous capsule followed by silicone bleeding, as well as mineralization. Macroscopic examination of the 97 explanted prostheses provided information on their integrity (38.1% of prostheses ruptured), gel differentiation (24.7%), sticky surfaces (26.8%), surface deposits (33%), memory folds (54.6%), and Dacron fixation patches (20.6%). According to the medical files, a fibrous capsule was found in association with 69.8% of the breast implants. We received only 46 capsules. The average thickness was 1.4 mm. Mineralizations were present on 15 capsules (32.6%). Two zinc phosphates were identified, for the first time, in human body: parascholzite and hopeite. Statistical examination showed that Heyer-Schulte prostheses stayed in place for a longer time. Integrity and gel differentiation depended on the duration of the implantation. Presence of mineralization was model-related (Dow Corning prostheses were associated with deposits) and depended on the presence of fixation patches. RN - 0 (Biocompatible Materials) RN - 0 (Minerals) RN - 0 (Silicones) IS - 0021-9304 IL - 0021-9304 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 2693454 [pubmed] PP - ppublish LG - English DP - 1989 Dec DC - 19900306 EZ - 1989/12/01 00:00 DA - 1989/12/01 00:01 DT - 1989/12/01 YR - 1989 ED - 19900306 RD - 20061115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=2693454 <572. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 2590443 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rattray G FA - Rattray, G IN - Rattray, G. Radiotherapy Department King's College Hospital, London. TI - Use of CT scanning to optimise the localisation procedure for breast radiotherapy. SO - Radiography Today. 55(626):11-5, 1989 Jul AS - Radiogr Today. 55(626):11-5, 1989 Jul NJ - Radiography today PI - Journal available in: Print PI - Citation processed from: Print JC - afq, 9002036 IO - Radiogr Today SB - Index Medicus CP - England MH - Breast Neoplasms/dg [Diagnostic Imaging] MH - *Breast Neoplasms/rt [Radiotherapy] MH - Breast Neoplasms/su [Surgery] MH - Combined Modality Therapy MH - Female MH - Humans MH - Lymph Nodes/dg [Diagnostic Imaging] MH - Mammography/mt [Methods] MH - Mastectomy MH - Mastectomy, Segmental MH - Radiography, Thoracic/mt [Methods] MH - *Tomography, X-Ray Computed/mt [Methods] AB - The continually improving technology in breast screening is now allowing diagnosis of patients with early stage breast cancer who would otherwise not have presented for many years. Surgical techniques are directed to achieving the best possible cosmetic result following the surgery. Radiotherapy treatment machines are becoming more complex and sophisticated in design and capability. Why, therefore, should we not employ today's technology for the localisation process? This is a report of our experience in using CT scanning to localise the treatment volumes for breast patients over a period of one year. A comparison between marking patients by palpation and the use of CT scanning has prevented a number of patients being under-treated and has enabled the reduction of lung volume included in the treatment volume for other patients. It has also proved a valuable aid in the decision to use electron fields for mastectomy patients. Other means of localising the treatment volumes are considered in the light of our experiences. IS - 0954-8211 IL - 0954-8211 PT - Journal Article ID - 2590443 [pubmed] PP - ppublish LG - English DP - 1989 Jul DC - 19900118 EZ - 1989/07/01 00:00 DA - 1989/07/01 00:01 DT - 1989/07/01 YR - 1989 ED - 19900118 RD - 20161123 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=2590443 <573. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 2849393 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Lew WY AU - Lee WH FA - Lew, W Y FA - Lee, W H IN - Lew, W Y. Department of Histopathology, Queen Elizabeth Hospital, Woodville, South Australia. TI - Fine needle aspiration cytology: its role in the management of breast tumours. SO - Australian & New Zealand Journal of Surgery. 58(12):941-6, 1988 Dec AS - Aust N Z J Surg. 58(12):941-6, 1988 Dec NJ - The Australian and New Zealand journal of surgery PI - Journal available in: Print PI - Citation processed from: Print JC - 0373115, 9ic IO - Aust N Z J Surg SB - Index Medicus CP - Australia MH - Aged MH - *Biopsy, Needle MH - *Breast Neoplasms/pa [Pathology] MH - Breast Neoplasms/su [Surgery] MH - *Carcinoma, Intraductal, Noninfiltrating/pa [Pathology] MH - Carcinoma, Intraductal, Noninfiltrating/su [Surgery] MH - Evaluation Studies as Topic MH - False Negative Reactions MH - Female MH - Fibrocystic Breast Disease/pa [Pathology] MH - Follow-Up Studies MH - Humans MH - Mastectomy MH - Neoplasm Recurrence, Local/pa [Pathology] AB - Fine needle aspiration (FNA) cytology is a cost-effective and clinically reliable tool in the management of breast tumours. This report summarizes the experience with 364 patients who had FNA of the breast. There was a total of 115 cancers of which 108 (93.9%) were diagnosed on FNA. There were no false positives amongst aspirates diagnosed as 'malignant'. Thirty-one patients had mastectomy with prior frozen section and nine had advanced or recurrent disease with no biopsy confirmation. FNA was 'suspicious of malignancy' in 12 patients of which 10 were malignant and two were benign on histology. There were 216 patients with 'benign' FNA and 28 FNA were 'unsatisfactory'. Biopsy confirmation was recommended in all clinically malignant or doubtful cases. Forty-one (19%) of the patients with 'benign' FNA and 13 (46%) of the 'unsatisfactory' group had excision biopsies which revealed six cancers, giving a false negative rate of 5.2%. FNA cytology gives rapid and reliable results which contribute towards planning of further management of the patient. It can replace the more painful tru-cut biopsy and reduce the need for excision biopsy and frozen section in the initial diagnosis of breast tumours. It is also an effective modality to monitor and confirm suspected recurrences. Although a negative FNA does not completely exclude malignancy, it can be used to reassure the surgeon and the patient and to support their decision not to operate. IS - 0004-8682 IL - 0004-8682 PT - Journal Article ID - 2849393 [pubmed] PP - ppublish LG - English DP - 1988 Dec DC - 19890125 EZ - 1988/12/01 00:00 DA - 1988/12/01 00:01 DT - 1988/12/01 YR - 1988 ED - 19890125 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=2849393 <574. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 3194329 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Caruthers BS FA - Caruthers, B S IN - Caruthers, B S. Department of Family Practice, University of Michigan Medical School, Ann Arbor 48109-0708. TI - Fine-needle aspiration biopsy of breast lesions. SO - Postgraduate Medicine. 84(8):46-51, 55-7, 1988 Dec AS - Postgrad Med. 84(8):46-51, 55-7, 1988 Dec NJ - Postgraduate medicine PI - Journal available in: Print PI - Citation processed from: Print JC - 0401147, pfk IO - Postgrad Med SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - Biopsy, Needle/is [Instrumentation] MH - *Biopsy, Needle/mt [Methods] MH - *Breast Neoplasms/pa [Pathology] MH - Diagnosis, Differential MH - Female MH - *Fibrocystic Breast Disease/pa [Pathology] MH - Humans MH - Mammography MH - Predictive Value of Tests AB - Fine-needle aspiration biopsy is a safe, cost-effective, and accurate technique, which has no contraindications and causes little discomfort. There is no breast lesion for which fine-needle biopsy is not appropriate. Results are available quickly to the patient and physician and aid in decision making about the necessity for excisional biopsy, mastectomy, or radiation therapy. False-negative rates may be decreased by adherence to proper technique and strict cytologic interpretation. A negative cytology report in the face of a clinically suspicious lesion mandates excisional biopsy. Fine-needle biopsy is valuable for diagnosis of breast cancer and can be easily learned and used by the clinician. Combining it with clinical examination and mammography increases the accuracy of diagnosis. IS - 0032-5481 IL - 0032-5481 PT - Journal Article ID - 3194329 [pubmed] PP - ppublish LG - English DP - 1988 Dec DC - 19890104 EZ - 1988/12/01 00:00 DA - 1988/12/01 00:01 DT - 1988/12/01 YR - 1988 ED - 19890104 RD - 20041117 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med3&AN=3194329 <575. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 2883395 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Leathem AJ AU - Brooks SA FA - Leathem, A J FA - Brooks, S A TI - Predictive value of lectin binding on breast-cancer recurrence and survival. SO - Lancet. 1(8541):1054-6, 1987 May 09 AS - Lancet. 1(8541):1054-6, 1987 May 09 NJ - Lancet (London, England) PI - Journal available in: Print PI - Citation processed from: Print JC - 2985213r, l0s, 0053266 IO - Lancet SB - Core Clinical Journals (AIM) SB - Index Medicus CP - England MH - Acetylgalactosamine/aa [Analogs & Derivatives] MH - Acetylgalactosamine/me [Metabolism] MH - Actuarial Analysis MH - Breast Neoplasms/me [Metabolism] MH - Breast Neoplasms/mo [Mortality] MH - *Breast Neoplasms/pa [Pathology] MH - Female MH - Follow-Up Studies MH - Helix (Snails) MH - *Hemagglutinins/me [Metabolism] MH - Humans MH - *Lectins/me [Metabolism] MH - Lymphatic Metastasis MH - Menopause MH - Middle Aged MH - *Neoplasm Recurrence, Local/me [Metabolism] MH - Oligosaccharides/me [Metabolism] MH - Probability MH - Prognosis MH - Retrospective Studies MH - Time Factors AB - A new approach for predicting long-term survival of breast-cancer patients is the detection of carbohydrate expression in paraffin-embedded sections of the primary tumour. The binding of a lectin (HPA), derived from the albumin gland of the Roman snail, Helix pomatia, to N-acetyl-galactosaminyl oligosaccharides appears valuable in assessing long-term prognosis. The clinical progress of 179 patients, followed-up for 15-20 years, was related to staining of paraffin sections of their primary breast cancers by HPA. All patients had had mastectomy but were not stratified by pathology or treatment. There were significant differences, in premenopausal patients, between groups with and without HPA staining in both time to first recurrence and survival time. HPA binding provides an extra tool for staging to aid decisions in early adjuvant treatment, with the advantage of being applicable to routinely fixed paraffin-embedded material. RN - 0 (Helix lectin) RN - 0 (Hemagglutinins) RN - 0 (Lectins) RN - 0 (Oligosaccharides) RN - KM15WK8O5T (Acetylgalactosamine) IS - 0140-6736 IL - 0140-6736 DI - S0140-6736(87)90482-X PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 2883395 [pubmed] ID - S0140-6736(87)90482-X [pii] PP - ppublish LG - English DP - 1987 May 09 DC - 19870612 EZ - 1987/05/09 00:00 DA - 1987/05/09 00:01 DT - 1987/05/09 YR - 1987 ED - 19870612 RD - 20150616 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med2&AN=2883395 <576. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 6877163 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - MEDLINE AU - Rassaby J AU - Hill D FA - Rassaby, J FA - Hill, D TI - Patients' perceptions of breast reconstruction after mastectomy. SO - Medical Journal of Australia. 2(4):173-6, 1983 Aug 20 AS - Med J Aust. 2(4):173-6, 1983 Aug 20 NJ - The Medical journal of Australia PI - Journal available in: Print PI - Citation processed from: Print JC - 0400714, m26 IO - Med. J. Aust. SB - Index Medicus CP - Australia MH - *Breast/su [Surgery] MH - Decision Making MH - Female MH - Humans MH - Mastectomy/px [Psychology] MH - *Mastectomy MH - Patient Education as Topic MH - Postoperative Complications MH - Retrospective Studies MH - *Self Concept MH - *Surgery, Plastic MH - Time Factors AB - Members of the Victorian section of Plastic and Reconstructive Surgery of the Royal Australasian College of Surgeons participated in a review of the benefits and problems associated with breast reconstruction after mastectomy from the patient's perspective. Fifty-four patients completed anonymous, open-ended questionnaires designed to elicit their frank thoughts and feelings about their breast reconstruction. The most commonly mentioned benefits and problems of reconstruction are reported. The benefits vastly outweighed any problems experienced by these women and none expressed any regret at having undergone breast reconstruction. Breast reconstruction can be a valuable aid to psychological adjustment after mastectomy. We believe that patients who may benefit from breast reconstruction should be identified and offered this option. IS - 0025-729X IL - 0025-729X PT - Comparative Study PT - Journal Article ID - 6877163 [pubmed] PP - ppublish LG - English DP - 1983 Aug 20 DC - 19830920 EZ - 1983/08/20 00:00 DA - 1983/08/20 00:01 DT - 1983/08/20 YR - 1983 ED - 19830920 RD - 20071115 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med2&AN=6877163 <577. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28289963 VI - 1 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Ivlev I AU - Hickman EN AU - McDonagh MS AU - Eden KB FA - Ivlev, Ilya FA - Hickman, Erin N FA - McDonagh, Marian S FA - Eden, Karen B IN - Ivlev, Ilya. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. ivlev@ohsu.edu. IN - Hickman, Erin N. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - McDonagh, Marian S. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - McDonagh, Marian S. Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - Eden, Karen B. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - Eden, Karen B. Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. TI - Use of patient decision aids increased younger women's reluctance to begin screening mammography: a systematic review and meta-analysis. SO - Journal of General Internal Medicine. 32(7):803-812, 2017 Jul AS - J Gen Intern Med. 32(7):803-812, 2017 Jul NJ - Journal of general internal medicine PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 8605834 IO - J Gen Intern Med CP - United States KW - breast cancer screening; decision support techniques; intention; mammography; patient decision aid; utilization of screening mammography AB - BACKGROUND: As breast cancer screening guidelines have changed recently, additional investigation is needed to understand changes in women's behavior after using breast cancer screening patient decision aids (BCS-PtDAs) and the potential effect on mammography utilization. This systematic review and meta-analysis sought to evaluate the effect of BCS-PtDAs on changes in women's intentions to undergo screening mammography and whether women deciding to begin or discontinue screening mammography displayed similar changes in screening intentions after using a BCS-PtDA. AB - METHODS: We searched Medline, Scopus, PsycINFO, CENTRAL, Health and Psychosocial Instruments, Health Technology Assessment Database, PsycARTICLES, and cited references in eligible papers for randomized controlled trials (RCTs) and observational studies, published through August 24, 2016. The proportions of women who did and not intend to undergo screening and who were uncertain about undergoing screening mammography were pooled, using risk ratios (RR) and random effects. According to the protocol, RCTs or observational studies and any language were considered eligible for systematic review if they included data about women for which shared decision making is recommended. AB - RESULTS: We ultimately included six studies with screening intention data for 2040 women. Compared to usual care, the use of BCS-PtDAs in three RCTs resulted in significantly more women deciding not to undergo screening mammography (RR 1.48 [95% CI 1.04-2.13]; P=0.03), particularly for younger (38-50 years) women (1.77 [1.34-2.34]; P<0.001). The use of BCS-PtDAs had a non-significant effect on the intentions of older women (69-89 years) to discontinue screening. AB - CONCLUSIONS: The use of BCS-PtDAs increased younger women's reluctance to undergo screening for breast cancer. The implementation of such BCS-PtDAs in clinical practice would be expected to result in a 77% increase in the number of younger women (aged 38-50) who do not intend to be screened, and as a consequence, may reduce utilization of screening mammography. AB - REGISTRATION: The protocol of this review is registered in the PROSPERO database, #CRD42016036695. ES - 1525-1497 IL - 0884-8734 DI - 10.1007/s11606-017-4027-9 DO - https://dx.doi.org/10.1007/s11606-017-4027-9 PT - Journal Article ID - 10.1007/s11606-017-4027-9 [doi] ID - 10.1007/s11606-017-4027-9 [pii] PP - ppublish PH - 2016/09/27 [received] PH - 2017/02/21 [accepted] PH - 2017/02/07 [revised] LG - English EP - 20170313 DP - 2017 Jul DC - 20170314 EZ - 2017/03/15 06:00 DA - 2017/03/16 06:00 DT - 2017/03/16 06:00 YR - 2017 RD - 20170623 UP - 20170623 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28289963 <578. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28474240 VI - 1 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Flitcroft K AU - Brennan M AU - Spillane A FA - Flitcroft, Kathy FA - Brennan, Meagan FA - Spillane, Andrew IN - Flitcroft, Kathy. Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia. kathy.flitcroft@melanoma.org.au. IN - Flitcroft, Kathy. Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia. kathy.flitcroft@melanoma.org.au. IN - Brennan, Meagan. Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia. IN - Brennan, Meagan. Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia. IN - Spillane, Andrew. Breast & Surgical Oncology at The Poche Centre, 40 Rocklands Rd, North Sydney, NSW, 2060, Australia. IN - Spillane, Andrew. Northern Clinical School, University of Sydney, Sydney, NSW, 2006, Australia. TI - Women's expectations of breast reconstruction following mastectomy for breast cancer: a systematic review. [Review] SO - Supportive Care in Cancer. 