Rebecca M Kwait1, Sarah Pesek2, Michaela Onstad3, David Edmonson4, Melissa A Clark5, Christina Raker6, Ashley Stuckey4, Jennifer Gass4. 1. The Program in Women's Oncology, Women and Infants Hospital Breast Health Center, Warren Alpert School of Medicine/Brown University, Providence, RI, USA. rebeccamkwait@gmail.com. 2. St. Peter's Health Partners Medical Associates, St. Peter's Hospital, Albany, NY, USA. 3. Department of Gynecologic Oncology, MD Anderson Cancer Center, Houston, TX, USA. 4. The Program in Women's Oncology, Women and Infants Hospital Breast Health Center, Warren Alpert School of Medicine/Brown University, Providence, RI, USA. 5. Center for Health Policy and Research, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA. 6. Division of Research, Women and Infants' Hospital of Rhode Island, Providence, RI, USA.
Abstract
BACKGROUND: Shared decision making with one's partner and body image satisfaction may affect surgical choices of breast cancer patients. This study analyzed whether partner opinion was associated with choice of operation and whether comfort level with one's partner was altered postoperatively. METHODS: A prospective anonymous survey was administered to breast cancer patients who underwent breast surgery between 2000 and 2014. Categorical variables were compared by χ (2) or Fisher's exact test. RESULTS: Women who elected to undergo mastectomy with reconstruction (MR) placed greater emphasis on their own decision making than on input from their partner, surgeon, or others (56.5 vs. 8.3 vs. 23.2 vs. 12, respectively), whereas those who chose lumpectomy (L) placed similar weight on surgeon input and self-input (44.2 vs. 42.7 %). Only 7.5 % of all patients identified their partner as the greatest influence on their surgical choice. Preoperatively, the L group was the most comfortable with their partner seeing their chest (91.9 % L vs. 83.9 % MR vs. 75.9 % mastectomy alone (M); p = 0.01), and postoperatively, the comfort levels for all were remarkably decreased. Furthermore, if a patient was a candidate for L but chose MR, the role her chest played in intimacy dropped more compared with those who chose L (83.8 % L vs. 91.7 % MR; p = 0.3 preoperatively to 65.1 % L vs. 42.9 % MR; p = 0.01 postoperatively). CONCLUSIONS: When making surgical decisions, most patients indicate that they value their own opinion over that of others. Mastectomy, regardless of reconstruction, leads to a significant reduction in comfort with one's partner postoperatively compared with lumpectomy. This information may be helpful in counseling couples at the time of consultation for breast cancer treatment.
BACKGROUND: Shared decision making with one's partner and body image satisfaction may affect surgical choices of breast cancerpatients. This study analyzed whether partner opinion was associated with choice of operation and whether comfort level with one's partner was altered postoperatively. METHODS: A prospective anonymous survey was administered to breast cancerpatients who underwent breast surgery between 2000 and 2014. Categorical variables were compared by χ (2) or Fisher's exact test. RESULTS:Women who elected to undergo mastectomy with reconstruction (MR) placed greater emphasis on their own decision making than on input from their partner, surgeon, or others (56.5 vs. 8.3 vs. 23.2 vs. 12, respectively), whereas those who chose lumpectomy (L) placed similar weight on surgeon input and self-input (44.2 vs. 42.7 %). Only 7.5 % of all patients identified their partner as the greatest influence on their surgical choice. Preoperatively, the L group was the most comfortable with their partner seeing their chest (91.9 % L vs. 83.9 % MR vs. 75.9 % mastectomy alone (M); p = 0.01), and postoperatively, the comfort levels for all were remarkably decreased. Furthermore, if a patient was a candidate for L but chose MR, the role her chest played in intimacy dropped more compared with those who chose L (83.8 % L vs. 91.7 % MR; p = 0.3 preoperatively to 65.1 % L vs. 42.9 % MR; p = 0.01 postoperatively). CONCLUSIONS: When making surgical decisions, most patients indicate that they value their own opinion over that of others. Mastectomy, regardless of reconstruction, leads to a significant reduction in comfort with one's partner postoperatively compared with lumpectomy. This information may be helpful in counseling couples at the time of consultation for breast cancer treatment.
Authors: Oluwadamilola M Fayanju; Karine Yenokyan; Yi Ren; Benjamin A Goldstein; Ilona Stashko; Steve Power; Madeline J Thornton; P Kelly Marcom; E Shelley Hwang Journal: Cancer Date: 2019-05-23 Impact factor: 6.860
Authors: Cameron W Swanick; Jing Jiang; J Alberto Maldonado; Xiudong Lei; Ya-Chen Tina Shih; Abigail S Caudle; Donald P Baumann; Sharon H Giordano; Simona F Shaitelman; Shervin M Shirvani; Benjamin D Smith Journal: Plast Reconstr Surg Glob Open Date: 2021-11-04
Authors: Tim C van de Grift; Marc A M Mureau; Vera N Negenborn; Rieky E G Dikmans; Mark-Bram Bouman; Margriet G Mullender Journal: Psychooncology Date: 2020-06-05 Impact factor: 3.894