Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2010

Open Access 01-12-2010 | Research article

Association of shared decision-making with type of breast cancer surgery: a cross-sectional study

Authors: Myung Kyung Lee, Dong Young Noh, Seok Jin Nam, Se Hyun Ahn, Byeong Woo Park, Eun Sook Lee, Young Ho Yun

Published in: BMC Health Services Research | Issue 1/2010

Login to get access

Abstract

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.

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.

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.

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.
Literature
1.
Ende J, Kazis L, Ash A, Moskowitz MA: Measuring patients' desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med. 1989, 4: 23-30. 10.1007/BF02596485.CrossRefPubMed
2.
Deber RB, Kraetschmer N, Irvine J: What role do patients wish to play in treatment decision making?. Arch Intern Med. 1996, 156: 1414-1420. 10.1001/archinte.156.13.1414.CrossRefPubMed
3.
Cameron C: Patient compliance: recognition of factors involved and suggestions for promoting compliance with therapeutic regimens. J Adv Nurs. 1996, 24: 244-250. 10.1046/j.1365-2648.1996.01993.x.CrossRefPubMed
4.
Schofield PE, Butow PN: Towards better communication in cancer care: a framework for developing evidence-based interventions. Patient Educ Couns. 2004, 55: 32-39. 10.1016/j.pec.2003.07.001.CrossRefPubMed
5.
6.
Siminoff LA, Ravdin P, Colabianchi N, Sturm CM: Doctor-patient communication patterns in breast cancer adjuvant therapy discussions. Health Expect. 2000, 3: 26-36. 10.1046/j.1369-6513.2000.00074.x.CrossRefPubMed
7.
Siminoff LA, Fetting JH, Abeloff MD: Doctor-patient communication about breast cancer adjuvant therapy. J Clin Oncol. 1989, 7: 1192-1200.PubMed
8.
9.
Degner LF, Kristjanson LJ, Bowman D, Sloan JA, Carriere KC, O'Neil J, Bilodeau B, Watson P, Mueller B: Information needs and decisional preferences in women with breast cancer. JAMA. 1997, 277: 1485-1492. 10.1001/jama.277.18.1485.CrossRefPubMed
10.
Bruera E, Sweeney C, Calder K, Palmer L, Benisch-Tolley S: Patient preferences versus physician perceptions of treatment decisions in cancer care. J Clin Oncol. 2001, 19: 2883-2885.PubMed
11.
Keating NL, Guadagnoli E, Landrum MB, Borbas C, Weeks JC: Treatment decision making in early-stage breast cancer: should surgeons match patients' desired level of involvement?. J Clin Oncol. 2002, 20: 1473-1479. 10.1200/JCO.20.6.1473.CrossRefPubMed
12.
Lantz PM, Janz NK, Fagerlin A, Schwartz K, Liu L, Lakhani I, Salem B, Katz SJ: Satisfaction with surgery outcomes and the decision process in a population-based sample of women with breast cancer. Health Serv Res. 2005, 40: 745-767. 10.1111/j.1475-6773.2005.00383.x.CrossRefPubMedPubMedCentral
13.
O'Connor AM, Fiset V, DeGrasse C, Graham ID, Evans W, Stacey D, Laupacis A, Tugwell P: Decision aids for patients considering options affecting cancer outcomes: evidence of efficacy and policy implications. J Natl Cancer Inst Monogr. 1999, 25: 67-80.CrossRefPubMed
14.
Fallowfield L, Jenkins V: Effective communication skills are the key to good cancer care. Eur J Cancer. 1999, 35: 1592-1597. 10.1016/S0959-8049(99)00212-9.CrossRefPubMed
15.
Verhoef MJ, White MA, Doll R: Cancer patients' expectations of the role of family physicians in communication about complementary therapies. Cancer Prev Control. 1999, 3: 181-187.PubMed
16.
Ganz PA: Interaction between the physician and the older patient: the oncologist's perspective. Cancer. 1997, 80: 1323-1325. 10.1002/(SICI)1097-0142(19971001)80:7<1323::AID-CNCR19>3.0.CO;2-9.CrossRefPubMed
