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Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer

dc.contributor.authorAlderman, Amy K.en_US
dc.contributor.authorHawley, Sarah T.en_US
dc.contributor.authorWaljee, Jennifer F.en_US
dc.contributor.authorMujahid, Mahasin S.en_US
dc.contributor.authorMorrow, Monicaen_US
dc.contributor.authorKatz, Steven J.en_US
dc.date.accessioned2008-02-04T19:15:58Z
dc.date.available2009-02-03T16:28:50Zen_US
dc.date.issued2008-02-01en_US
dc.identifier.citationAlderman, Amy K.; Hawley, Sarah T.; Waljee, Jennifer; Mujahid, Mahasin; Morrow, Monica; Katz, Steven J. (2008). "Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer The collection of cancer incidence data used in this publication was supported by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885. The ideas and opinions expressed herein are those of the author, and no endorsement by the State of California, Department of Health Services is intended or should be inferred. ." Cancer 112(3): 489-494. <http://hdl.handle.net/2027.42/57900>en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.issn1097-0142en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/57900
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=18157830&dopt=citationen_US
dc.description.abstractBACKGROUND. 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. METHODS. We surveyed women aged ≤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. 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). 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. Cancer 2008. © 2007 American Cancer Society.en_US
dc.format.extent80985 bytes
dc.format.extent3118 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.publisherWiley Subscription Services, Inc., A Wiley Companyen_US
dc.subject.otherLife and Medical Sciencesen_US
dc.subject.otherCancer Research, Oncology and Pathologyen_US
dc.titleUnderstanding the impact of breast reconstruction on the surgical decision-making process for breast canceren_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelOncology and Hematologyen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumSection of Plastic Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan ; Veterans Administration Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, Michigan ; Fax: (734) 763-5354 ; Plastic and Reconstructive Surgery, University of Michigan, 2130 Taubman Center, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0340en_US
dc.contributor.affiliationumVeterans Administration Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, Michigan ; Division of General Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michiganen_US
dc.contributor.affiliationumRobert Wood Johnson Clinical Scholars Program and the Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michiganen_US
dc.contributor.affiliationumVeterans Administration Center for Practice Management and Outcomes Research, Ann Arbor VA Health Care System, Ann Arbor, Michigan ; Division of General Medicine, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michiganen_US
dc.contributor.affiliationotherDepartment of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvaniaen_US
dc.identifier.pmid18157830en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/57900/1/23214_ftp.pdf
dc.identifier.doihttp://dx.doi.org/10.1002/cncr.23214en_US
dc.identifier.sourceCanceren_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


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