25(8):2631-2661, 2017 Aug AS - Support Care Cancer. 25(8):2631-2661, 2017 Aug NJ - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9302957, b1l IO - Support Care Cancer CP - Germany KW - Breast cancer; Breast reconstruction; Expectations; Patient-reported data; Quality of life; Survivorship AB - PURPOSE: Breast reconstruction (BR) makes an important positive contribution to the quality of life of many women who have undergone mastectomy for breast cancer. The purpose of this article is to evaluate the evidence for possible relationships between women's expectations of BR and their satisfaction with outcomes to inform and facilitate improved communication about BR options prior to initial surgery. AB - METHODS: A systematic review of the literature reporting expectations of BR published between 1 January 1994 and 6 March 2017 identified 2107 initial search results. Twenty-one publications, reporting 20 studies (2288 participants), satisfied the selection criteria. Information on study aim and time frame, participation rate, design/methods, limitations/bias, results and conclusions, as well as participant clinical and demographic information, was reported. An overall quality score was generated for each study. AB - RESULTS: Four of five studies that quantified expectations and satisfaction found a positive relationship between the two. This may indicate a possible trend, but as 16 of the 21 included publications did not provide quantifiable data, no firm conclusions are possible. AB - CONCLUSION: Our findings have important implications for policy and practice which are applicable to medical decision-making more broadly. There is a clear need to utilise accurate and consistent measures of patient-reported expectations and to educate both patients and health practitioners about the importance of informed discussion about treatment options. This is particularly salient for women facing a choice about BR, a major breast cancer survivorship decision. Routine use of an expectations checklist in pre-operative consultations may be useful. ES - 1433-7339 IL - 0941-4355 DI - 10.1007/s00520-017-3712-x DO - https://dx.doi.org/10.1007/s00520-017-3712-x PT - Journal Article PT - Review ID - 10.1007/s00520-017-3712-x [doi] ID - 10.1007/s00520-017-3712-x [pii] PP - ppublish PH - 2016/10/10 [received] PH - 2017/04/17 [accepted] LG - English EP - 20170504 DP - 2017 Aug DC - 20170505 EZ - 2017/05/06 06:00 DA - 2017/05/06 06:00 DT - 2017/05/06 06:00 YR - 2017 RD - 20170622 UP - 20170622 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28474240 <579. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28145105 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Toledo-Chavarri A AU - Rue M AU - Codern-Bove N AU - Carles-Lavila M AU - Perestelo-Perez L AU - Perez-Lacasta MJ AU - Feijoo-Cid M AU - InforMa Study Group AI - Feijoo-Cid, M; ORCID: http://orcid.org/0000-0002-7010-373X FA - Toledo-Chavarri, A FA - Rue, M FA - Codern-Bove, N FA - Carles-Lavila, M FA - Perestelo-Perez, L FA - Perez-Lacasta, M J FA - Feijoo-Cid, M FA - InforMa Study Group IN - Toledo-Chavarri, A. Canary Islands Foundation of Health Research (FUNCANIS), Tenerife, Spain. IN - Toledo-Chavarri, A. Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain. IN - Rue, M. Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain. IN - Rue, M. Basic Medical Sciences Department, University of Lleida-IRBLLEIDA, Lleida, Spain. IN - Rue, M. Research Group in Economic Analysis and Health (GRAES, 2014 SGR 978), Rovira i Virgili University (URV), Reus, Spain. IN - Codern-Bove, N. AreaQ, Evaluation and Qualitative Research, Barcelona, Spain. IN - Codern-Bove, N. Escola Universitaria d'Infermeria i Terapia Ocupacional (EUIT), Terrassa, Universitat Autonoma de Barcelona, Barcelona, Spain. IN - Carles-Lavila, M. Research Group in Economic Analysis and Health (GRAES, 2014 SGR 978), Rovira i Virgili University (URV), Reus, Spain. IN - Carles-Lavila, M. Department of Economics and CREIP, Rovira i Virgili University (URV), Tarragona, Spain. IN - Perestelo-Perez, L. Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain. IN - Perestelo-Perez, L. Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain. IN - Perestelo-Perez, L. Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain. IN - Perez-Lacasta, M J. Research Group in Economic Analysis and Health (GRAES, 2014 SGR 978), Rovira i Virgili University (URV), Reus, Spain. IN - Perez-Lacasta, M J. Department of Economics and CREIP, Rovira i Virgili University (URV), Tarragona, Spain. IN - Feijoo-Cid, M. Department of Nursing, Faculty of Medicine, Universitat Autonoma de Barcelona, Bellaterra, Spain. IN - Feijoo-Cid, M. Researcher in Grups de Recerca d'America i Africa Llatines (GRAAL) (2014 SGR 1175), Barcelona, Spain. IN - Feijoo-Cid, M. Researcher Collaborator of the Infectious Diseases Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. IR - Cardona A IR - Codern N IR - Perestelo L IR - Garcia M IR - Vidal C IR - Buil S IR - Martinez-Alonso M IR - Ortega M IR - Pla S IR - Pons A IR - Soler J IR - Vinyals C IR - Vinyals L IR - Carles M IR - Pla R IR - Buron A IR - Castells X IR - Romero A IR - Sala M TI - A qualitative study on a decision aid for breast cancer screening: Views from women and health professionals. SO - European Journal of Cancer Care. 26(3), 2017 May AS - Eur J Cancer Care (Engl). 26(3), 2017 May NJ - European journal of cancer care PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - bzx, 9301979 IO - Eur J Cancer Care (Engl) CP - England KW - breast cancer screening; decision aid; decision-making; patients' information AB - This qualitative study evaluates a decision aid that includes the benefits and harms of breast cancer screening and analyses women's perception of the information received and healthcare professionals' perceptions of the convenience of providing it. Seven focus groups of women aged 40-69 years (n = 39) and two groups of healthcare professionals (n = 23) were conducted in Catalonia and the Canary Islands. The focus groups consisted of guided discussions regarding decision-making about breast cancer screening, and acceptability and feasibility of the decision aid. A content analysis was performed. Women positively value receiving information regarding the benefits and harms of breast cancer screening. Several women had difficulties understanding some concepts, especially those regarding overdiagnosis. Women preferred to share the decisions on screening with healthcare professionals. The professionals noted the lack of inclusion of some harms and benefits in the decision aid, and proposed improving the clarity of the statistical information. The information on overdiagnosis generates confusion among women and controversy among professionals. Faced with the new information presented by the decision aid, the majority of women prefer shared decision-making; however, its feasibility might be limited by a lack of knowledge and attitudes of rejection from healthcare professionals. AB - Copyright © 2017 John Wiley & Sons Ltd. ES - 1365-2354 IL - 0961-5423 DO - https://dx.doi.org/10.1111/ecc.12660 PT - Journal Article ID - 10.1111/ecc.12660 [doi] PP - ppublish PH - 2016/12/22 [accepted] LG - English EP - 20170201 DP - 2017 May DC - 20170201 EZ - 2017/02/02 06:00 DA - 2017/02/02 06:00 DT - 2017/02/02 06:00 YR - 2017 RD - 20170525 UP - 20170530 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28145105 <580. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28087390 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Benedict C AU - Thom B AU - Teplinsky E AU - Carleton J AU - Kelvin JF FA - Benedict, Catherine FA - Thom, Bridgette FA - Teplinsky, Eleonora FA - Carleton, Jane FA - Kelvin, Joanne F IN - Benedict, Catherine. Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY. Electronic address: cbenedict@northwell.edu. IN - Thom, Bridgette. Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY. IN - Teplinsky, Eleonora. Hofstra Northwell School of Medicine, Monter Cancer Center, New Hyde Park, NY. IN - Carleton, Jane. Hofstra Northwell School of Medicine, Monter Cancer Center, New Hyde Park, NY. IN - Kelvin, Joanne F. Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY. TI - Family-building After Breast Cancer: Considering the Effect on Adherence to Adjuvant Endocrine Therapy. SO - Clinical Breast Cancer. 17(3):165-170, 2017 Jun AS - Clin Breast Cancer. 17(3):165-170, 2017 Jun NJ - Clinical breast cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100898731 IO - Clin. Breast Cancer CP - United States KW - Adjuvant therapy; Fertility; Infertility; Tamoxifen; Young adult AB - Adherence to endocrine therapy (ET) is a longstanding problem in breast cancer (BC) survivorship care, particularly among younger women. Younger patients have reported lower ET initiation rates and greater rates of early discontinuation and are considered an "at risk" group for nonadherence. For women who hope to have children in the future, concerns about premature menopause and the implications of postponing childbearing for the 5 to 10 years of ET are widespread. Preliminary evidence suggests that prioritizing fertility, along with concerns about side effects, leads to ET noninitiation and early discontinuation. Clinical efforts to improve adherence might need to consider patients' family-building goals during the course of treatment and to appropriately counsel patients according to their priorities and family-building intentions. Educational materials about family building after cancer are still not consistently available or provided. Helping patients to access trusted informational resources and decision support tools, in conjunction with medical counseling, will promote informed decisions regarding ET adherence and pregnancy that are medically appropriate. Such shared patient-provider decision-making about ET adherence and pregnancy could help to maximize patient autonomy by incorporating their values, preferences, and priorities into decisions, using providers' medical expertise. AB - Copyright © 2016 Elsevier Inc. All rights reserved. ES - 1938-0666 IL - 1526-8209 DI - S1526-8209(16)30567-5 DO - https://dx.doi.org/10.1016/j.clbc.2016.12.002 PT - Journal Article ID - S1526-8209(16)30567-5 [pii] ID - 10.1016/j.clbc.2016.12.002 [doi] PP - ppublish PH - 2016/08/10 [received] PH - 2016/12/02 [revised] PH - 2016/12/16 [accepted] LG - English EP - 20161224 DP - 2017 Jun DC - 20170114 EZ - 2017/01/15 06:00 DA - 2017/01/15 06:00 DT - 2017/01/15 06:00 YR - 2017 RD - 20170526 UP - 20170530 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28087390 <581. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28083826 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Kostopoulos S AU - Ravazoula P AU - Asvestas P AU - Kalatzis I AU - Xenogiannopoulos G AU - Cavouras D AU - Glotsos D FA - Kostopoulos, Spiros FA - Ravazoula, Panagiota FA - Asvestas, Pantelis FA - Kalatzis, Ioannis FA - Xenogiannopoulos, George FA - Cavouras, Dionisis FA - Glotsos, Dimitris IN - Kostopoulos, Spiros. Medical Image and Signal Processing Laboratory (MEDISP), Department of Biomedical Engineering, Technological Educational Institute of Athens, Ag. Spyridonos Street, 122 10, Egaleo, Athens, Greece. IN - Ravazoula, Panagiota. Department of Pathology, University Hospital of Patras, Rio, 265 04, Patras, Greece. IN - Asvestas, Pantelis. Medical Image and Signal Processing Laboratory (MEDISP), Department of Biomedical Engineering, Technological Educational Institute of Athens, Ag. Spyridonos Street, 122 10, Egaleo, Athens, Greece. IN - Kalatzis, Ioannis. Medical Image and Signal Processing Laboratory (MEDISP), Department of Biomedical Engineering, Technological Educational Institute of Athens, Ag. Spyridonos Street, 122 10, Egaleo, Athens, Greece. IN - Xenogiannopoulos, George. Medical Image and Signal Processing Laboratory (MEDISP), Department of Biomedical Engineering, Technological Educational Institute of Athens, Ag. Spyridonos Street, 122 10, Egaleo, Athens, Greece. IN - Cavouras, Dionisis. Medical Image and Signal Processing Laboratory (MEDISP), Department of Biomedical Engineering, Technological Educational Institute of Athens, Ag. Spyridonos Street, 122 10, Egaleo, Athens, Greece. IN - Glotsos, Dimitris. Medical Image and Signal Processing Laboratory (MEDISP), Department of Biomedical Engineering, Technological Educational Institute of Athens, Ag. Spyridonos Street, 122 10, Egaleo, Athens, Greece. dimglo@teiath.gr. TI - Development of a Reference Image Collection Library for Histopathology Image Processing, Analysis and Decision Support Systems Research. SO - Journal of Digital Imaging. 30(3):287-295, 2017 Jun AS - J Digit Imaging. 30(3):287-295, 2017 Jun NJ - Journal of digital imaging PI - Journal available in: Print PI - Citation processed from: Internet JC - a19, 9100529 IO - J Digit Imaging CP - United States KW - Brain cancer; Breast cancer; Cancer; Computer-aided diagnosis; Histology image collection; Laryngeal cancer; Microscopy AB - Histopathology image processing, analysis and computer-aided diagnosis have been shown as effective assisting tools towards reliable and intra-/inter-observer invariant decisions in traditional pathology. Especially for cancer patients, decisions need to be as accurate as possible in order to increase the probability of optimal treatment planning. In this study, we propose a new image collection library (HICL-Histology Image Collection Library) comprising 3831 histological images of three different diseases, for fostering research in histopathology image processing, analysis and computer-aided diagnosis. Raw data comprised 93, 116 and 55 cases of brain, breast and laryngeal cancer respectively collected from the archives of the University Hospital of Patras, Greece. The 3831 images were generated from the most representative regions of the pathology, specified by an experienced histopathologist. The HICL Image Collection is free for access under an academic license at http://medisp.bme.teiath.gr/hicl/ . Potential exploitations of the proposed library may span over a board spectrum, such as in image processing to improve visualization, in segmentation for nuclei detection, in decision support systems for second opinion consultations, in statistical analysis for investigation of potential correlations between clinical annotations and imaging findings and, generally, in fostering research on histopathology image processing and analysis. To the best of our knowledge, the HICL constitutes the first attempt towards creation of a reference image collection library in the field of traditional histopathology, publicly and freely available to the scientific community. ES - 1618-727X IL - 0897-1889 DI - 10.1007/s10278-017-9947-8 DO - https://dx.doi.org/10.1007/s10278-017-9947-8 PT - Journal Article ID - 10.1007/s10278-017-9947-8 [doi] ID - 10.1007/s10278-017-9947-8 [pii] ID - PMC5422235 [pmc] PP - ppublish PH - 2018/06/01 [pmc-release] LG - English DP - 2017 Jun DC - 20170113 EZ - 2017/01/14 06:00 DA - 2017/01/14 06:00 DT - 2017/01/14 06:00 YR - 2017 RD - 20170523 UP - 20170524 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28083826 <582. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27650678 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Davies KR AU - Brewster AM AU - Bedrosian I AU - Parker PA AU - Crosby MA AU - Peterson SK AU - Shen Y AU - Volk RJ AU - Cantor SB FA - Davies, Kalatu R FA - Brewster, Abenaa M FA - Bedrosian, Isabelle FA - Parker, Patricia A FA - Crosby, Melissa A FA - Peterson, Susan K FA - Shen, Yu FA - Volk, Robert J FA - Cantor, Scott B IN - Davies, Kalatu R. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Unit 1444, P.O. Box 301402, Houston, TX, 77230-1402, USA. IN - Brewster, Abenaa M. Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Bedrosian, Isabelle. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Parker, Patricia A. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. IN - Crosby, Melissa A. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Peterson, Susan K. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Shen, Yu. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. IN - Volk, Robert J. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Unit 1444, P.O. Box 301402, Houston, TX, 77230-1402, USA. IN - Cantor, Scott B. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Unit 1444, P.O. Box 301402, Houston, TX, 77230-1402, USA. sbcantor@mdanderson.org. TI - Outcomes of contralateral prophylactic mastectomy in relation to familial history: a decision analysis (BRCR-D-16-00033). SO - Breast Cancer Research. 