17.
Mazur DJ, Hickam DH, Mazur MD, Mazur MD: The role of doctor's opinion in shared decision making: what does shared decision making really mean when considering invasive medical procedures?. Health Expect. 2005, 8: 97-102. 10.1111/j.1369-7625.2005.00315.x.CrossRefPubMed
18.
Robins JM, Hernan MA, Brumback B: Marginal structural models and causal inference in epidemiology. Epidemiology. 2000, 11: 550-560. 10.1097/00001648-200009000-00011.CrossRefPubMed
19.
MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, Salkever DS, Scharfstein DO: A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006, 354: 366-378. 10.1056/NEJMsa052049.CrossRefPubMed
20.
21.
Potter F: A study of procedures to identify and trim extreme sampling weights. Proceedings of the section on survey research methods. 1990, Washington, D.C. American Statistical Association, 225-230.
22.
Collins ED, Moore CP, Clay KF, Kearing SA, O'Connor AM, Llewellyn-Thomas HA, Barth RJ, Sepucha KR: Can Women With Early-Stage Breast Cancer Make an Informed Decision for Mastectomy?. Journal of Clinical Oncology. 2009, 27: 519-525. 10.1200/JCO.2008.16.6215.CrossRefPubMed
23.
Whelan T, Levine M, Gafni A, Sanders K, Willan A, Mirsky D, Schnider D, McCready D, Reid S, Kobylecky A, Reed K: Mastectomy or lumpectomy? Helping women make informed choices. J Clin Oncol. 1999, 17: 1727-1735.PubMed
24.
Mandelblatt JS, Berg CD, Meropol NJ, Edge SB, Gold K, Hwang YT, Hadley J: Measuring and predicting surgeons' practice styles for breast cancer treatment in older women. Med Care. 2001, 39: 228-242. 10.1097/00005650-200103000-00004.CrossRefPubMed
25.
Katz SJ, Lantz P, Zemencuk J: Correlates of surgical treatment type for women with noninvasive and invasive breast cancer. J Womens Health Gend Based Med. 2001, 10: 659-670. 10.1089/15246090152563533.CrossRefPubMed
26.
Baxter NN, Virnig BA, Durham SB, Tuttle TM: Trends in the treatment of ductal carcinoma in situ of the breast. J Natl Cancer Inst. 2004, 96: 443-448.CrossRefPubMed
27.
Maly RC, Leake B, Silliman RA: Breast cancer treatment in older women: impact of the patient-physician interaction. J Am Geriatr Soc. 2004, 52: 1138-1145. 10.1111/j.1532-5415.2004.52312.x.CrossRefPubMed
28.
Levy SM, Herberman RB, Lee JK, Lippman ME, d'Angelo T: Breast conservation versus mastectomy: distress sequelae as a function of choice. J Clin Oncol. 1989, 7: 367-375.PubMed
29.
Ray JA, Loescher LJ, Brewer M: Risk-reduction surgery decisions in high-risk women seen for genetic counseling. J Genet Couns. 2005, 14: 473-484. 10.1007/s10897-005-5833-5.CrossRefPubMed
30.
Demicheli R, Bonadonna G, Hrushesky WJ, Retsky MW, Valagussa P: Menopausal status dependence of early mortality reduction due to diagnosis of smaller breast cancers (T1 v T2-T3): relevance to screening. J Clin Oncol. 2004, 22: 102-107. 10.1200/JCO.2004.12.139.CrossRefPubMed
31.
Fentiman IS: Communication with older breast cancer patients. Breast J. 2007, 13: 406-409. 10.1111/j.1524-4741.2007.00449.x.CrossRefPubMed
32.
33.
Nattinger AB, Gottlieb MS, Veum J, Yahnke D, Goodwin JS: Geographic variation in the use of breast-conserving treatment for breast cancer. N Engl J Med. 1992, 326: 1102-1107.CrossRefPubMed
34.
Ballard-Barbash R, Potosky AL, Harlan LC, Nayfield SG, Kessler LG: Factors associated with surgical and radiation therapy for early stage breast cancer in older women. J Natl Cancer Inst. 1996, 88: 716-726. 10.1093/jnci/88.11.716.CrossRefPubMed
35.
Bleicher RJ, Abrahamse P, Hawley ST, Katz SJ, Morrow M: The influence of age on the breast surgery decision-making process. Ann Surg Oncol. 2008, 15: 854-862. 10.1245/s10434-007-9708-x.CrossRefPubMed
