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Published in:

01-09-2007

Conflicts in Decision-Making for Breast Cancer Surgery

Authors: Diane Opatt, MD, Monica Morrow, MD, Sarah Hawley, PhD, MPH, Kendra Schwartz, MD, MSPH, Nancy K. Janz, MD, Steven J. Katz, MD, MPH

Published in: Annals of Surgical Oncology | Issue 9/2007

Abstract

Background

Little is known about the interaction among surgeons, patients, and other physicians in selecting breast cancer surgery.

Methods

We contacted attending surgeons (n = 456) of a population-based sample of 2645 breast cancer patients diagnosed in Detroit and Los Angeles from December 2001 to January 2003. Eighty percent completed a written survey with clinical scenarios.

Results

The mean surgeon age was 50 years, 50% practiced in a community hospital, and breast cancer averaged 31% of practice volume. The mean number of years in practice was 17.2. Female surgeons made up 14.4% of the sample and 35% of the high-volume surgeons. Conflict with patients and other providers was reported by 58% and 32% of surgeons, respectively. When the patient preferred mastectomy and the surgeon favored BCS, conflict was reported by 49.9% of surgeons. Compared with low-volume surgeons, high-volume surgeons were significantly more likely to report conflict in this scenario (44% vs 62%; P = .047). When another provider preferred mastectomy and the respondent surgeon favored BCS, conflict was reported by 34% of surgeons and was more common for high-volume surgeons (P < .001). In a logistic regression model, surgeon volume and practice setting were strongly associated with conflict in this scenario.

Conclusion

High-volume surgeons and those in cancer centers more frequently endorse current clinical guidelines that favor BCS over mastectomy, resulting in greater conflict with patients. These findings support patient reports that patient choice is a key factor in continued mastectomy use.

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Title: Conflicts in Decision-Making for Breast Cancer Surgery
Authors: Diane Opatt, MD
Monica Morrow, MD
Sarah Hawley, PhD, MPH
Kendra Schwartz, MD, MSPH
Nancy K. Janz, MD
Steven J. Katz, MD, MPH
Publication date: 01-09-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 9/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9431-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Conflicts in Decision-Making for Breast Cancer Surgery

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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