Abstract:
PURPOSE:Rates of both unilateral (UM) and contralateral prophylactic mastectomy (CPM) for unilateral early-stage breast cancer (ESBC) have been increasing since 2003. Recent studies suggest that this increase may be due to women choosing UM and CPM because of fear. We conducted an in-depth qualitative study to identify those factors influencing a woman's choice for more extensive surgery. METHODS:Semi-structured interviews were conducted with breast cancer patients to examine the experiences, decision making, and choice of UM ± CPM for the treatment of ESBC. Purposive sampling identified suitable candidates for breast-conserving therapy (BCT) who underwent UM ± CPM. Interviews were guided by grounded theory methodology, and constant comparative analysis identified key concepts and themes. RESULTS:Data saturation was achieved after 29 interviews. 'Taking control of cancer' was the dominant theme. Fear of breast cancer was expressed at diagnosis and remained throughout decision making. Personal experiences of family or friends 'living with cancer' were the most influential source of information during the decision-making process. Fear translated into an overestimated risk of recurrence, contralateral breast cancer (CBC), and death. Despite surgeons discussing equivalent survival with BCT, UM ± CPM patients believed that by choosing UM ± CPM they would eliminate recurrence, CBC and live longer. By choosing more extensive surgery, women were actively trying to control cancer outcomes as more surgery was believed to offer greater survival. CONCLUSIONS:Women seek UM and CPM to take control of cancer and manage their fear. It is important for surgeons to understand how personal experiences shape women's choice for UM ± CPM to facilitate informed decision making.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Covelli AM,Baxter NN,Fitch MI,McCready DR,Wright FCdoi
10.1245/s10434-014-4033-7subject
Has Abstractpub_date
2015-02-01 00:00:00pages
383-91issue
2eissn
1068-9265issn
1534-4681journal_volume
22pub_type
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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abstract:BACKGROUND:Although the sentinel lymph node (SLN) hypothesis has been applied to many tissues and organs, liver has remained unstudied. Currently, it is unclear whether hepatic SLNs even exist. If so, they could alter the management of intrahepatic cholangiocarcinoma and other hepatic malignancies by minimizing the ext...
journal_title:Annals of surgical oncology
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abstract:: ...
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pub_type: 评论,杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:1997-09-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1245/s10434-011-2016-5
更新日期:2012-03-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02557375
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:There are few reports on microvascular invasion (MVI) located intra- or extratumorally and prognosis of hepatocellular carcinoma (HCC). OBJECTIVE:The aim of this study was to evaluate patient outcome according to the location of MVI, and to build a nomogram predicting extratumoral MVI. METHODS:We included ...
journal_title:Annals of surgical oncology
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pub_type: 杂志文章
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abstract:: ...
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pub_type: 评论,信件
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更新日期:2018-12-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 评论,杂志文章
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更新日期:2018-12-01 00:00:00
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pub_type: 临床试验,杂志文章
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