Floortje M Knuttel1, Maurice A A J van den Bosch2, Danny A Young-Afat3, Marleen J Emaus2, Desirée H J G van den Bongard4, Arjen J Witkamp5, Helena M Verkooijen2. 1. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: fknuttel@gmail.com. 2. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. 3. Department of Clinical Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. 5. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
BACKGROUND: Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated. OBJECTIVES: To assess preferences of patients with breast cancer and of healthy women regarding these new techniques, compared with conventional surgical treatments. METHODS: Six hypothetical breast cancer treatment-outcome scenarios were developed: three standard surgical scenarios (mastectomy, mastectomy with immediate implant-based reconstruction, and breast-conserving therapy [BCT]) and three minimally invasive or noninvasive scenarios (radiofrequency ablation, magnetic resonance-guided high-intensity focused ultrasound ablation, and single-dose ablative radiotherapy). Participants rated treatment-outcome scenarios by visual analogue scale (VAS) and time trade-off (TTO). The Friedman and post hoc Wilcoxon signed-rank tests were used to test whether scores were significantly different from BCT. RESULTS: Seventy-one patients with breast cancer and 50 healthy volunteers participated. Overall, BCT was rated the highest in terms of VAS (0.80) and TTO (0.90) scores. After stratification, BCT ranked the highest in most subgroups, with the exception of healthy individuals, who had given the highest score to ablative boost (VAS, 0.80; TTO, 0.88). Mastectomy with immediate reconstruction was the least preferred in most subgroups. CONCLUSIONS: This study showed no significant preference for minimally invasive treatment for breast cancer. Using hypothetical scenarios, breast cancer survivors attributed the highest scores to BCT, whereas healthy volunteers showed a slight preference for minimally invasive treatments.
BACKGROUND: Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated. OBJECTIVES: To assess preferences of patients with breast cancer and of healthy women regarding these new techniques, compared with conventional surgical treatments. METHODS: Six hypothetical breast cancer treatment-outcome scenarios were developed: three standard surgical scenarios (mastectomy, mastectomy with immediate implant-based reconstruction, and breast-conserving therapy [BCT]) and three minimally invasive or noninvasive scenarios (radiofrequency ablation, magnetic resonance-guided high-intensity focused ultrasound ablation, and single-dose ablative radiotherapy). Participants rated treatment-outcome scenarios by visual analogue scale (VAS) and time trade-off (TTO). The Friedman and post hoc Wilcoxon signed-rank tests were used to test whether scores were significantly different from BCT. RESULTS: Seventy-one patients with breast cancer and 50 healthy volunteers participated. Overall, BCT was rated the highest in terms of VAS (0.80) and TTO (0.90) scores. After stratification, BCT ranked the highest in most subgroups, with the exception of healthy individuals, who had given the highest score to ablative boost (VAS, 0.80; TTO, 0.88). Mastectomy with immediate reconstruction was the least preferred in most subgroups. CONCLUSIONS: This study showed no significant preference for minimally invasive treatment for breast cancer. Using hypothetical scenarios, breast cancer survivors attributed the highest scores to BCT, whereas healthy volunteers showed a slight preference for minimally invasive treatments.
Authors: Louise L Blankensteijn; Sabine A Egeler; Hani H Sinno; Ahmed M S Ibrahim; Ali Izadpanah; Joshua Vorstenbosch; Tassos Dionisopoulos; Adam M Tobias; Samuel J Lin; Bernard T Lee Journal: Plast Surg (Oakv) Date: 2020-05-21 Impact factor: 0.947
Authors: Manraj N Kaur; Jiajun Yan; Anne F Klassen; Justin P David; Dilshan Pieris; Manraj Sharma; Louise Bordeleau; Feng Xie Journal: Med Decis Making Date: 2022-01-18 Impact factor: 2.749