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Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation

  
@article{GS11115,
	author = {Rosalyn Shearer and Majid Rashid and Gill Hubbard and Nick Abbott and Ian Daltrey and Russell Mullen},
	title = {Factors associated with patients in the Scottish Highlands who chose mastectomy when suitable for breast conservation},
	journal = {Gland Surgery},
	volume = {5},
	number = {4},
	year = {2016},
	keywords = {},
	abstract = {Background: Despite being suitable for breast conservation surgery (BCS) a proportion of women choose mastectomy. This study aimed to assess the pre-operative pathological and geographic factors associated with choosing mastectomy rather than BCS in a single centre that serves a large geographical area encompassing urban, rural and remote island populations. 
Methods: A retrospective analysis of all patients suitable for BCS between January 2011 and December 2013 was undertaken. Pre-operative pathological features were compared using the Pearson chi squared test as was distance to the treatment centre from the patient’s home. A questionnaire was sent to all those who chose mastectomy to identify the factors that influenced their decision.
Results: A total of 446 patients suitable for BCS were identified of which 46 (11%) chose to undergo mastectomy. Patients choosing mastectomy were more likely to present symptomatically (P=0.009), have tumours larger than 20 mm at diagnostic imaging (P=0.001) and have positive axillary staging (P=0.004). Patients choosing mastectomy were more likely to live remotely (P=0.051). Those patients who chose mastectomy felt this gave a better long-term outcome (18 patients, 44%) and peace of mind (14 patients, 34%).
Conclusions: Adverse pre-operative pathological features were associated with patients choosing mastectomy rather than BCS. There was a trend for patients who chose mastectomy to live remotely from the treatment centre. Patients choosing mastectomy most commonly cited a better long-term outcome and peace of mind as the reason behind their decision. Understanding what influences a patient’s surgical choice will allow clinicians and patients to engage in a fully informed pre-operative decision making process.},
	issn = {2227-8575},	url = {http://gs.amegroups.com/article/view/11115}
}