Maria Paz Galeano Machuca1, Shelly Chien-Chien Cheng2, Tony Hong-Ting Jou3, Chih-Tao Cheng4,5. 1. Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, 125 Lih-Der Rd, Pei-Tou District, Taipei, Taiwan. 2. Department of Medicine, National Taiwan University, Taipei, Taiwan. 3. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. 4. Department of Medical Research, Koo Foundation Sun Yat-Sen Cancer Center, 125 Lih-Der Rd, Pei-Tou District, Taipei, Taiwan. chihtao@kfsyscc.org. 5. Department of Psychology and Social Work, National Defense University, Taipei, Taiwan. chihtao@kfsyscc.org.
Abstract
BACKGROUND: Treatment guidelines recommend breast-conserving therapy (BCT) for patients with early-stage breast cancer. However, Asian patients choose mastectomy over BCT, and the factors influencing this choice are unknown. This review aimed to identify the factors most frequently reported in the Eastern and Southeastern Asian population influencing the choice of BCT for treatment of early-stage breast cancer. METHODS: PRISMA guidelines were followed, and PubMed and EMBASE databases were used. The literature search initially identified 4619 articles; abstract screening and full-text screening were performed on 150 and 19 articles, respectively, and 9 articles were finally included in the study. RESULTS: Selection of BCT was associated with sociodemographic factors, such as high socioeconomic status and education level and young age at diagnosis; clinicopathological factors, such as small tumor size and mammographically detected tumors; and healthcare provider factors, such as treatment from a female doctor or from a breast specialist. However, not selecting BCT was associated with personal factors, such as fear of recurrence and avoidance of further treatment. CONCLUSIONS: The process of making a treatment decision is complicated and involves many factors influencing patients' choice of surgery type. Exploring these factors helps to elucidate why patients do not choose BCT as their treatment option.
BACKGROUND: Treatment guidelines recommend breast-conserving therapy (BCT) for patients with early-stage breast cancer. However, Asian patients choose mastectomy over BCT, and the factors influencing this choice are unknown. This review aimed to identify the factors most frequently reported in the Eastern and Southeastern Asian population influencing the choice of BCT for treatment of early-stage breast cancer. METHODS: PRISMA guidelines were followed, and PubMed and EMBASE databases were used. The literature search initially identified 4619 articles; abstract screening and full-text screening were performed on 150 and 19 articles, respectively, and 9 articles were finally included in the study. RESULTS: Selection of BCT was associated with sociodemographic factors, such as high socioeconomic status and education level and young age at diagnosis; clinicopathological factors, such as small tumor size and mammographically detected tumors; and healthcare provider factors, such as treatment from a female doctor or from a breast specialist. However, not selecting BCT was associated with personal factors, such as fear of recurrence and avoidance of further treatment. CONCLUSIONS: The process of making a treatment decision is complicated and involves many factors influencing patients' choice of surgery type. Exploring these factors helps to elucidate why patients do not choose BCT as their treatment option.
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