18(1):93, 2016 Sep 20 AS - Breast Cancer Res. 18(1):93, 2016 Sep 20 NJ - Breast cancer research : BCR PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 100927353, dyz IO - Breast Cancer Res. PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028980 SB - Index Medicus CP - England KW - Breast cancer; Contralateral breast cancer; Decision analysis; Prophylactic mastectomy AB - BACKGROUND: Family history of breast cancer is associated with an increased risk of contralateral breast cancer (CBC) even in the absence of mutations in the breast cancer susceptibility genes BRCA1/2. We compared quality-adjusted survival after contralateral prophylactic mastectomy (CPM) with surveillance only (no CPM) among women with breast cancer incorporating the degree of family history. AB - METHODS: We created a microsimulation model for women with first-degree, second-degree, and no family history treated for a stage I, II, or III estrogen receptor (ER)-positive or ER-negative breast cancer at the ages of 40, 50, 60, and 70. The model incorporated a 10-year posttreatment period for risk of developing CBC and/or dying of the primary cancer or CBC. For each patient profile, we used 100,000 microsimulation trials to estimate quality-adjusted life expectancy for the clinical strategies CPM and no CPM. AB - RESULTS: CPM showed minimal improvement on quality-adjusted life expectancy among women age 50-60 with no or a unilateral first-degree or second-degree family history (decreasing from 0.31 to -0.06 quality-adjusted life-years (QALYs)) and was unfavorable for most subgroups of women age 70 with stage III breast cancer regardless of degree of family history (range -0.08 to -0.02 QALYs). Sensitivity analysis showed that the highest predicted benefit of CPM assuming 95 % risk reduction in CBC was 0.57 QALYs for a 40-year-old woman with stage I breast cancer who had a first-degree relative with bilateral breast cancer. AB - CONCLUSIONS: Women age 40 with stage I breast cancer and a first-degree relative with bilateral breast cancer have a QALY benefit from CPM similar to that reported for BRCA1/2 mutation carriers. For most subgroups of women, CPM has a minimal to no effect on quality-adjusted life expectancy, irrespective of family history of breast cancer. ES - 1465-542X IL - 1465-5411 DI - 10.1186/s13058-016-0752-y DO - https://dx.doi.org/10.1186/s13058-016-0752-y PT - Journal Article ID - 10.1186/s13058-016-0752-y [doi] ID - 10.1186/s13058-016-0752-y [pii] ID - PMC5028980 [pmc] PP - epublish PH - 2016/01/21 [received] PH - 2016/08/11 [accepted] GI - No: P30 CA008748 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA016672 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20160920 DP - 2016 Sep 20 DC - 20160921 EZ - 2016/09/22 06:00 DA - 2016/09/22 06:00 DT - 2016/09/22 06:00 YR - 2016 RD - 20170510 UP - 20170511 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27650678 <583. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28243695 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Wilson A AU - Ronnekleiv-Kelly SM AU - Pawlik TM FA - Wilson, Ana FA - Ronnekleiv-Kelly, Sean M FA - Pawlik, Timothy M IN - Wilson, Ana. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. IN - Ronnekleiv-Kelly, Sean M. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. IN - Pawlik, Timothy M. Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Wexner Medical Center, The Ohio State University, 395 W. 12th Ave., Suite 670, Columbus, OH, USA. tim.pawlik@osumc.edu. TI - Regret in Surgical Decision Making: A Systematic Review of Patient and Physician Perspectives. [Review] SO - World Journal of Surgery. 41(6):1454-1465, 2017 Jun AS - World J Surg. 41(6):1454-1465, 2017 Jun NJ - World journal of surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - xo8, 7704052 IO - World J Surg CP - United States AB - OBJECTIVE: Regret is a powerful motivating factor in medical decision making among patients and surgeons. Regret can be particularly important for surgical decisions, which often carry significant risk and may have uncertain outcomes. We performed a systematic review of the literature focused on patient and physician regret in the surgical setting. AB - METHODS: A search of the English literature between 1986 and 2016 that examined patient and physician self-reported decisional regret was carried out using the MEDLINE/PubMed and Web of Science databases. Clinical studies performed in patients and physicians participating in elective surgical treatment were included. AB - RESULTS: Of 889 studies identified, 73 patient studies and 6 physician studies met inclusion criteria. Among the 73 patient studies, 57.5% examined patients with a cancer diagnosis, with breast (26.0%) and prostate (28.8%) cancers being most common. Interestingly, self-reported patient regret was relatively uncommon with an average prevalence across studies of 14.4%. Factors most often associated with regret included type of surgery, disease-specific quality of life, and shared decision making. Only 6 studies were identified that focused on physician regret; 2 pertained to surgical decision making. These studies primarily measured regret of omission and commission using hypothetical case scenarios and used the results to develop decision curve analysis tools. AB - CONCLUSION: Self-reported decisional regret was present in about 1 in 7 surgical patients. Factors associated with regret were both patient- and procedure related. While most studies focused on patient regret, little data exist on how physician regret affects shared decision making. ES - 1432-2323 IL - 0364-2313 DI - 10.1007/s00268-017-3895-9 DO - https://dx.doi.org/10.1007/s00268-017-3895-9 PT - Journal Article PT - Review ID - 10.1007/s00268-017-3895-9 [doi] ID - 10.1007/s00268-017-3895-9 [pii] PP - ppublish LG - English DP - 2017 Jun DC - 20170228 EZ - 2017/03/01 06:00 DA - 2017/03/01 06:00 DT - 2017/03/01 06:00 YR - 2017 RD - 20170509 UP - 20170510 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28243695 <584. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28402085 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Stacey D AU - Legare F AU - Lewis K AU - Barry MJ AU - Bennett CL AU - Eden KB AU - Holmes-Rovner M AU - Llewellyn-Thomas H AU - Lyddiatt A AU - Thomson R AU - Trevena L FA - Stacey, Dawn FA - Legare, France FA - Lewis, Krystina FA - Barry, Michael J FA - Bennett, Carol L FA - Eden, Karen B FA - Holmes-Rovner, Margaret FA - Llewellyn-Thomas, Hilary FA - Lyddiatt, Anne FA - Thomson, Richard FA - Trevena, Lyndal IN - Stacey, Dawn. School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada. IN - Stacey, Dawn. Centre for Practice Changing Research, Ottawa Hospital Research Institute, 501 Smyth Rd, Ottawa, ON, Canada, K1H 8L6. IN - Legare, France. Population Health and Optimal Health Practices Research Axis, CHU de Quebec Research Center, Universite Laval, 10 Rue de l'Espinay, D6-727, Quebec City, QC, Canada, G1L 3L5. IN - Lewis, Krystina. School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, ON, Canada. IN - Barry, Michael J. Informed Medical Decisions Foundation, Boston, MA, USA. IN - Bennett, Carol L. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Administrative Services Building, Room 2-013, 1053 Carling Avenue, Ottawa, ON, Canada, K1Y 4E9. IN - Eden, Karen B. Department of Medical Informatics and Clinical Epidemiology, Oregon Health Sciences University, BICC 535, 3181 S.W. Sam Jackson Park Road, Portland, Oregon, USA, 97239-3098. IN - Holmes-Rovner, Margaret. Center for Ethics and Humanities in the Life Sciences, Michigan State University College of Human Medicine, East Fee Road, 956 Fee Road Rm C203, East Lansing, Michigan, USA, 48824-1316. IN - Llewellyn-Thomas, Hilary. The Dartmouth Center for Health Policy & Clinical Practice, The Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire, USA, 03755. IN - Lyddiatt, Anne. No affiliation, 28 Greenwood Road, Ingersoll, ON, Canada, N5C 3N1. IN - Thomson, Richard. Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK, NE2 4AX. IN - Trevena, Lyndal. The University of Sydney, Room 322, Edward Ford Building (A27), Sydney, NSW, Australia, 2006. TI - Decision aids for people facing health treatment or screening decisions. [Review] SO - Cochrane Database of Systematic Reviews. 4:CD001431, 2017 Apr 12 AS - Cochrane Database Syst Rev. 4:CD001431, 2017 Apr 12 NJ - The Cochrane database of systematic reviews PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 100909747 IO - Cochrane Database Syst Rev CP - England AB - BACKGROUND: Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values. AB - OBJECTIVES: To assess the effects of decision aids in people facing treatment or screening decisions. AB - SEARCH METHODS: Updated search (2012 to April 2015) in CENTRAL; MEDLINE; Embase; PsycINFO; and grey literature; includes CINAHL to September 2008. AB - SELECTION CRITERIA: We included published randomized controlled trials comparing decision aids to usual care and/or alternative interventions. For this update, we excluded studies comparing detailed versus simple decision aids. AB - DATA COLLECTION AND ANALYSIS: Two reviewers independently screened citations for inclusion, extracted data, and assessed risk of bias. Primary outcomes, based on the International Patient Decision Aid Standards (IPDAS), were attributes related to the choice made and the decision-making process.Secondary outcomes were behavioural, health, and health system effects.We pooled results using mean differences (MDs) and risk ratios (RRs), applying a random-effects model. We conducted a subgroup analysis of studies that used the patient decision aid to prepare for the consultation and of those that used it in the consultation. We used GRADE to assess the strength of the evidence. AB - MAIN RESULTS: We included 105 studies involving 31,043 participants. This update added 18 studies and removed 28 previously included studies comparing detailed versus simple decision aids. During the 'Risk of bias' assessment, we rated two items (selective reporting and blinding of participants/personnel) as mostly unclear due to inadequate reporting. Twelve of 105 studies were at high risk of bias.With regard to the attributes of the choice made, decision aids increased participants' knowledge (MD 13.27/100; 95% confidence interval (CI) 11.32 to 15.23; 52 studies; N = 13,316; high-quality evidence), accuracy of risk perceptions (RR 2.10; 95% CI 1.66 to 2.66; 17 studies; N = 5096; moderate-quality evidence), and congruency between informed values and care choices (RR 2.06; 95% CI 1.46 to 2.91; 10 studies; N = 4626; low-quality evidence) compared to usual care.Regarding attributes related to the decision-making process and compared to usual care, decision aids decreased decisional conflict related to feeling uninformed (MD -9.28/100; 95% CI -12.20 to -6.36; 27 studies; N = 5707; high-quality evidence), indecision about personal values (MD -8.81/100; 95% CI -11.99 to -5.63; 23 studies; N = 5068; high-quality evidence), and the proportion of people who were passive in decision making (RR 0.68; 95% CI 0.55 to 0.83; 16 studies; N = 3180; moderate-quality evidence).Decision aids reduced the proportion of undecided participants and appeared to have a positive effect on patient-clinician communication. Moreover, those exposed to a decision aid were either equally or more satisfied with their decision, the decision-making process, and/or the preparation for decision making compared to usual care.Decision aids also reduced the number of people choosing major elective invasive surgery in favour of more conservative options (RR 0.86; 95% CI 0.75 to 1.00; 18 studies; N = 3844), but this reduction reached statistical significance only after removing the study on prophylactic mastectomy for breast cancer gene carriers (RR 0.84; 95% CI 0.73 to 0.97; 17 studies; N = 3108). Compared to usual care, decision aids reduced the number of people choosing prostate-specific antigen screening (RR 0.88; 95% CI 0.80 to 0.98; 10 studies; N = 3996) and increased those choosing to start new medications for diabetes (RR 1.65; 95% CI 1.06 to 2.56; 4 studies; N = 447). For other testing and screening choices, mostly there were no differences between decision aids and usual care.The median effect of decision aids on length of consultation was 2.6 minutes longer (24 versus 21; 7.5% increase). The costs of the decision aid group were lower in two studies and similar to usual care in four studies. People receiving decision aids do not appear to differ from those receiving usual care in terms of anxiety, general health outcomes, and condition-specific health outcomes. Studies did not report adverse events associated with the use of decision aids.In subgroup analysis, we compared results for decision aids used in preparation for the consultation versus during the consultation, finding similar improvements in pooled analysis for knowledge and accurate risk perception. For other outcomes, we could not conduct formal subgroup analyses because there were too few studies in each subgroup. AB - AUTHORS' CONCLUSIONS: Compared to usual care across a wide variety of decision contexts, people exposed to decision aids feel more knowledgeable, better informed, and clearer about their values, and they probably have a more active role in decision making and more accurate risk perceptions. There is growing evidence that decision aids may improve values-congruent choices. There are no adverse effects on health outcomes or satisfaction. New for this updated is evidence indicating improved knowledge and accurate risk perceptions when decision aids are used either within or in preparation for the consultation. Further research is needed on the effects on adherence with the chosen option, cost-effectiveness, and use with lower literacy populations. ES - 1469-493X IL - 1361-6137 DO - https://dx.doi.org/10.1002/14651858.CD001431.pub5 PT - Journal Article PT - Review ID - 10.1002/14651858.CD001431.pub5 [doi] PP - epublish LG - English EP - 20170412 DP - 2017 Apr 12 DC - 20170412 EZ - 2017/04/13 06:00 DA - 2017/04/13 06:00 DT - 2017/04/13 06:00 YR - 2017 RD - 20170502 UP - 20170503 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28402085 <585. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28118228 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Brandel MG AU - Reid CM AU - Parmeshwar N AU - Dobke MK AU - Gosman AA FA - Brandel, Michael G FA - Reid, Christopher M FA - Parmeshwar, Nisha FA - Dobke, Marek K FA - Gosman, Amanda A IN - Brandel, Michael G. From the Division of Plastic Surgery, Department of Surgery, UC San Diego Medical Center, San Diego, CA. TI - Efficacy of a Procedure-Specific Education Module on Informed Consent in Plastic Surgery. SO - Annals of Plastic Surgery. 78(5 Suppl 4):S225-S228, 2017 May AS - Ann Plast Surg. 78(5 Suppl 4):S225-S228, 2017 May NJ - Annals of plastic surgery PI - Journal available in: Print PI - Citation processed from: Internet JC - 5vb, 7805336 IO - Ann Plast Surg CP - United States AB - INTRODUCTION: Truly informed consent is an elusive goal, seldom attained in medical or surgical practice. Patients often do not fully understand procedures and therapies they undergo or the associated sequelae. Historically, informed consent and patient education have been limited to physician discussions, sometimes with the addition of simple visual aids. More recently, there is a growing body of decision aids available, including interactive multimedia patient educational modules that review preoperative through postoperative care, risks, benefits, alternatives, different surgical options, as well as commonly asked questions. We hypothesized that the addition of a Web-based educational tool would positively impact attainment of informed consent and satisfaction in plastic surgery patients. AB - METHODS: We performed a prospective randomized controlled study comparing patients who presented in consultation for breast reconstruction, breast reduction, and abdominoplasty. Patients received standard patient education along with a procedure-specific (study) or general patient safety (control) Web-based educational module. Informed consent was measured using a surgical-focused, modified version of the Shared Decision-making 25 index tool. Patient demographic information as well as surrogate markers of familiarity with technology were recorded preoperatively and postoperatively. Comparisons were made between study and control groups, procedure subgroups, and preoperative and postoperative time points. Demographic factors and consent variables were compared among experimental and procedure groups. AB - RESULTS: Data were collected from 65 patients preoperatively and 48 patients postoperatively. Thirty patients competed both surveys. Overall, no differences in patient characteristics or familiarity with technology were observed between experimental groups. Demographic characteristics were also similar between groups. No meaningful differences were identified in comparisons between experimental groups on either cross-sectional or longitudinal analyses. Nearly all patient responses were consistent with being well informed and satisfied with the educational process. AB - CONCLUSIONS: Overall, patients undergoing plastic surgery procedures are adequately informed and have a high degree of satisfaction regarding their patient education. The addition of a Web-based informed consent tool did not make a demonstrable difference in informed consent. ES - 1536-3708 IL - 0148-7043 DO - https://dx.doi.org/10.1097/SAP.0000000000000970 PT - Journal Article ID - 10.1097/SAP.0000000000000970 [doi] PP - ppublish LG - English DP - 2017 May DC - 20170124 EZ - 2017/01/25 06:00 DA - 2017/01/25 06:00 DT - 2017/01/25 06:00 YR - 2017 RD - 20170411 UP - 20170413 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28118228 <586. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27654108 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Yao K AU - Belkora J AU - Bedrosian I AU - Rosenberg S AU - Sisco M AU - Barrera E AU - Kyrillios A AU - Tilburt J AU - Wang C AU - Rabbitt S AU - Pesce C AU - Simovic S AU - Winchester DJ AU - Sepucha K FA - Yao, Katharine FA - Belkora, Jeff FA - Bedrosian, Isabelle FA - Rosenberg, Shoshana FA - Sisco, Mark FA - Barrera, Ermilo FA - Kyrillios, Alexandra FA - Tilburt, Jon FA - Wang, Chihsiung FA - Rabbitt, Sarah FA - Pesce, Catherine FA - Simovic, Sandra FA - Winchester, David J FA - Sepucha, Karen IN - Yao, Katharine. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. kyao@northshore.org. IN - Belkora, Jeff. University of California San Francisco School of Medicine, San Francisco, CA, USA. IN - Bedrosian, Isabelle. Department of Surgery, MD Anderson Cancer Center, Houston, TX, USA. IN - Rosenberg, Shoshana. Dana Farber Cancer Institute, Boston, MA, USA. IN - Sisco, Mark. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Barrera, Ermilo. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Kyrillios, Alexandra. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Tilburt, Jon. Mayo Clinic, Rochester, MN, USA. IN - Wang, Chihsiung. Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, IL, USA. IN - Rabbitt, Sarah. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Pesce, Catherine. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Simovic, Sandra. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Winchester, David J. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Sepucha, Karen. Massachusetts General Hospital, Health Decision Sciences Center, Boston, MA, USA. TI - Impact of an In-visit Decision Aid on Patient Knowledge about Contralateral Prophylactic Mastectomy: A Pilot Study.[Erratum appears in Ann Surg Oncol. 2017 Mar 27;:; PMID: 28349337] SO - Annals of Surgical Oncology. 24(1):91-99, 2017 Jan AS - Ann Surg Oncol. 24(1):91-99, 2017 Jan NJ - Annals of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b9r, 9420840 IO - Ann. Surg. Oncol. CP - United States AB - BACKGROUND: Studies have reported that breast cancer patients have limited understanding about the oncologic outcomes following contralateral prophylactic mastectomy (CPM). We hypothesized that an in-visit decision aid (DA) would be associated with higher patient knowledge about the anticipated short and long term outcomes of CPM. AB - METHODS: We piloted a DA which used the SCOPED: (Situation, Choices, Objectives, People, Evaluation and Decision) framework. Knowledge, dichotomized as "low" (<=3 correct) versus "high" (>=4 correct), was assessed immediately after the visit by a 5 item survey. There were 97 DA patients (response rate 62.2 %) and 114 usual care (UC) patients (response rate 71.3 %). AB - RESULTS: Patient demographic factors were similar between the two groups. Twenty-one (21.7 %) patients in the DA group underwent CPM compared with 18 (15.8 %) in the UC group (p = 0.22). Mean and median knowledge levels were significantly higher in the DA group compared with the UC group for patients of all ages, tumor stage, race, family history, anxiety levels, worry about CBC, and surgery type. Eighty-six (78.9 %) of UC versus 35 (37.9 %) DA patients had low knowledge. Of patients who underwent CPM, 15 (83.3 %) in the UC cohort versus 5 (25.0 %) of DA patients had "low" knowledge. AB - CONCLUSIONS: Knowledge was higher in the DA group. The UC group had approximately three times the number of patients of the DA group who were at risk for making a poorly informed decision to have CPM. Future studies should assess the impact of increased knowledge on overall CPM rates. ES - 1534-4681 IL - 1068-9265 DI - 10.1245/s10434-016-5556-x DO - https://dx.doi.org/10.1245/s10434-016-5556-x PT - Journal Article ID - 10.1245/s10434-016-5556-x [doi] ID - 10.1245/s10434-016-5556-x [pii] PP - ppublish PH - 2016/07/19 [received] LG - English EP - 20160921 DP - 2017 Jan DC - 20160922 EZ - 2016/09/23 06:00 DA - 2016/09/23 06:00 DT - 2016/09/23 06:00 YR - 2017 RD - 20170328 UP - 20170329 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27654108 <587. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28269836 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Coe AM AU - Ueng W AU - Vargas JM AU - David R AU - Vanegas A AU - Infante K AU - Trivedi M AU - Yi H AU - Dimond J AU - Crew KD AU - Kukafka R FA - Coe, Austin M FA - Ueng, William FA - Vargas, Jennifer M FA - David, Raven FA - Vanegas, Alejandro FA - Infante, Katherine FA - Trivedi, Meghna FA - Yi, Haeseung FA - Dimond, Jill FA - Crew, Katherine D FA - Kukafka, Rita IN - Coe, Austin M. Columbia University, New York, NY. IN - Ueng, William. Columbia University, New York, NY. IN - Vargas, Jennifer M. Columbia University, New York, NY. IN - David, Raven. Columbia University, New York, NY. IN - Vanegas, Alejandro. Columbia University, New York, NY. IN - Infante, Katherine. Columbia University, New York, NY. IN - Trivedi, Meghna. Columbia University, New York, NY. IN - Yi, Haeseung. Columbia University, New York, NY. IN - Dimond, Jill. Sassafras Tech Collective, Ann Arbor, MI. IN - Crew, Katherine D. Columbia University, New York, NY. IN - Kukafka, Rita. Columbia University, New York, NY. TI - Usability Testing of a Web-Based Decision Aid for Breast Cancer Risk Assessment Among Multi-Ethnic Women. SO - AMIA ... Annual Symposium Proceedings/AMIA Symposium. 2016:411-420, 2016 AS - AMIA Annu Symp Proc. 2016:411-420, 2016 NJ - AMIA ... Annual Symposium proceedings. AMIA Symposium PI - Journal available in: Electronic-eCollection PI - Citation processed from: Internet JC - 101209213 IO - AMIA Annu Symp Proc CP - United States AB - Chemoprevention with antiestrogens could decrease the incidence of invasive breast cancer but uptake has been low among high-risk women in the United States. We have designed a web-based patient-facing decision aid, called RealRisks, to inform high-risk women about the risks and benefits of chemoprevention and facilitate shared decision-making with their primary care provider. We conducted two rounds of usability testing to determine how subjects engaged with and understood the information in RealRisks. A total of 7 English-speaking and 4 Spanish-speaking subjects completed testing. Using surveys, think-aloud protocols, and subject recordings, we identified several themes relating to the usability of RealRisks, specifically in the content, ease of use, and navigability of the application. By conducting studies in two languages with a diverse multi-ethnic population, we were able to implement interface changes to make RealRisks accessible to users with varying health literacy and acculturation. ES - 1942-597X IL - 1559-4076 PT - Journal Article ID - PMC5333260 [pmc] PP - epublish LG - English EP - 20170210 DP - 2016 DC - 20170308 EZ - 2017/03/09 06:00 DA - 2017/03/09 06:00 DT - 2017/03/09 06:00 YR - 2016 RD - 20170312 UP - 20170314 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28269836 <588. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27981122 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Obeidat RF FA - Obeidat, Rana F IN - Obeidat, Rana F. Faculty of Nursing, Zarqa University, Zarqa, Jordan. TI - Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women. SO - Asiapacific Journal of Oncology Nursing. 2(4):257-263, 2015 Oct-Dec AS - Asia-Pac. j. oncol. nurs.. 2(4):257-263, 2015 Oct-Dec NJ - Asia-Pacific journal of oncology nursing PI - Journal available in: Print PI - Citation processed from: Print JC - 101673157 IO - Asia Pac J Oncol Nurs CP - India KW - Breast cancer; Jordanian; decision-making; early stage; emancipation; surgical treatment AB - To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers' support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system. CI - Conflicts of Interest: None declared. IS - 2347-5625 IL - 2347-5625 DI - APJON-2-257 DO - https://dx.doi.org/10.4103/2347-5625.159351 PT - Journal Article ID - 27981122 [pubmed] ID - 10.4103/2347-5625.159351 [doi] ID - APJON-2-257 [pii] ID - PMC5123509 [pmc] PP - ppublish LG - English DP - 2015 Oct-Dec DC - 20161216 EZ - 2016/12/17 06:00 DA - 2015/01/01 00:01 DT - 2015/01/01 00:00 YR - 2015 RD - 20170224 UP - 20170228 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27981122 <589. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27251058 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Schapira MM AU - Sprague BL AU - Klabunde CN AU - Tosteson AN AU - Bitton A AU - Chen JS AU - Beaber EF AU - Onega T AU - MacLean CD AU - Harris K AU - Howe K AU - Pearson L AU - Feldman S AU - Brawarsky P AU - Haas JS AU - PROSPR consortium FA - Schapira, Marilyn M FA - Sprague, Brian L FA - Klabunde, Carrie N FA - Tosteson, Anna N A FA - Bitton, Asaf FA - Chen, Jane S FA - Beaber, Elisabeth F FA - Onega, Tracy FA - MacLean, Charles D FA - Harris, Kimberly FA - Howe, Kathleen FA - Pearson, Loretta FA - Feldman, Sarah FA - Brawarsky, Phyllis FA - Haas, Jennifer S FA - PROSPR consortium IN - Schapira, Marilyn M. University of Pennsylvania and the Philadelphia VA Medical Center, 1110 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA. mschap@upenn.edu. IN - Sprague, Brian L. University of Vermont, Burlington, VT, USA. IN - Klabunde, Carrie N. Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD, USA. IN - Tosteson, Anna N A. Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA. IN - Bitton, Asaf. Harvard Medical School, Boston, MA, USA. IN - Bitton, Asaf. Brigham and Women's Hospital, Boston, MA, USA. IN - Chen, Jane S. Brigham and Women's Hospital, Boston, MA, USA. IN - Beaber, Elisabeth F. Fred Hutchinson Cancer Research Center, Seattle, WA, USA. IN - Onega, Tracy. Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA. IN - MacLean, Charles D. University of Vermont, Burlington, VT, USA. IN - Harris, Kimberly. Brigham and Women's Hospital, Boston, MA, USA. IN - Howe, Kathleen. University of Vermont, Burlington, VT, USA. IN - Pearson, Loretta. Geisel School of Medicine at Dartmouth and Norris Cotton Cancer Center, Lebanon, NH, USA. IN - Feldman, Sarah. Harvard Medical School, Boston, MA, USA. IN - Feldman, Sarah. Brigham and Women's Hospital, Boston, MA, USA. IN - Brawarsky, Phyllis. Brigham and Women's Hospital, Boston, MA, USA. IN - Haas, Jennifer S. Division of General Internal Medicine and Primary Care, Brigham and Woman's Hospital, Boston, MA, USA. TI - Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice. SO - Journal of General Internal Medicine. 31(10):1148-55, 2016 Oct AS - J Gen Intern Med. 31(10):1148-55, 2016 Oct NJ - Journal of general internal medicine PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 8605834 IO - J Gen Intern Med PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023599 SB - Index Medicus CP - United States KW - breast cancer screening; cervical cancer screening; patient-centered medical home AB - BACKGROUND: Despite substantial resources devoted to cancer screening nationally, the availability of clinical practice-based systems to support screening guidelines is not known. AB - OBJECTIVE: To characterize the prevalence and correlates of practice-based systems to support breast and cervical cancer screening, with a focus on the patient-centered medical home (PCMH). AB - DESIGN: Web and mail survey of primary care providers conducted in 2014. The survey assessed provider (gender, training) and facility (size, specialty training, physician report of National Committee for Quality Assurance (NCQA) PCMH recognition, and practice affiliation) characteristics. A hierarchical multivariate analysis clustered by clinical practice was conducted to evaluate characteristics associated with the adoption of practice-based systems and technology to support guideline-adherent screening. AB - PARTICIPANTS: Primary care physicians in family medicine, general internal medicine, and obstetrics and gynecology, and nurse practitioners or physician assistants from four clinical care networks affiliated with PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) consortium research centers. AB - MAIN MEASURES: The prevalence of routine breast cancer risk assessment, electronic health record (EHR) decision support, comparative performance reports, and panel reports of patients due for routine screening and follow-up. AB - KEY RESULTS: There were 385 participants (57.6 % of eligible). Forty-seven percent (47.0 %) of providers reported NCQA recognition as a PCMH. Less than half reported EHR decision support for breast (48.8 %) or cervical cancer (46.2 %) screening. A minority received comparative performance reports for breast (26.2 %) or cervical (19.7 %) cancer screening, automated reports of patients overdue for breast (18.7 %) or cervical (16.4 %) cancer screening, or follow-up of abnormal breast (18.1 %) or cervical (17.6 %) cancer screening tests. In multivariate analysis, reported NCQA recognition as a PCMH was associated with greater use of comparative performance reports of guideline-adherent breast (OR 3.23, 95 % CI 1.58-6.61) or cervical (OR 2.56, 95 % CI 1.32-4.96) cancer screening and automated reports of patients overdue for breast (OR 2.19, 95 % CI 1.15-41.7) or cervical (OR. 2.56, 95 % CI 1.26-5.26) cancer screening. AB - CONCLUSIONS: Providers lack systems to support breast and cervical cancer screening. Practice transformation toward a PCMH may support the adoption of systems to achieve guideline-adherent cancer screening in primary care settings. CI - The authors declare that they do not have a conflict of interest. Funders This study was conducted as part of the National Cancer Institute-funded consortium, Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) (grant numbers U54 CA163307, U54CA 163313, U54 CA163303, U01CA163304). A list of PROSPR investigators and contributing research staff is provided at: http://healthcaredelivery.cancer.gov/prospr/ ES - 1525-1497 IL - 0884-8734 DI - 10.1007/s11606-016-3726-y DO - https://dx.doi.org/10.1007/s11606-016-3726-y PT - Journal Article ID - 27251058 [pubmed] ID - 10.1007/s11606-016-3726-y [doi] ID - 10.1007/s11606-016-3726-y [pii] ID - PMC5023599 [pmc] PP - ppublish PH - 2015/12/07 [received] PH - 2016/04/22 [accepted] PH - 2016/03/25 [revised] PH - 2017/10/01 [pmc-release] GI - No: U54 CA163313 Organization: (CA) *NCI NIH HHS* Country: United States No: U54 CA163307 Organization: (CA) *NCI NIH HHS* Country: United States No: U54 CA163303 Organization: (CA) *NCI NIH HHS* Country: United States No: P30 CA023108 Organization: (CA) *NCI NIH HHS* Country: United States No: U01 CA163304 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20160601 DP - 2016 Oct DC - 20160917 EZ - 2016/06/03 06:00 DA - 2016/06/03 06:00 DT - 2016/06/03 06:00 YR - 2016 RD - 20170224 UP - 20170228 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27251058 <590. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26780376 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Manne SL AU - Topham N AU - Kirstein L AU - Virtue SM AU - Brill K AU - Devine KA AU - Gajda T AU - Frederick S AU - Darabos K AU - Sorice K FA - Manne, Sharon L FA - Topham, Neal FA - Kirstein, Laurie FA - Virtue, Shannon Myers FA - Brill, Kristin FA - Devine, Katie A FA - Gajda, Tina FA - Frederick, Sara FA - Darabos, Katie FA - Sorice, Kristen IN - Manne, Sharon L. Author Affiliations: Section of Population Science, Department of Medicine, Robert Wood Johnson Medical School, Rutgers, the Cancer Institute of New Jersey, New Brunswick (Drs Manne, Kirstein, Myers Virtue, and Devine and Mss Gajda, Frederick, and Darabos); Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania (Dr Topham); MD Anderson Cancer Center at Cooper Health Systems, Voorhees Township, New Jersey (Dr Brill); and Department of Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania (Ms Sorice). TI - Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients. SO - Cancer Nursing. 36(6):427-436, 2016 Nov/Dec AS - Cancer Nurs. 36(6):427-436, 2016 Nov/Dec NJ - Cancer nursing PI - Journal available in: Print PI - Citation processed from: Internet JC - 7805358, cnc IO - Cancer Nurs CP - United States AB - BACKGROUND: The decision to undergo breast reconstruction (BR) surgery after mastectomy is made during stressful circumstances. Many women do not feel well prepared to make this decision. AB - OBJECTIVE: Using the Ottawa Decision Support Framework, this study aims to describe women's reasons to choose or not choose BR, BR knowledge, decisional preparedness, and decisional conflict about BR. Possible demographic, medical, BR knowledge, and attitudinal correlates of decisional conflict about BR were also evaluated. AB - METHODS: Participants were 55 women with early-stage breast cancer drawn from the baseline data of a pilot randomized trial evaluating the efficacy of a BR decision support aid for breast cancer patients considering BR. AB - RESULTS: The most highly ranked reasons to choose BR were the desire for breasts to be equal in size, the desire to wake up from surgery with a breast in place, and perceived bother of a scar with no breast. The most highly ranked reasons not to choose BR were related to the surgical risks and complications. Regression analyses indicated that decisional conflict was associated with higher number of reasons not to choose BR and lower levels of decisional preparedness. AB - CONCLUSIONS: The results suggest that breast cancer patients considering BR may benefit from decisional support. AB - IMPLICATIONS FOR CLINICAL PRACTICE: Healthcare professionals may facilitate decision making by focusing on reasons for each patient's uncertainty and unaddressed concerns. All patients, even those who have consulted with a plastic surgeon and remain uncertain about their decision, may benefit from decision support from a health professional. CI - The authors have no conflicts of interest to disclose. ES - 1538-9804 IL - 0162-220X DO - https://dx.doi.org/10.1097/NCC.0000000000000320 PT - Journal Article ID - 26780376 [pubmed] ID - 10.1097/NCC.0000000000000320 [doi] ID - PMC4947023 [pmc] ID - NIHMS728274 [mid] PP - ppublish PH - 2017/11/01 [pmc-release] GI - No: R21 CA149531 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2016 Nov/Dec DC - 20160118 EZ - 2016/01/19 06:00 DA - 2016/10/26 06:00 DT - 2016/10/26 06:00 YR - 2016 RD - 20170224 UP - 20170228 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26780376 <591. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26958276 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - PubMed-not-MEDLINE AU - Yi H AU - Xiao T AU - Thomas PS AU - Aguirre AN AU - Smalletz C AU - Dimond J AU - Finkelstein J AU - Infante K AU - Trivedi M AU - David R AU - Vargas J AU - Crew KD AU - Kukafka R FA - Yi, Haeseung FA - Xiao, Tong FA - Thomas, Parijatham S FA - Aguirre, Alejandra N FA - Smalletz, Cindy FA - Dimond, Jill FA - Finkelstein, Joseph FA - Infante, Katherine FA - Trivedi, Meghna FA - David, Raven FA - Vargas, Jennifer FA - Crew, Katherine D FA - Kukafka, Rita IN - Yi, Haeseung. Columbia University, New York, NY. IN - Xiao, Tong. Columbia University, New York, NY. IN - Thomas, Parijatham S. MD Anderson Cancer Center, Houston, TX. IN - Aguirre, Alejandra N. Columbia University, New York, NY. IN - Smalletz, Cindy. Columbia University, New York, NY. IN - Dimond, Jill. Sassafras Tech Collective, Ann Arbor, MI. IN - Finkelstein, Joseph. Columbia University, New York, NY. IN - Infante, Katherine. Columbia University, New York, NY. IN - Trivedi, Meghna. Columbia University, New York, NY. IN - David, Raven. Columbia University, New York, NY. IN - Vargas, Jennifer. Columbia University, New York, NY. IN - Crew, Katherine D. Columbia University, New York, NY. IN - Kukafka, Rita. Columbia University, New York, NY. TI - Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools. SO - AMIA ... Annual Symposium Proceedings/AMIA Symposium. 2015:1352-60, 2015 AS - AMIA Annu Symp Proc. 2015:1352-60, 2015 NJ - AMIA ... Annual Symposium proceedings. AMIA Symposium PI - Journal available in: Electronic-eCollection PI - Citation processed from: Internet JC - 101209213 IO - AMIA Annu Symp Proc PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765687 SB - Index Medicus CP - United States AB - The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention. ES - 1942-597X IL - 1559-4076 PT - Journal Article ID - 26958276 [pubmed] ID - PMC4765687 [pmc] PP - epublish GI - No: R01 CA177995 Organization: (CA) *NCI NIH HHS* Country: United States No: R18 HS019313 Organization: (HS) *AHRQ HHS* Country: United States LG - English EP - 20151105 DP - 2015 DC - 20160309 EZ - 2016/03/10 06:00 DA - 2015/01/01 00:01 DT - 2015/01/01 00:00 YR - 2015 RD - 20170208 UP - 20170210 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26958276 <592. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27071383 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Liang X AU - Wang Y AU - Franzblau L AU - Ma J FA - Liang, Xuebing FA - Wang, Yang FA - Franzblau, Lauren FA - Ma, Jiguang IN - Liang, Xuebing. 17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, People's Republic of China. IN - Wang, Yang. Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China. IN - Franzblau, Lauren. Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. IN - Ma, Jiguang. 17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, People's Republic of China. majiguangsurgeon@163.com. TI - Potential Safety Loophole of Fat Grafting in Breast Cancer Patients. [Review] SO - Aesthetic Plastic Surgery. 40(3):380-6, 2016 Jun AS - Aesthetic Plast Surg. 40(3):380-6, 2016 Jun NJ - Aesthetic plastic surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 2wn, 7701756 IO - Aesthetic Plast Surg SB - Index Medicus CP - United States KW - AFG; Breast cancer; Recurrence AB - UNLABELLED: Autologous fat grafting (AFG) accounts for 9.1 % of all cosmetic surgical procedures in the world. Its use has been increasing tremendously in breast reconstruction and produces satisfying outcomes. However, the lack of standard guidelines for routine screening protocols in breast cancer patients before and after AFG warrants consideration of the safety of AFG use in post-mastectomy and post-lumpectomy reconstruction. This manuscript examines AFG in breast reconstruction publications and details the complications, the mechanism of AFG, as well as the relationship between adipose stem cells (ASCs) and cancer recurrence. The ASCs transferred in AFG act as multiple potent stem cells, which can impact cancer recurrence in various ways. Both in vitro and in vivo studies show that ASCs can stimulate the recurrence of breast cancer. Based on a review of existing evidence, we provide recommendations and guidelines for AFG use in breast reconstruction to aid in clinical decision-making. Further investigations are needed to evaluate the long-term clinical safety of AFG as well as the proposed guidelines. AB - NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. ES - 1432-5241 IL - 0364-216X DI - 10.1007/s00266-016-0634-9 DO - https://dx.doi.org/10.1007/s00266-016-0634-9 PT - Journal Article PT - Review ID - 27071383 [pubmed] ID - 10.1007/s00266-016-0634-9 [doi] ID - 10.1007/s00266-016-0634-9 [pii] PP - ppublish PH - 2015/10/26 [received] PH - 2016/03/16 [accepted] LG - English EP - 20160412 DP - 2016 Jun DC - 20160518 EZ - 2016/04/14 06:00 DA - 2016/04/14 06:00 DT - 2016/04/14 06:00 YR - 2016 RD - 20170208 UP - 20170209 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27071383 <593. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28096715 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - DiPiro PJ AU - Krajewski KM AU - Giardino AA AU - Braschi-Amirfarzan M AU - Ramaiya NH FA - DiPiro, Pamela J FA - Krajewski, Katherine M FA - Giardino, Angela A FA - Braschi-Amirfarzan, Marta FA - Ramaiya, Nikhil H IN - DiPiro, Pamela J. Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. IN - Krajewski, Katherine M. Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. IN - Giardino, Angela A. Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. IN - Braschi-Amirfarzan, Marta. Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. IN - Ramaiya, Nikhil H. Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA. TI - Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting. [Review] SO - Korean Journal of Radiology. 18(1):18-27, 2017 Jan-Feb AS - Korean J Radiol. 18(1):18-27, 2017 Jan-Feb NJ - Korean journal of radiology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 100956096 IO - Korean J Radiol CP - Korea (South) KW - Precision medicine; Radiology consultation; Radiology services; Tertiary cancer center AB - The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners. ES - 2005-8330 IL - 1229-6929 DO - https://dx.doi.org/10.3348/kjr.2017.18.1.18 PT - Review PT - Journal Article ID - 28096715 [pubmed] ID - 10.3348/kjr.2017.18.1.18 [doi] ID - PMC5240488 [pmc] PP - ppublish PH - 2016/06/30 [received] PH - 2016/08/11 [accepted] LG - English EP - 20170105 DP - 2017 Jan-Feb DC - 20170118 EZ - 2017/01/19 06:00 DA - 2017/01/18 06:00 DT - 2017/01/18 06:00 YR - 2017 RD - 20170125 UP - 20170126 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=28096715 <594. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 25807575 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Song L AU - Hsu W AU - Xu J AU - van der Schaar M FA - Song, Linqi FA - Hsu, William FA - Xu, Jie FA - van der Schaar, Mihaela TI - Using Contextual Learning to Improve Diagnostic Accuracy: Application in Breast Cancer Screening. SO - IEEE Journal of Biomedical & Health Informatics. 20(3):902-914, 2016 May AS - IEEE j. biomed. health inform.. 20(3):902-914, 2016 May NJ - IEEE journal of biomedical and health informatics PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101604520 IO - IEEE J Biomed Health Inform CP - United States AB - Clinicians need to routinely make management decisions about patients who are at risk for a disease such as breast cancer. This paper presents a novel clinical decision support tool that is capable of helping physicians make diagnostic decisions. We apply this support system to improve the specificity of breast cancer screening and diagnosis. The system utilizes clinical context (e.g., demographics, medical history) to minimize the false positive rates while avoiding false negatives. An online contextual learning algorithm is used to update the diagnostic strategy presented to the physicians over time. We analytically evaluate the diagnostic performance loss of the proposed algorithm, in which the true patient distribution is not known and needs to be learned, as compared with the optimal strategy where all information is assumed known, and prove that the false positive rate of the proposed learning algorithm asymptotically converges to the optimum. In addition, our algorithm also has the important merit that it can provide individualized confidence estimates about the accuracy of the diagnosis recommendation. Moreover, the relevancy of contextual features is assessed, enabling the approach to identify specific contextual features that provide the most value of information in reducing diagnostic errors. Experiments were conducted using patient data collected at a large academic medical center. Our proposed approach outperforms the current clinical practice by 36% in terms of false positive rate given a 2% false negative rate. ES - 2168-2208 IL - 2168-2194 DO - https://dx.doi.org/10.1109/JBHI.2015.2414934 PT - Journal Article ID - 25807575 [pubmed] ID - 10.1109/JBHI.2015.2414934 [doi] PP - ppublish LG - English EP - 20150320 DP - 2016 May DC - 20150325 EZ - 2015/03/26 06:00 DA - 2015/03/26 06:00 DT - 2015/03/26 06:00 YR - 2016 RD - 20170123 UP - 20170125 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=25807575 <595. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26965020 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Klein KA AU - Watson L AU - Ash JS AU - Eden KB FA - Klein, Krystal A FA - Watson, Lindsey FA - Ash, Joan S FA - Eden, Karen B IN - Klein, Krystal A. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, USA. Electronic address: kleinkr@ohsu.edu. IN - Watson, Lindsey. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, USA. Electronic address: watsolin@ohsu.edu. IN - Ash, Joan S. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, USA. Electronic address: ash@ohsu.edu. IN - Eden, Karen B. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, USA. Electronic address: edenk@ohsu.edu. TI - Evaluation of risk communication in a mammography patient decision aid. SO - Patient Education & Counseling. 99(7):1240-8, 2016 07 AS - Patient Educ Couns. 99(7):1240-8, 2016 07 NJ - Patient education and counseling PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - pec, 8406280 IO - Patient Educ Couns PM - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022358 OI - Source: NLM. NIHMS766814 [Available on 07/01/17] SB - Nursing Journal CP - Ireland KW - Mammography; Patient decision aid; Risk communication; Women's health AB - OBJECTIVES: We characterized patients' comprehension, memory, and impressions of risk communication messages in a patient decision aid (PtDA), Mammopad, and clarified perceived importance of numeric risk information in medical decision making. AB - METHODS: Participants were 75 women in their forties with average risk factors for breast cancer. We used mixed methods, comprising a risk estimation problem administered within a pretest-posttest design, and semi-structured qualitative interviews with a subsample of 21 women. AB - RESULTS: Participants' positive predictive value estimates of screening mammography improved after using Mammopad. Although risk information was only briefly memorable, through content analysis, we identified themes describing why participants value quantitative risk information, and obstacles to understanding. We describe ways the most complicated graphic was incompletely comprehended. AB - CONCLUSIONS: Comprehension of risk information following Mammopad use could be improved. Patients valued receiving numeric statistical information, particularly in pictograph format. Obstacles to understanding risk information, including potential for confusion between statistics, should be identified and mitigated in PtDA design. AB - PRACTICE IMPLICATIONS: Using simple pictographs accompanied by text, PtDAs may enhance a shared decision-making discussion. PtDA designers and providers should be aware of benefits and limitations of graphical risk presentations. Incorporating comprehension checks could help identify and correct misapprehensions of graphically presented statistics. AB - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved. ES - 1873-5134 IL - 0738-3991 DI - S0738-3991(16)30080-5 DO - https://dx.doi.org/10.1016/j.pec.2016.02.013 PT - Journal Article PT - Research Support, Non-U.S. Gov't ID - 26965020 [pubmed] ID - S0738-3991(16)30080-5 [pii] ID - 10.1016/j.pec.2016.02.013 [doi] ID - PMC5022358 [pmc] ID - NIHMS766814 [mid] PP - ppublish PH - 2015/06/02 [received] PH - 2016/02/18 [revised] PH - 2016/02/23 [accepted] PH - 2017/07/01 [pmc-release] GI - No: T15 LM007088 Organization: (LM) *NLM NIH HHS* Country: United States LG - English EP - 20160226 DP - 2016 07 DC - 20160617 EZ - 2016/03/12 06:00 DA - 2016/03/12 06:00 DT - 2016/03/12 06:00 YR - 2016 RD - 20170113 UP - 20170116 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26965020 <596. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 26383833 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Manne SL AU - Topham N AU - D'Agostino TA AU - Myers Virtue S AU - Kirstein L AU - Brill K AU - Manning C AU - Grana G AU - Schwartz MD AU - Ohman-Strickland P FA - Manne, Sharon L FA - Topham, Neal FA - D'Agostino, Thomas A FA - Myers Virtue, Shannon FA - Kirstein, Laurie FA - Brill, Kristin FA - Manning, Cheryl FA - Grana, Generosa FA - Schwartz, Marc D FA - Ohman-Strickland, Pamela IN - Manne, Sharon L. Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. IN - Topham, Neal. Department of Surgery, Fox Chase Cancer Center, Philadelphia, PA,, USA. IN - D'Agostino, Thomas A. Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. IN - Myers Virtue, Shannon. Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. IN - Kirstein, Laurie. Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. IN - Brill, Kristin. MD Anderson Cancer Center at Cooper Health Systems, Camden, NJ, USA. IN - Manning, Cheryl. Triad Interactive, Inc, Washington, DC, USA. IN - Grana, Generosa. MD Anderson Cancer Center at Cooper Health Systems, Camden, NJ, USA. IN - Schwartz, Marc D. Lombardi Cancer Center, Washington, DC, USA. IN - Ohman-Strickland, Pamela. Department of Medicine, Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. TI - Acceptability and pilot efficacy trial of a web-based breast reconstruction decision support aid for women considering mastectomy. SO - Psycho-Oncology. 25(12):1424-1433, 2016 Dec AS - Psychooncology. 25(12):1424-1433, 2016 Dec NJ - Psycho-oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology CP - England AB - OBJECTIVE: The study aim was to test the acceptability and preliminary efficacy of a novel interactive web-based breast reconstruction decision support aid (BRAID) for newly diagnosed breast cancer patients considering mastectomy. AB - METHODS: Fifty-five women considering mastectomy were randomly assigned to receive the BRAID versus the Cancer Support Community's Frankly Speaking About Cancer: Breast Reconstruction pamphlet. Participants completed measures of breast reconstruction (BR) knowledge, preparation to make a decision, decisional conflict, anxiety, and BR intentions before randomization and 2 weeks later. AB - RESULTS: In terms of acceptability, enrollment into the study was satisfactory, but the rate of return for follow-up surveys was lower among BRAID participants than pamphlet participants. Both interventions were evaluated favorably in terms of their value in facilitating the BR decision, and the majority of participants completing the follow-up reported viewing the materials. In terms of preliminary efficacy, both interventions resulted in significant increases in BR knowledge and completeness and satisfaction with preparation to make a BR decision, and both interventions resulted in a significant reduction in decision conflict. However, there were no differences between interventions. AB - CONCLUSION: A widely available free pamphlet and a web-based customized decision aid were highly utilized. The pamphlet was as effective in educating women about BR and prepared women equally as well to make the BR decision as compared with a more costly, customized web-based decision support aid. Copyright © 2015 John Wiley & Sons, Ltd. AB - Copyright © 2015 John Wiley & Sons, Ltd. ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.3984 PT - Journal Article ID - 26383833 [pubmed] ID - 10.1002/pon.3984 [doi] PP - ppublish PH - 2015/02/17 [received] PH - 2015/07/10 [revised] PH - 2015/08/21 [accepted] GI - No: R21 CA149531 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20150918 DP - 2016 Dec DC - 20150918 EZ - 2015/09/19 06:00 DA - 2015/09/19 06:00 DT - 2015/09/19 06:00 YR - 2016 RD - 20170106 UP - 20170109 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=26383833 <597. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27215718 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Process AU - Schmidt H AU - Cohen A AU - Mandeli J AU - Weltz C AU - Port ER FA - Schmidt, Hank FA - Cohen, Almog FA - Mandeli, John FA - Weltz, Christina FA - Port, Elisa R IN - Schmidt, Hank. Department of Surgery, Dubin Breast Center/Mount Sinai Medical Center, New York, New York, USA. TI - Decision-Making in Breast Cancer Surgery: Where Do Patients Go for Information?. SO - American Surgeon. 