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Attitudes towards breast conservation in patients aged over 70 with breast cancer.

Smith LI, Dayal S, Murray J, Lannigan A - Springerplus (2016)

Bottom Line: This detailed surgical options and recommendations, timing of decision making, treatment expectations, psychological and cosmetic concerns and other factors which may have influenced any decision made e.g. travel for radiotherapy and potential side effects.BCS is something that patients aged over 70 are interested in considering in the same way as younger patients.More than a third of patients requiring mastectomy would be willing to take neoadjuvant endocrine therapy to attempt to downstage their tumour to facilitate BCS.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Wishaw General Hospital, 50 Netherton Street, Wishaw, ML2 0DP UK.

ABSTRACT

Background: The majority of breast conserving surgery (BCS) is performed in younger women. There is little published information about the views of women aged over 70 regarding BCS. The aim of this study was to investigate the attitudes of this age group towards BCS, and factors which may influence their treatment decision-making.

Methods: A questionnaire was sent to all patients who were aged 70 or over at the time they had breast cancer surgery in NHS Lanarkshire between 1999 and 2013. This detailed surgical options and recommendations, timing of decision making, treatment expectations, psychological and cosmetic concerns and other factors which may have influenced any decision made e.g. travel for radiotherapy and potential side effects.

Results: Responses were received from 339 patients, 192 of whom had a mastectomy with the remaining undergoing BCS. In the mastectomy group 18 % (35) would have preferred to have BCS had it been an option, with 40 % (76) of group being happy to take neoadjuvant endocrine therapy to try and facilitate this. However, only 14 % (26) of patients would have considered neoadjuvant chemotherapy with the same aim. Almost half (82) of the mastectomy patients said that the risk of local recurrence following BCS was a factor which influenced their decision.

Conclusion: BCS is something that patients aged over 70 are interested in considering in the same way as younger patients. More than a third of patients requiring mastectomy would be willing to take neoadjuvant endocrine therapy to attempt to downstage their tumour to facilitate BCS.

No MeSH data available.


Related in: MedlinePlus

Psychological concerns associated with having a mastectomy
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Fig4: Psychological concerns associated with having a mastectomy

Mentions: Interestingly, 38 % (74) of patients who opted to have a mastectomy and only 26 % (37) of patients undergoing BCS were worried about the cosmetic effects of losing a breast (very worried, fairly worried and slightly worried), this was not statistically significant (p = 0.013) (Fig. 3). Whereas concerns over the psychological consequences of mastectomy were significant (p = 0.0008) with 55 % (106) of mastectomy patients and 37 % (53) of BCS patients being worried that a mastectomy may have led to feelings of low self-esteem or depression (very worried, fairly worried and slightly worried; Fig. 4). It should also be noted that the level of non-response was much larger within the BCS group for both the cosmetic and psychological concerns (32 and 26 % respectively) when compared to the mastectomy group (3 and 2 %).Fig. 3


Attitudes towards breast conservation in patients aged over 70 with breast cancer.

Smith LI, Dayal S, Murray J, Lannigan A - Springerplus (2016)

Psychological concerns associated with having a mastectomy
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835403&req=5

Fig4: Psychological concerns associated with having a mastectomy
Mentions: Interestingly, 38 % (74) of patients who opted to have a mastectomy and only 26 % (37) of patients undergoing BCS were worried about the cosmetic effects of losing a breast (very worried, fairly worried and slightly worried), this was not statistically significant (p = 0.013) (Fig. 3). Whereas concerns over the psychological consequences of mastectomy were significant (p = 0.0008) with 55 % (106) of mastectomy patients and 37 % (53) of BCS patients being worried that a mastectomy may have led to feelings of low self-esteem or depression (very worried, fairly worried and slightly worried; Fig. 4). It should also be noted that the level of non-response was much larger within the BCS group for both the cosmetic and psychological concerns (32 and 26 % respectively) when compared to the mastectomy group (3 and 2 %).Fig. 3

Bottom Line: This detailed surgical options and recommendations, timing of decision making, treatment expectations, psychological and cosmetic concerns and other factors which may have influenced any decision made e.g. travel for radiotherapy and potential side effects.BCS is something that patients aged over 70 are interested in considering in the same way as younger patients.More than a third of patients requiring mastectomy would be willing to take neoadjuvant endocrine therapy to attempt to downstage their tumour to facilitate BCS.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Wishaw General Hospital, 50 Netherton Street, Wishaw, ML2 0DP UK.

ABSTRACT

Background: The majority of breast conserving surgery (BCS) is performed in younger women. There is little published information about the views of women aged over 70 regarding BCS. The aim of this study was to investigate the attitudes of this age group towards BCS, and factors which may influence their treatment decision-making.

Methods: A questionnaire was sent to all patients who were aged 70 or over at the time they had breast cancer surgery in NHS Lanarkshire between 1999 and 2013. This detailed surgical options and recommendations, timing of decision making, treatment expectations, psychological and cosmetic concerns and other factors which may have influenced any decision made e.g. travel for radiotherapy and potential side effects.

Results: Responses were received from 339 patients, 192 of whom had a mastectomy with the remaining undergoing BCS. In the mastectomy group 18 % (35) would have preferred to have BCS had it been an option, with 40 % (76) of group being happy to take neoadjuvant endocrine therapy to try and facilitate this. However, only 14 % (26) of patients would have considered neoadjuvant chemotherapy with the same aim. Almost half (82) of the mastectomy patients said that the risk of local recurrence following BCS was a factor which influenced their decision.

Conclusion: BCS is something that patients aged over 70 are interested in considering in the same way as younger patients. More than a third of patients requiring mastectomy would be willing to take neoadjuvant endocrine therapy to attempt to downstage their tumour to facilitate BCS.

No MeSH data available.


Related in: MedlinePlus