36.
Cyran EM, Crane LA, Palmer L: Physician sex and other factors associated with type of breast cancer surgery in older women. Arch Surg. 2001, 136: 185-191. 10.1001/archsurg.136.2.185.CrossRefPubMed
37.
Liang W, Burnett CB, Rowland JH, Meropol NJ, Eggert L, Hwang YT, Silliman RA, Weeks JC, Mandelblatt JS: Communication between physicians and older women with localized breast cancer: implications for treatment and patient satisfaction. J Clin Oncol. 2002, 20: 1008-1016. 10.1200/JCO.20.4.1008.CrossRefPubMed
38.
Guadagnoli E, Weeks JC, Shapiro CL, Gurwitz JH, Borbas C, Soumerai SB: Use of breast-conserving surgery for treatment of stage I and stage II breast cancer. J Clin Oncol. 1998, 16: 101-106.PubMed
39.
Albain KS, Green SR, Lichter AS, Hutchins LF, Wood WC, Henderson IC, Ingle JN, O'Sullivan J, Osborne CK, Martino S: Influence of patient characteristics, socioeconomic factors, geography, and systemic risk on the use of breast-sparing treatment in women enrolled in adjuvant breast cancer studies: an analysis of two intergroup trials. J Clin Oncol. 1996, 14: 3009-3017.PubMed
40.
Katz SJ, Lantz PM, Janz NK, Fagerlin A, Schwartz K, Liu L, Deapen D, Salem B, Lakhani I, Morrow M: Patient involvement in surgery treatment decisions for breast cancer. J Clin Oncol. 2005, 23: 5526-5533. 10.1200/JCO.2005.06.217.CrossRefPubMed
41.
Slevin ML, Stubbs L, Plant HJ, Wilson P, Gregory WM, Armes PJ, Downer SM: Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public. BMJ. 1990, 300: 1458-1460. 10.1136/bmj.300.6737.1458.CrossRefPubMedPubMedCentral
42.
Whitney SN: A new model of medical decisions: exploring the limits of shared decision making. Med Decis Making. 2003, 23: 275-280. 10.1177/0272989X03256006.CrossRefPubMed
43.
Elwyn G, Edwards A, Mowle S, Wensing M, Wilkinson C, Kinnersley P, Grol R: Measuring the involvement of patients in shared decision-making: a systematic review of instruments. Patient Educ Couns. 2001, 43: 5-22. 10.1016/S0738-3991(00)00149-X.CrossRefPubMed
44.
Ford S, Schofield T, Hope T: Are patients' decision-making preferences being met?. Health Expect. 2003, 6: 72-80. 10.1046/j.1369-6513.2003.00211.x.CrossRefPubMed
Metadata
Title
Association of shared decision-making with type of breast cancer surgery: a cross-sectional study
Authors
Myung Kyung Lee
Dong Young Noh
Seok Jin Nam
Se Hyun Ahn
Byeong Woo Park
Eun Sook Lee
Young Ho Yun
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2010
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-10-48

Other articles of this Issue 1/2010

BMC Health Services Research 1/2010 Go to the issue

Research article

Predictors of nursing home admission of individuals without a dementia diagnosis before admission - results from the Leipzig Longitudinal Study of the Aged (LEILA 75+)

Research article

Professional Service Utilisation among Patients with Severe Mental Disorders

Correspondence

Development and early experience from an intervention to facilitate teamwork between general practices and allied health providers: the Team-link study

Research article

Health plan administrative records versus birth certificate records: quality of race and ethnicity information in children

Research article

Physicians' use of the 5As in counseling obese patients: is the quality of counseling associated with patients' motivation and intention to lose weight?

Research article

Randomised primary health center based interventions to improve the diagnosis and treatment of undifferentiated fever and dengue in Vietnam