82(5):397-402, 2016 May AS - Am Surg. 82(5):397-402, 2016 May NJ - The American surgeon PI - Journal available in: Print PI - Citation processed from: Internet JC - 43e, 0370522 IO - Am Surg SB - Index Medicus CP - United States AB - Patient decision-making regarding breast cancer surgery is multifactorial, and patients derive information on surgical treatment options from a variety of sources which may have an impact on choice of surgery. We investigated the role of different information sources in patient decision-making regarding breast cancer surgery. Two hundred and sixty-eight patients with breast cancer, eligible for breast-conserving therapy were surveyed in the immediate preoperative period, and clinical data were also collected. This survey evaluated the scope and features of patient-driven research regarding their ultimate choice of surgical treatment. The two most common sources of information used by patients were written material from surgeons (199/268-74%) and the Internet (184/268-69%). There was a trend for women who chose bilateral mastectomy to use the Internet more frequently than those choosing unilateral mastectomy (P = 0.056). Number of surgeons consulted, genetic testing, and MRI were significant predictors of patient choice of mastectomy over breast-conserving therapy. Multivariate analysis showed that the number of surgeons consulted (P < 0.001) and genetic testing (P < 0.001) were independent predictors of choosing mastectomy, whereas MRI was not. In conclusions, understanding factors driving patient decision-making may promote more effective education for patients requiring breast cancer surgery. ES - 1555-9823 IL - 0003-1348 PT - Journal Article ID - 27215718 [pubmed] PP - ppublish LG - English DP - 2016 May DC - 20160524 EZ - 2016/05/25 06:00 DA - 2016/05/25 06:00 DT - 2016/05/25 06:00 YR - 2016 RD - 20161219 UP - 20161222 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27215718 <598. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27052646 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Sabel MS AU - Dal Cin S FA - Sabel, Michael S FA - Dal Cin, Sonya IN - Sabel, Michael S. Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA. msabel@umich.edu. IN - Dal Cin, Sonya. Department of Communication Studies, University of Michigan, Ann Arbor, MI, USA. TI - Trends in Media Reports of Celebrities' Breast Cancer Treatment Decisions.[Erratum appears in Ann Surg Oncol. 2016 Dec 13;:; PMID: 27966182] SO - Annals of Surgical Oncology. 23(9):2795-801, 2016 Sep AS - Ann Surg Oncol. 23(9):2795-801, 2016 Sep NJ - Annals of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States AB - BACKGROUND: Although the increasing use of bilateral mastectomies is multifaceted, one source of influence may be the media, including coverage of celebrity breast cancer treatment. We examined trends in media reporting that might impact decision making among women with breast cancer. AB - METHODS: We performed searches of two comprehensive online databases for articles from major U.S. print publications mentioning celebrities and terms related to the word "breast" and terms related to cancer treatment. Automated analysis using custom-created dictionaries was used to determine word frequencies over time. An analysis of net media tone was conducted using Lexicoder Sentiment Dictionaries. AB - RESULTS: Celebrity breast cancer media reports significantly increased since 2004 (p < .05). Dramatic increases in bilateral mastectomy articles occurred in 2008-2009, with an increase in net positive tone. The surgical treatment was significantly more likely to be mentioned when a celebrity had bilateral mastectomies than unilateral mastectomy or breast conservation (44.8 vs 26.1 %, p < .001). The majority (60 %) of articles on celebrities undergoing bilateral mastectomy for cancer had no mention of genetics, family history, or risk. AB - CONCLUSIONS: Media reports of celebrity breast cancer present a bias toward bilateral mastectomies in both frequency and tone. This may sway public opinion, particularly when factors such as risk and genetics are excluded. Surgeons need to work with the media to improve cancer reporting and identify methods to better educate patients prior to surgical consultations. ES - 1534-4681 IL - 1068-9265 DI - 10.1245/s10434-016-5202-7 DO - https://dx.doi.org/10.1245/s10434-016-5202-7 PT - Journal Article ID - 27052646 [pubmed] ID - 10.1245/s10434-016-5202-7 [doi] ID - 10.1245/s10434-016-5202-7 [pii] PP - ppublish PH - 2015/12/20 [received] LG - English EP - 20160406 DP - 2016 Sep DC - 20160804 EZ - 2016/04/08 06:00 DA - 2016/04/08 06:00 DT - 2016/04/08 06:00 YR - 2016 RD - 20161214 UP - 20161222 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27052646 <599. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27803595 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Pataky RE AU - Baliski CR FA - Pataky, R E FA - Baliski, C R IN - Pataky, R E. Canadian Centre for Applied Research in Cancer Control, BC Cancer Agency, Vancouver. IN - Baliski, C R. Surgical Oncology, Sindi Ahluwalia Hawkins Centre for the Southern Interior, BC Cancer Agency, Kelowna, University of British Columbia, Vancouver, BC; Department of Surgery, University of British Columbia, Vancouver, BC. TI - Reoperation costs in attempted breast-conserving surgery: a decision analysis. SO - Current Oncology. 23(5):314-321, 2016 Oct AS - Curr. oncol.. 23(5):314-321, 2016 Oct NJ - Current oncology (Toronto, Ont.) PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - 9502503 IO - Curr Oncol CP - Canada KW - Breast cancer; breast-conserving surgery; costs; mastectomy; quality of care AB - BACKGROUND: Breast-conserving surgery (bcs) is the preferred surgical approach for most patients with early-stage breast cancer. Frequently, concerns arise about the pathologic margin status, resulting in an average reoperation rate of 23% in Canada. No consensus has been reached about the ideal reoperation rate, although 10% has been suggested as a target. Upon undergoing reoperation, many patients choose mastectomy and breast reconstruction, which add to the morbidity and cost of patient care. We attempted to identify the cost of reoperation after bcs, and the effect that a reduction in the reoperation rate could have on the B.C. health care system. AB - METHODS: A decision tree was constructed to estimate the average cost per patient undergoing initial bcs with two reoperation frequency scenarios: 23% and 10%. The model included the direct medical costs from the perspective of the B.C. health care system for the most common surgical treatment options, including breast reconstruction and postoperative radiation therapy. AB - RESULTS: Costs ranged from a low of $8,225 per patient with definitive bcs [95% confidence interval (ci): $8,061 to $8,383] to a high of $26,026 for reoperation with mastectomy and delayed reconstruction (95% ci: $23,991 to $28,122). If the reoperation rate could be reduced to 10%, the average saving would be $1,055 per patient undergoing attempted bcs (95% ci: $959 to $1,156). If the lower rate were to be achieved in British Columbia, it would translate into a savings of $1.9 million annually. AB - SUMMARY: The implementation of initiatives to reduce reoperation after bcs could result in significant savings to the health care system, while potentially improving the quality of patient care. IS - 1198-0052 IL - 1198-0052 DI - conc-23-314 DO - https://dx.doi.org/10.3747/co.23.2989 PT - Journal Article ID - 27803595 [pubmed] ID - 10.3747/co.23.2989 [doi] ID - conc-23-314 [pii] ID - PMC5081007 [pmc] PP - ppublish LG - English EP - 20161025 DP - 2016 Oct DC - 20161102 EZ - 2016/11/03 06:00 DA - 2016/11/03 06:00 DT - 2016/11/03 06:00 YR - 2016 RD - 20161104 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27803595 <600. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27464606 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Margenthaler JA AU - Ollila DW FA - Margenthaler, Julie A FA - Ollila, David W IN - Margenthaler, Julie A. Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. margenthalerj@wudosis.wustl.edu. IN - Ollila, David W. Department of Surgery, University of North Carolina, Chapel Hill, NC, USA. TI - Breast Conservation Therapy Versus Mastectomy: Shared Decision-Making Strategies and Overcoming Decisional Conflicts in Your Patients. SO - Annals of Surgical Oncology. 23(10):3133-7, 2016 Oct AS - Ann Surg Oncol. 23(10):3133-7, 2016 Oct NJ - Annals of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b9r, 9420840 IO - Ann. Surg. Oncol. SB - Index Medicus CP - United States AB - Although breast-conserving therapy is considered the preferred treatment for the majority of women with early-stage breast cancer, mastectomy rates in this group remain high. The patient, physician, and systems factors contributing to a decision for mastectomy are complicated. Understanding the individual patient's values and goals when making this decision is paramount to providing a shared decision-making process that will yield the desired outcome. The cornerstones of this discussion include education of the patient, access to decision-aid tools, and time to make an informed decision. However, it is also paramount for the physician to understand that a significant majority of women with an informed and complete understanding of their surgical choices will still prefer mastectomy. The rates of breast conservation versus mastectomy should not be considered a quality measure alone. Rather, the extent by which patients are informed, involved in decision-making, and undergoing treatments that reflect their goals is the true test of quality. Here we explore some of the factors that impact the patient preference for breast conservation versus mastectomy and how shared decision-making can be maximized for patient satisfaction. ES - 1534-4681 IL - 1068-9265 DI - 10.1245/s10434-016-5369-y DO - https://dx.doi.org/10.1245/s10434-016-5369-y PT - Journal Article ID - 27464606 [pubmed] ID - 10.1245/s10434-016-5369-y [doi] ID - 10.1245/s10434-016-5369-y [pii] PP - ppublish PH - 2016/05/09 [received] LG - English EP - 20160727 DP - 2016 Oct DC - 20160826 EZ - 2016/07/29 06:00 DA - 2016/07/29 06:00 DT - 2016/07/29 06:00 YR - 2016 RD - 20160826 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27464606 <601. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27278271 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Balneaves LG AU - Panagiotoglou D AU - Brazier AS AU - Lambert LK AU - Porcino A AU - Forbes M AU - Van Patten C AU - Truant TL AU - Seely D AU - Stacey D FA - Balneaves, Lynda G FA - Panagiotoglou, Dimitra FA - Brazier, Alison S A FA - Lambert, Leah K FA - Porcino, Antony FA - Forbes, Margaret FA - Van Patten, Cheri FA - Truant, Tracy L O FA - Seely, Dugald FA - Stacey, Dawn IN - Balneaves, Lynda G. Centre for Integrative Medicine, Leslie Dan Faculty of Pharmacy, 144 College St., Room 737, Toronto, ON, M5S 3M2, Canada. lynda.balneaves@utoronto.ca. IN - Balneaves, Lynda G. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. lynda.balneaves@utoronto.ca. IN - Panagiotoglou, Dimitra. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. IN - Brazier, Alison S A. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. IN - Lambert, Leah K. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. IN - Porcino, Antony. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. IN - Forbes, Margaret. Juravinski Cancer Centre, Hamilton, Ontario, Canada. IN - Van Patten, Cheri. British Columbia Cancer Agency, Vancouver, British Columbia, Canada. IN - Truant, Tracy L O. School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada. IN - Seely, Dugald. Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada. IN - Stacey, Dawn. School of Nursing, University of Ottawa, Ottawa, Ontario, Canada. TI - Qualitative assessment of information and decision support needs for managing menopausal symptoms after breast cancer. SO - Supportive Care in Cancer. 24(11):4567-75, 2016 Nov AS - Support Care Cancer. 24(11):4567-75, 2016 Nov NJ - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 9302957, b1l IO - Support Care Cancer SB - Index Medicus CP - Germany KW - Breast cancer; Complementary therapy; Decision support; Information needs; Menopause AB - PURPOSE: For breast cancer (BrCa) survivors, premature menopause can result from conventional cancer treatment. Due to limited treatment options, survivors often turn to complementary therapies (CTs), but struggle to make informed decisions. In this study, we identified BrCa survivors' CT and general information and decision-making needs related to menopausal symptoms. AB - METHODS: The needs assessment was informed by interpretive descriptive methodology. Focus groups with survivors (n = 22) and interviews with conventional (n = 12) and CT (n = 5) healthcare professionals (HCPs) were conducted at two Canadian urban cancer centers. Thematic, inductive analysis was conducted on the data. AB - RESULTS: Menopausal symptoms have significant negative impact on BrCa survivors. Close to 70 % of the sample were currently using CTs, including mind-body therapies (45.5 %), natural health products (NHPs) and dietary therapies (31.8 %), and lifestyle interventions (36.4 %). However, BrCa survivors reported inadequate access to information on the safety and efficacy of CT options. Survivors also struggled in their efforts to discuss CT with HCPs, who had limited time and information to support women in their CT decisions. Concise and credible information about CTs was required by BrCa survivors to support them in making informed and safe decisions about using CTs for menopausal symptom management. AB - CONCLUSIONS: High quality research is needed on the efficacy and safety of CTs in managing menopausal symptoms following BrCa treatment. Decision support strategies, such as patient decision aids (DAs), may help synthesize and translate evidence on CTs and promote shared decision-making between BrCa survivors and HCPs about the role of CTs in coping with menopause following cancer treatment. ES - 1433-7339 IL - 0941-4355 DI - 10.1007/s00520-016-3296-x DO - https://dx.doi.org/10.1007/s00520-016-3296-x PT - Journal Article ID - 27278271 [pubmed] ID - PMC5031723 [pmc] ID - 10.1007/s00520-016-3296-x [doi] ID - 10.1007/s00520-016-3296-x [pii] PP - ppublish PH - 2016/01/24 [received] PH - 2016/05/30 [accepted] LG - English EP - 20160608 DP - 2016 Nov DC - 20160922 EZ - 2016/06/10 06:00 DA - 2016/06/10 06:00 DT - 2016/06/10 06:00 YR - 2016 RD - 20161011 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27278271 <602. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27944909 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - In-Data-Review AU - Rouch D AU - Mayer I AU - Truica C FA - Rouch, D FA - Mayer, I FA - Truica, C IN - Rouch, D. Vanderbilt Univ, Nashville, TN; Sinai Hosp, Baltimore, MD. IN - Mayer, I. Vanderbilt Univ, Nashville, TN; Sinai Hosp, Baltimore, MD. IN - Truica, C. Vanderbilt Univ, Nashville, TN; Sinai Hosp, Baltimore, MD. TI - Barriers to chemoprevention of breast cancer with tamoxifen. SO - Journal of Clinical Oncology. 23(16_suppl):1010, 2005 Jun AS - J Clin Oncol. 23(16_suppl):1010, 2005 Jun NJ - Journal of clinical oncology : official journal of the American Society of Clinical Oncology PI - Journal available in: Print PI - Citation processed from: Internet JC - jco, 8309333 IO - J. Clin. Oncol. CP - United States AB - 1010 Background: Tamoxifen (T) is the only drug FDA approved for chemoprevention (CP) of breast cancer (BC). Over two million women in the US may have a net benefit from CP with T. OB/GYN and primary care physicians (PCP) are the most likely physicians to first encounter women at high risk for BC. There are no data on whether these physicians' communicate a woman's objective risk of BC and discuss CP with those at high risk. The goal of this study was to ascertain if OB/GYN and PCP discuss CP with women they determine to be at high risk for BC, and if they prescibe T for these women. AB - METHODS: Data were obtained via a survey sent to 152 PCP (internal medicine, medicine/pediatrics, family practice) and 101 OB/GYN physicians selected from the Nashville, TN phonebook. Information was collected about respondents' demographics, use of an objective tool to quantify BC risk, practice style regarding discussing CP with T, reasons they may not discuss CP, and if they prescribe T for high risk patients. The survey also contained two clinical vignettes regarding women at high risk for breast cancer. The responses were tallied and analyzed using decriptive statistics, and Chi sqare was used to compare responses between PCP and OB/GYN. AB - RESULTS: Sixty-three surveys were returned for a total response rate of 25%. 27/101(27%) were OB/GYN, and 36/152 (24%) were PCP. The responses to key questions are summarized in the table below. 17/36 (47%) of PCP vs 19/27 (70%) of OB/GYN were familiar with the STAR trial (p=.066), while 10/36(28%) of PCP and 9/27 (33%) of OB/GYN referred patients to CP studies. AB - CONCLUSIONS: CP of BC with T is a complex topic. While OB/GYN are more likely than PCP to objectively quantify a woman's risk for BC and discuss CP with patients, neither group is likely to prescribe T for CP. Many women who are eligible for CP or referral to CP trials may not have these options prestented to them. Efforts at patient education, either by physicans or patient decision aids, need to be explored. [Figure: see text] No significant financial relationships to disclose. ES - 1527-7755 IL - 0732-183X DI - 10.1200/jco.2005.23.16_suppl.1010 PT - Journal Article ID - 27944909 [pubmed] ID - 10.1200/jco.2005.23.16_suppl.1010 [pii] PP - ppublish LG - English DP - 2005 Jun DC - 20161212 EZ - 2016/12/13 06:00 YR - 2005 RD - 20161212 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=prem&AN=27944909 <603. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28453892 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Collins K AU - Gee M AU - Clack A AU - Wyld L AI - Collins, Karen; ORCID: http://orcid.org/0000-0002-4317-142X FA - Collins, Karen FA - Gee, Melanie FA - Clack, Anna FA - Wyld, Lynda IN - Collins, Karen. Centre for Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK. IN - Gee, Melanie. Centre for Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK. IN - Clack, Anna. Centre for Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK. IN - Wyld, Lynda. Academic Unit of Surgical Oncology, Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK. TI - The psychosocial impact of contralateral risk reducing mastectomy (CRRM) on women: A rapid review. [Review] SO - Psycho-Oncology. , 2017 Apr 28 AS - Psychooncology. , 2017 Apr 28 NJ - Psycho-oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology CP - England KW - breast; cancer; contralateral; oncology; psychosocial; rapid review AB - OBJECTIVES: For women who have been diagnosed with unilateral breast cancer, there is an increasing trend for them to request removal of the contralateral healthy breast, the so-called contralateral risk reducing mastectomy (CRRM). The current literature is only just beginning to identify patient-reported reasons for undergoing CRRM and associated patient-reported outcomes. It is also unclear whether women at moderate/high risk of developing a subsequent primary contralateral breast cancer report similar outcomes to those considered to be at low/average risk. This lack of knowledge provides the rationale for this review. AB - METHODS: A rapid review methodology was undertaken to identify and explore the published research literature focused on the longer term (>5 y) psychosocial impacts on women who undergo CRRM. AB - RESULTS: Fifteen studies were identified. No UK studies were identified. High satisfaction and psychosocial well-being were consistently reported across all studies. Reducing the risk of a subsequent contralateral breast cancer and therefore reducing cancer-related anxiety, and satisfaction with cosmesis, were key themes running across all studies explaining satisfaction. Dissatisfaction was associated with adverse effects such as poor cosmesis, body image changes, femininity, sexual relationships, reoperations for acute and longer term complications, and reconstructive problems. AB - CONCLUSIONS: Satisfaction and psychological well-being following CRRM was consistently high across all studies. However, the findings suggest women need to be more fully informed of the risks and benefits of CRRM and/or immediate/delayed reconstruction to support informed decision making. AB - Copyright © 2017 John Wiley & Sons, Ltd. ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.4448 PT - Journal Article PT - Review ID - 10.1002/pon.4448 [doi] PP - aheadofprint PH - 2017/02/27 [received] PH - 2017/04/24 [revised] PH - 2017/04/27 [accepted] LG - English EP - 20170428 DP - 2017 Apr 28 DC - 20170428 EZ - 2017/04/29 06:00 DA - 2017/04/30 06:00 DT - 2017/04/30 06:00 YR - 2017 RD - 20170531 UP - 20170601 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28453892 <604. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28467530 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Lee CN AU - Deal AM AU - Huh R AU - Ubel PA AU - Liu YJ AU - Blizard L AU - Hunt C AU - Pignone MP FA - Lee, Clara Nan-Hi FA - Deal, Allison M FA - Huh, Ruth FA - Ubel, Peter Anthony FA - Liu, Yuen-Jong FA - Blizard, Lillian FA - Hunt, Caprice FA - Pignone, Michael Patrick IN - Lee, Clara Nan-Hi. Department of Plastic Surgery, College of Medicine, The Ohio State University, Columbus2Richard J. Solove Research Institute, Comprehensive Cancer Center-Arthur G. James Cancer Hospital, The Ohio State University, Columbus3Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus. IN - Deal, Allison M. Lineberger Comprehensive Cancer Center Biostatistics Core Facility, University of North Carolina-Chapel Hill. IN - Huh, Ruth. Lineberger Comprehensive Cancer Center Biostatistics Core Facility, University of North Carolina-Chapel Hill. IN - Ubel, Peter Anthony. Duke-Margolis Center for Health Policy, Fuqua School of Business, Duke University, Durham, North Carolina6Duke-Margolis Center for Health Policy, Sanford School of Public Policy, Duke University, Durham, North Carolina7Duke-Margolis Center for Health Policy, Duke University School of Medicine, Durham, North Carolina. IN - Liu, Yuen-Jong. Department of Surgery, University of North Carolina Hospitals, University of North Carolina-Chapel Hill. IN - Blizard, Lillian. Gastrointestinal Unit, Massachusetts General Hospital, Boston. IN - Hunt, Caprice. Department of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina-Chapel Hill. IN - Pignone, Michael Patrick. Department of Internal Medicine, Dell Medical School, University of Texas at Austin12Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina. TI - Quality of Patient Decisions About Breast Reconstruction After Mastectomy. SO - JAMA Surgery. , 2017 May 03 AS - JAMA Surg. , 2017 May 03 NJ - JAMA surgery PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 101589553 IO - JAMA Surg CP - United States AB - Importance: Breast reconstruction has the potential to improve a person's body image and quality of life but has important risks. Variations in who undergoes breast reconstruction have led to questions about the quality of patient decisions. AB - Objective: To assess the quality of patient decisions about breast reconstruction. AB - Design, Setting, and Participants: A prospective, cross-sectional survey study was conducted from June 27, 2012, to February 28, 2014, at a single, academic, multidisciplinary oncology clinic among women planning to undergo mastectomy for stage I to III invasive ductal or lobular breast cancer, ductal carcinoma in situ, or prophylaxis. AB - Exposures: Mastectomy only and mastectomy with reconstruction. AB - Main Outcome and Measures: Knowledge, as ascertained using the Decision Quality Instrument; preference concordance, based on rating and ranking of key attributes; and decision quality, defined as having knowledge of 50% or more and preference concordance. AB - Results: During the 20-month period, 214 patients were eligible, 182 were approached, and 32 missed. We enrolled 145 patients (79.7% enrollment rate), and received surveys from 131 patients (72.0% participation rate). Five participants became ineligible. The final study population was 126 patients. Among the 126 women in the study (mean [SD] age, 53.2 [12.1] years), the mean (SD) knowledge score was 58.5% (16.2%) and did not differ by treatment group (mastectomy only, 55.2% [15.0%]; mastectomy with reconstruction, 60.5% [16.5%]). A total of 82 of 123 participants (66.7%) had a calculated treatment preference of mastectomy only; 39 of these women (47.6%) underwent mastectomy only. A total of 41 participants (32.5%) had a calculated treatment preference of mastectomy with reconstruction; 36 of these women (87.8%) underwent mastectomy with reconstruction. Overall, 52 of 120 participants (43.3%) made a high-quality decision. In multivariable analysis, white race/ethnicity (odds ratio [OR], 2.72; 95% CI, 1.00-7.38; P=.05), having private insurance (OR, 1.61; 95% CI, 1.35-1.93; P<.001), having a high school education or less (vs some college) (OR, 4.84; 95% CI, 1.22-19.21; P=.02), having a college degree (vs some college) (OR, 1.95; 95% CI, 1.53-2.49; P<.001), and not having a malignant neoplasm (eg, BRCA carriers) (OR, 3.13; 95% CI, 1.25-7.85; P=.01) were independently associated with making a high-quality decision. AB - Conclusions and Relevance: A minority of patients undergoing mastectomy in a single academic center made a high-quality decision about reconstruction. Shared decision making is needed to support decisions about breast reconstruction. ES - 2168-6262 IL - 2168-6254 DI - 2623723 DO - https://dx.doi.org/10.1001/jamasurg.2017.0977 PT - Journal Article ID - 2623723 [pii] ID - 10.1001/jamasurg.2017.0977 [doi] PP - aheadofprint GI - No: P50 CA058223 Organization: (CA) *NCI NIH HHS* Country: United States No: T32 CA106209 Organization: (CA) *NCI NIH HHS* Country: United States LG - English EP - 20170503 DP - 2017 May 03 DC - 20170503 EZ - 2017/05/04 06:00 DA - 2017/05/04 06:00 DT - 2017/05/04 06:00 YR - 2017 RD - 20170523 UP - 20170524 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28467530 <605. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28349337 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Yao K AU - Belkora J AU - Bedrosian I AU - Rosenberg S AU - Sisco M AU - Barrera E AU - Kyrillos A AU - Tilburt J AU - Wang C AU - Rabbitt S AU - Pesce C AU - Simovic S AU - Winchester DJ AU - Sepucha K FA - Yao, Katharine FA - Belkora, Jeff FA - Bedrosian, Isabelle FA - Rosenberg, Shoshana FA - Sisco, Mark FA - Barrera, Ermilo FA - Kyrillos, Alexandra FA - Tilburt, Jon FA - Wang, Chihsiung FA - Rabbitt, Sarah FA - Pesce, Catherine FA - Simovic, Sandra FA - Winchester, David J FA - Sepucha, Karen IN - Yao, Katharine. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. kyao@northshore.org. IN - Belkora, Jeff. University of California San Francisco School of Medicine, San Francisco, CA, USA. IN - Bedrosian, Isabelle. Department of Surgery, MD Anderson Cancer Center, Houston, TX, USA. IN - Rosenberg, Shoshana. Dana Farber Cancer Institute, Boston, MA, USA. IN - Sisco, Mark. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Barrera, Ermilo. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Kyrillos, Alexandra. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Tilburt, Jon. Mayo Clinic, Rochester, MN, USA. IN - Wang, Chihsiung. Center for Biomedical Research Informatics, NorthShore University HealthSystem, Evanston, IL, USA. IN - Rabbitt, Sarah. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Pesce, Catherine. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Simovic, Sandra. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Winchester, David J. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. IN - Sepucha, Karen. Massachusetts General Hospital, Health Decision Sciences Center, Boston, MA, USA. TI - Erratum to: Impact of an In-visit Decision Aid on Patient Knowledge about Contralateral Prophylactic Mastectomy: A Pilot Study.[Erratum for Ann Surg Oncol. 2017 Jan;24(1):91-99; PMID: 27654108] SO - Annals of Surgical Oncology. , 2017 Mar 27 AS - Ann Surg Oncol. , 2017 Mar 27 NJ - Annals of surgical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - b9r, 9420840 IO - Ann. Surg. Oncol. CP - United States ES - 1534-4681 IL - 1068-9265 DI - 10.1245/s10434-017-5850-2 DO - https://dx.doi.org/10.1245/s10434-017-5850-2 PT - Published Erratum ID - 10.1245/s10434-017-5850-2 [doi] ID - 10.1245/s10434-017-5850-2 [pii] PP - aheadofprint LG - English EP - 20170327 DP - 2017 Mar 27 DC - 20170328 EZ - 2017/03/29 06:00 DA - 2017/03/30 06:00 DT - 2017/03/30 06:00 YR - 2017 RD - 20170328 UP - 20170331 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28349337 <606. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28289963 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Ivlev I AU - Hickman EN AU - McDonagh MS AU - Eden KB FA - Ivlev, Ilya FA - Hickman, Erin N FA - McDonagh, Marian S FA - Eden, Karen B IN - Ivlev, Ilya. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. ivlev@ohsu.edu. IN - Hickman, Erin N. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - McDonagh, Marian S. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - McDonagh, Marian S. Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - Eden, Karen B. Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. IN - Eden, Karen B. Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA. TI - Use of patient decision aids increased younger women's reluctance to begin screening mammography: a systematic review and meta-analysis. SO - Journal of General Internal Medicine. , 2017 Mar 13 AS - J Gen Intern Med. , 2017 Mar 13 NJ - Journal of general internal medicine PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 8605834 IO - J Gen Intern Med CP - United States KW - breast cancer screening; decision support techniques; intention; mammography; patient decision aid; utilization of screening mammography AB - BACKGROUND: As breast cancer screening guidelines have changed recently, additional investigation is needed to understand changes in women's behavior after using breast cancer screening patient decision aids (BCS-PtDAs) and the potential effect on mammography utilization. This systematic review and meta-analysis sought to evaluate the effect of BCS-PtDAs on changes in women's intentions to undergo screening mammography and whether women deciding to begin or discontinue screening mammography displayed similar changes in screening intentions after using a BCS-PtDA. AB - METHODS: We searched Medline, Scopus, PsycINFO, CENTRAL, Health and Psychosocial Instruments, Health Technology Assessment Database, PsycARTICLES, and cited references in eligible papers for randomized controlled trials (RCTs) and observational studies, published through August 24, 2016. The proportions of women who did and not intend to undergo screening and who were uncertain about undergoing screening mammography were pooled, using risk ratios (RR) and random effects. According to the protocol, RCTs or observational studies and any language were considered eligible for systematic review if they included data about women for which shared decision making is recommended. AB - RESULTS: We ultimately included six studies with screening intention data for 2040 women. Compared to usual care, the use of BCS-PtDAs in three RCTs resulted in significantly more women deciding not to undergo screening mammography (RR 1.48 [95% CI 1.04-2.13]; P=0.03), particularly for younger (38-50 years) women (1.77 [1.34-2.34]; P<0.001). The use of BCS-PtDAs had a non-significant effect on the intentions of older women (69-89 years) to discontinue screening. AB - CONCLUSIONS: The use of BCS-PtDAs increased younger women's reluctance to undergo screening for breast cancer. The implementation of such BCS-PtDAs in clinical practice would be expected to result in a 77% increase in the number of younger women (aged 38-50) who do not intend to be screened, and as a consequence, may reduce utilization of screening mammography. AB - REGISTRATION: The protocol of this review is registered in the PROSPERO database, #CRD42016036695. ES - 1525-1497 IL - 0884-8734 DI - 10.1007/s11606-017-4027-9 DO - https://dx.doi.org/10.1007/s11606-017-4027-9 PT - Journal Article ID - 10.1007/s11606-017-4027-9 [doi] ID - 10.1007/s11606-017-4027-9 [pii] PP - aheadofprint PH - 2016/09/27 [received] PH - 2017/02/21 [accepted] PH - 2017/02/07 [revised] LG - English EP - 20170313 DP - 2017 Mar 13 DC - 20170314 EZ - 2017/03/15 06:00 DA - 2017/03/16 06:00 DT - 2017/03/16 06:00 YR - 2017 RD - 20170314 UP - 20170317 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28289963 <607. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27892670 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Lee HCh AU - Chen WY AU - Huang WN AU - Cheng KO AU - Tian YF AU - Ho ChH AU - Tsao ChO AU - Feng YN FA - Lee, Hsiu-Chuan FA - Chen, Wei-Yu FA - Huang, Wen- Tsung FA - Cheng, Kuo- Chen FA - Tian, Yu-Feng FA - Ho, Chung-Han FA - Tsao, Chao- Jung FA - Feng, Yin- Hsun IN - Lee, Hsiu-Chuan. Department of Internal Medicine, Chi-Mei Medical Center, Yong Kang, Tainan, Taiwan, Email: yinhsun.feng@gmail.com. TI - Impact of Adjuvant Chemotherapy in Elderly Breast Patients in Taiwan, A Hospital-Based Study. SO - Asian Pacific Journal of Cancer Prevention: Apjcp. 17(10):4591-4597, 2016 10 01 AS - Asian Pac J Cancer Prev. 17(10):4591-4597, 2016 10 01 NJ - Asian Pacific journal of cancer prevention : APJCP PI - Journal available in: Electronic PI - Citation processed from: Internet JC - 101130625 IO - Asian Pac. J. Cancer Prev. CP - Thailand KW - Breast cancer; adjuvant chemotherapy; elderly AB - Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age (mean=74.0+/-5.3 vs 77.5+/-5.3, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted. AB - Copyright Creative Commons Attribution License ES - 2476-762X IL - 1513-7368 PT - Journal Article PP - epublish LG - English EP - 20161001 DP - 2016 10 01 DC - 20161128 EZ - 2016/11/29 06:00 DA - 2016/11/29 06:00 DT - 2016/11/29 06:00 YR - 2016 RD - 20170308 UP - 20170310 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=27892670 <608. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 28221673 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Wong SM AU - Stout NK AU - Punglia RS AU - Prakash I AU - Sagara Y AU - Golshan M FA - Wong, Stephanie M FA - Stout, Natasha K FA - Punglia, Rinaa S FA - Prakash, Ipshita FA - Sagara, Yasuaki FA - Golshan, Mehra IN - Wong, Stephanie M. Harvard School of Public Health, Boston, Massachusetts. IN - Wong, Stephanie M. Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada. IN - Stout, Natasha K. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts. IN - Punglia, Rinaa S. Department of Radiation Oncology Brigham, and Women's Hospital/Dana-Farber Cancer Institute Harvard Medical School, Boston, Massachusetts. IN - Prakash, Ipshita. Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada. IN - Sagara, Yasuaki. Department of Breast Oncology, Sagara Hospital, Hakuaikai Medical Corporation, Kagoshima, Japan. IN - Sagara, Yasuaki. Department of Surgery, Brigham and Women's Hospital/Dana-Farber Cancer Institute Harvard Medical School, Boston, Massachusetts. IN - Golshan, Mehra. Department of Surgery, Brigham and Women's Hospital/Dana-Farber Cancer Institute Harvard Medical School, Boston, Massachusetts. TI - Breast cancer prevention strategies in lobular carcinoma in situ: A decision analysis. SO - Cancer. , 2017 Feb 21 AS - Cancer. , 2017 Feb 21 NJ - Cancer PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 0374236, clz IO - Cancer CP - United States KW - breast neoplasms; cancer outcomes; decision analysis; prognosis; survival AB - BACKGROUND: Women diagnosed with lobular carcinoma in situ (LCIS) have a 3-fold to 10-fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk-reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS. AB - METHODS: A Markov simulation model was constructed to determine average LE and quality-adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk-reduction strategies. Probabilities for invasive breast cancer, breast cancer-specific mortality, other-cause mortality and the effectiveness of preventive strategies were derived from published studies and from the National Cancer Institute's Surveillance, Epidemiology, and End Results database. AB - RESULTS: Assuming a breast cancer incidence from 1.02% to 1.37% per year under active surveillance, a woman aged 50 years diagnosed with LCIS would have a total LE of 32.78 years and would gain 0.13 years (1.6 months) in LE by adding chemoprevention and 0.25 years (3.0 months) in LE by adding bilateral prophylactic mastectomy. After quality adjustment, chemoprevention resulted in the greatest QALE for women ages 40 to 60 years at LCIS diagnosis, whereas surveillance remained the preferred strategy for optimizing QALE among women diagnosed at age 65 years and older. AB - CONCLUSIONS: In this model, among women with a diagnosis of LCIS, breast cancer prevention strategies only modestly affected overall survival, whereas chemoprevention was modeled as the preferred management strategy for optimizing invasive disease-free survival while prolonging QALE form women younger than 65 years. Cancer 2017. © 2017 American Cancer Society. AB - Copyright © 2017 American Cancer Society. ES - 1097-0142 IL - 0008-543X DO - https://dx.doi.org/10.1002/cncr.30644 PT - Journal Article ID - 28221673 [pubmed] ID - 10.1002/cncr.30644 [doi] PP - aheadofprint PH - 2016/12/03 [received] PH - 2017/01/14 [revised] PH - 2017/02/05 [accepted] LG - English EP - 20170221 DP - 2017 Feb 21 DC - 20170221 EZ - 2017/02/22 06:00 DA - 2017/02/22 06:00 DT - 2017/02/22 06:00 YR - 2017 RD - 20170221 UP - 20170222 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=28221673 <609. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27957772 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Sherman KA AU - Shaw LK AU - Jorgensen L AU - Harcourt D AU - Cameron L AU - Boyages J AU - Elder E AU - Kirk J AU - Tucker K AI - Sherman, Kerry A; ORCID: http://orcid.org/0000-0001-7780-6668 AI - Boyages, John; ORCID: http://orcid.org/0000-0003-3208-3966 FA - Sherman, Kerry A FA - Shaw, Laura-Kate FA - Jorgensen, Lone FA - Harcourt, Diana FA - Cameron, Linda FA - Boyages, John FA - Elder, Elisabeth FA - Kirk, Judy FA - Tucker, Katherine IN - Sherman, Kerry A. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. IN - Sherman, Kerry A. Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Sydney, Australia. IN - Shaw, Laura-Kate. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. IN - Jorgensen, Lone. Clinic for Surgery and Oncology & Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark. IN - Harcourt, Diana. Centre for Appearance Research, Faculty of Health & Applied Sciences, University of the West of England, Bristol, UK. IN - Cameron, Linda. Psychological Sciences, University of California, Merced, CA, USA. IN - Cameron, Linda. School of Psychology, The University of Auckland, Auckland, New Zealand. IN - Boyages, John. Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia. IN - Elder, Elisabeth. Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Sydney, Australia. IN - Kirk, Judy. Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney Medical School, University of Sydney, Sydney, Australia. IN - Kirk, Judy. Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, Australia. IN - Tucker, Katherine. Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, Australia. TI - Qualitatively understanding patients' and health professionals' experiences of the BRECONDA breast reconstruction decision aid. SO - Psycho-Oncology. , 2016 Dec 13 AS - Psychooncology. , 2016 Dec 13 NJ - Psycho-oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - cps, 9214524 IO - Psychooncology CP - England KW - BRCA; breast reconstruction; cancer; decision aid; oncology; user experience AB - OBJECTIVE: Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction. AB - METHOD: Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N = 36) and with their healthcare providers (N = 6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders. AB - RESULTS: Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey. AB - CONCLUSION: These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources. AB - Copyright © 2016 John Wiley & Sons, Ltd. ES - 1099-1611 IL - 1057-9249 DO - https://dx.doi.org/10.1002/pon.4346 DO - https://dx.doi.org/ 10.1002/cam4.1016 PT - Journal Article ID - 28135055 [pubmed] ID - 10.1002/cam4.1016 [doi] PP - aheadofprint PH - 2016/ 09/ 24 [received] PH - 2016/ 12/ 11 [revised] PH - 2016/ 12/ 20 [accepted] LG - English EP - 20161213 DP - 2016 Dec 13 DC - 20161213 EZ - 2017/ 01/ 31 06: 00 YR - 2016 RD - 20170130 UP - 20170131 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=27957772 <610. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 11281859 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Sawka CA AU - Goel V AU - Mahut CA AU - Taylor GA AU - Thiel EC AU - O'Connor AM AU - Ackerman I AU - Burt JH AU - Gort EH FA - Sawka, Carol A. FA - Goel, Vivek FA - Mahut, Catherine A. FA - Taylor, Glen A. FA - Thiel, Elaine C. FA - O'Connor, Annette M. FA - Ackerman, Ida FA - Burt, Janet H. FA - Gort, Elaine H. IN - Sawka, Carol A.. Divisions of Medical Oncology/Hematology, Faculty of Medicine, University of Toronto, Toronto, Canada; Divisions of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada; Divisions of Surgical Oncology, Faculty of Medicine, University of Toronto, Toronto, Canada; Toronto-Sunnybrook Regional Cancer Center, Toronto, Faculty of Medicine, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Science in Ontario, Toronto, Canada; Faculty of Health Sciences, University of Ottawa, Ottawa; York County Hospital, Newmarket, Canada. TI - Development of a patient decision aid for choice of surgical treatment for breast cancer. SO - Health Expectations. 1(1):23-36, 1998 Jun AS - Health Expect. 1(1):23-36, 1998 Jun NJ - Health expectations : an international journal of public participation in health care and health policy PI - Journal available in: Print PI - Citation processed from: Internet JC - dzo, 9815926 IO - Health Expect CP - England AB - PURPOSE: A patient decision aid for the surgical treatment of early stage breast cancer was developed and evaluated. The rationale for its development was the knowledge that breast conserving therapy (lumpectomy followed by breast radiation) and mastectomy produce equivalent outcomes, and the current general agreement that the decision for the type of surgery should rest with the patient. METHODS: A decision aid was developed and evaluated in sequential pilot studies of 18 and 10 women with newly diagnosed breast cancer who were facing a decision for breast conserving therapy or mastectomy. Both qualitative (general reaction, self-reported anxiety, clarity, satisfaction) and quantitative (knowledge and decisional conflict) measures were assessed. RESULTS: The decision aid consists of an audiotape and workbook and takes 36 min to complete. Based on qualitative comments and satisfaction ratings, 17 of 18 women reported a positive reaction to the decision aid, and all 18 reported that it helped clarify information given by the surgeon. Women did not report an increase in anxiety and 17 of 18 women were either satisfied or very satisfied with the decision aid. CONCLUSION: This pilot study supports the hypothesis that this decision aid may be a helpful adjunct in the decision for surgical management of early stage breast cancer. We are currently conducting a randomized trial of the decision aid versus a simple educational pamphlet to evaluate its efficacy as measured by knowledge, decisional conflict, anxiety and post-decisional regret. ES - 1369-7625 IL - 1369-6513 DI - hex003 PT - Journal Article ID - 11281859 [pubmed] ID - hex003 [pii] ID - PMC5081065 [pmc] PP - ppublish LG - English DP - 1998 Jun DC - 20010402 EZ - 2001/04/03 10:00 DA - 2001/04/03 10:00 DT - 2001/04/03 10:00 YR - 1998 RD - 20161215 UP - 20161221 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=11281859 <611. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 27465657 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Venetis MK AU - MacGeorge EL AU - Baptiste DF AU - Mouton A AU - Friley LB AU - Pastor R AU - Hatten K AU - Lagoo J AU - Bowling MW AU - Clare SE FA - Venetis, Maria K FA - MacGeorge, Erina L FA - Baptiste, Dadrie F FA - Mouton, Ashton FA - Friley, Lorin B FA - Pastor, Rebekah FA - Hatten, Kristen FA - Lagoo, Janaka FA - Bowling, Monet W FA - Clare, Susan E IN - Venetis, Maria K. *Brian Lamb School of Communication, Purdue University, West Lafayette ++Department of Surgery, Indiana University School of Medicine, Indianapolis, IN +Department of Communication Arts and Sciences, Pennsylvania State University, University Park, PA Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL. TI - Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy. SO - American Journal of Clinical Oncology. , 2016 Jul 26 AS - Am J Clin Oncol. , 2016 Jul 26 NJ - American journal of clinical oncology PI - Journal available in: Print-Electronic PI - Citation processed from: Internet JC - 3ez, 8207754 IO - Am. J. Clin. Oncol. CP - United States AB - OBJECTIVES: The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. AB - METHODS: Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013. Questions addressed the involvement and influence of the social network (family, friends, and nonsurgeon health professionals), surgeon, and media on the CPM decision. AB - RESULTS: Spouses, children, family, friends, and health professionals were reported as exerting a meaningful degree of influence on patients' decisions, largely in ways that were positive or neutral toward CPM. Most surgeons were regarded as providing options rather than encouraging or discouraging CPM. Media influence was present, but limited. AB - CONCLUSIONS: Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/. ES - 1537-453X IL - 0277-3732 DO - https://dx.doi.org/10.1097/COC.0000000000000321 PT - Journal Article ID - 27465657 [pubmed] ID - 10.1097/COC.0000000000000321 [doi] PP - aheadofprint LG - English EP - 20160726 DP - 2016 Jul 26 DC - 20160728 EZ - 2016/07/29 06:00 DA - 2016/07/29 06:00 DT - 2016/07/29 06:00 YR - 2016 RD - 20160728 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=27465657 <612. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 24910814 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Sun CS AU - Reece GP AU - Crosby MA AU - Fingeret MC AU - Skoracki RJ AU - Villa MT AU - Hanasono MM AU - Baumann DP AU - Chang DW AU - Cantor SB AU - Markey MK FA - Sun, Clement S FA - Reece, Gregory P FA - Crosby, Melissa A FA - Fingeret, Michelle C FA - Skoracki, Roman J FA - Villa, Mark T FA - Hanasono, Matthew M FA - Baumann, Donald P FA - Chang, David W FA - Cantor, Scott B FA - Markey, Mia K IN - Sun, Clement S. Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX ; Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Reece, Gregory P. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Crosby, Melissa A. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Fingeret, Michelle C. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX ; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Skoracki, Roman J. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Villa, Mark T. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Hanasono, Matthew M. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Baumann, Donald P. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Chang, David W. Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Cantor, Scott B. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX. IN - Markey, Mia K. Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX ; Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX. TI - Plastic Surgeon Expertise in Predicting Breast Reconstruction Outcomes for Patient Decision Analysis. SO - Plastic and Reconstructive Surgery - Global Open. 1(6):e78, 2013 Nov 01 AS - Plast. reconstr. surg., Glob. open. 1(6):e78, 2013 Nov 01 NJ - Plastic and reconstructive surgery. Global open PI - Journal available in: Print PI - Citation processed from: Print JC - 101622231 IO - Plast Reconstr Surg Glob Open CP - United States AB - BACKGROUND: Decision analysis offers a framework that may help breast cancer patients make good breast reconstruction decisions. A requirement for this type of analysis is information about the possibility of outcomes occurring in the form of probabilities. The purpose of this study was to determine if plastic surgeons are good sources of probability information, both individually and as a group, when data are limited. AB - METHODS: Seven plastic surgeons were provided with pertinent medical information and preoperative photographs of patients, and were asked to assign probabilities to predict number of revisions, complications, and final aesthetic outcome using a questionnaire designed for the study. Logarithmic strictly proper scoring was used to evaluate the surgeons' abilities to predict breast reconstruction outcomes. Surgeons' responses were analyzed for calibration and confidence in their answers. AB - RESULTS: As individuals, there was variation in surgeons' ability to predict outcomes. For each prediction category, a different surgeon was more accurate. As a group, surgeons possessed knowledge of future events despite not being well calibrated in their probability assessments. Prediction accuracy for the group was up to six-fold greater than that of the best individual. AB - CONCLUSIONS: The use of individual plastic surgeon-elicited probability information is not encouraged unless the individual's prediction skill has been evaluated. In the absence of this information, a group consensus on the probability of outcomes is preferred. Without a large evidence base for calculating probabilities, estimates assessed from a group of plastic surgeons may be acceptable for purposes of breast reconstruction decision analysis. IL - 2169-7574 DO - https://dx.doi.org/10.1097/GOX.0000000000000010 PT - Journal Article ID - 24910814 [pubmed] ID - 10.1097/GOX.0000000000000010 [doi] ID - PMC4044723 [pmc] ID - NIHMS543308 [mid] PP - ppublish GI - No: R01 CA143190 Organization: (CA) *NCI NIH HHS* Country: United States LG - English DP - 2013 Nov 01 DC - 20140609 EZ - 2014/06/10 06:00 DA - 2014/06/10 06:00 DT - 2014/06/10 06:00 YR - 2013 RD - 20161025 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=24910814 <613. > VN - Ovid Technologies DB - Ovid MEDLINE(R) UI - 22848286 RO - From MEDLINE, a database of the U.S. National Library of Medicine. ST - Publisher AU - Jacobson-Raber G AU - Lazarev I AU - Novack V AU - Mermershtein W AU - Baumfeld Y AU - Geffen DB AU - Sion-Vardy N AU - Ariad S FA - Jacobson-Raber, Galia FA - Lazarev, Irena FA - Novack, Victor FA - Mermershtein, Willmosh FA - Baumfeld, Yael FA - Geffen, David B FA - Sion-Vardy, Netta FA - Ariad, Samuel IN - Jacobson-Raber, Galia. Department of Oncology, Soroka Medical Center and Ben-Gurion University of the Negev, Beer Sheva 84101, Israel. TI - The prognostic importance of cathepsin D and E-cadherin in early breast cancer: A single-institution experience. SO - Oncology Letters. 2(6):1183-1190, 2011 Nov AS - Oncol. Lett.. 2(6):1183-1190, 2011 Nov NJ - Oncology letters PI - Journal available in: Print-Electronic PI - Citation processed from: Print JC - ovftdb,1408060, 101531236 IO - Oncol Lett CP - Greece AB - Molecular tools have increasingly been used for decision-making in patients with early breast cancer (EBC). Nevertheless, simple tools such as immunohistochemistry may still be required in particular cases to complement traditional and molecular prognosticators. In this study, the prognostic significance of three well-known immunohistochemical biomarkers, cathepsin D, E-cadherin and Ki67, was studied in 270 patients with EBC, followed by a median time of 126 months in a single institution. Histological examination was performed to confirm the histopathological diagnosis and select specimens. The specimens were evaluated using immunohistochemistry and survival curves were plotted. Results revealed the following patient characteristics: node-negative/1-3 lymph nodes in 228 (86%) patients, hormone receptor-positive in 217 (80%); triple-negative in 31 (11%), and Her2-overexpression in 23 (9%) patients. Breast cancer-related events occurred in 37 patients (14%). A total of 217 patients (80%) survived. Receiver operating characteristic analysis for breast cancer-specific survival showed an area under curve for the clinicopathological model of 0.75 (95% CI, 0.64-0.86), 0.79 (95% CI, 0.68-0.90) for the three-biomarker model, and 0.82 (95% CI, 0.72-0.92) for the E-cadherin and cathepsin D only model. We propose that a simple prognostic model based on combined scores of E-cadherin and cathepsin D may aid treatment decisions in patients with EBC. IS - 1792-1074 IL - 1792-1074 DI - ol-02-06-1183 DO - https://dx.doi.org/10.3892/ol.2011.393 PT - Journal Article ID - 22848286 [pubmed] ID - 10.3892/ol.2011.393 [doi] ID - ol-02-06-1183 [pii] ID - PMC3406547 [pmc] PP - ppublish PH - 2011/05/03 [received] PH - 2011/08/11 [accepted] LG - English EP - 20110824 DP - 2011 Nov DC - 20120731 EZ - 2012/08/01 06:00 DA - 2012/08/01 06:00 DT - 2012/08/01 06:00 YR - 2011 RD - 20120731 UP - 20161215 XL - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medp&AN=22848286