英国一家乳房切除术率高的专科中心的患者决策。

Patients' decision-making in a UK specialist centre with high mastectomy rates.

作者信息

Ballinger Rachel S, Mayer Karl Fortes, Lawrence Gill, Fallowfield Lesley

机构信息

Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9QG, UK.

出版信息

Breast. 2008 Dec;17(6):574-9. doi: 10.1016/j.breast.2008.08.001. Epub 2008 Sep 14.

DOI:10.1016/j.breast.2008.08.001

PMID:18793856

Abstract

A national audit identified one breast cancer unit as having the highest mastectomy rate in the UK: 50% compared to a national average of 14% for cancers <15mm in diameter. This anomaly needed investigation. A questionnaire was sent within 2 years of their surgery to 189 breast cancer patients probing perceived surgical choice, factors in decision-making and usefulness of information. One hundred thirty-one (69%) replied, of these 97 (74%) felt they had choice of surgery. Of these, the most important factor was minimising worry about recurrence. However, only 16% knew that recurrence rates were different between types of surgery. Sixty-one percent felt their healthcare professionals had surgical preferences for them, believed that clinical issues determined these preferences, but still knew the choice was theirs. The extent to which surgical choice is offered and patients are made aware that it is their choice, may account for the high mastectomy rate in this unit.

摘要

一项全国性审计发现，英国有一个乳腺癌治疗单位的乳房切除术率最高：对于直径小于15毫米的癌症，该单位的乳房切除术率为50%，而全国平均水平为14%。这种异常情况需要调查。在患者手术后两年内，向189名乳腺癌患者发送了一份问卷，询问他们对手术选择的看法、决策因素以及信息的有用性。131人（69%）回复了问卷，其中97人（74%）觉得自己有手术选择。在这些人中，最重要的因素是尽量减少对复发的担忧。然而，只有16%的人知道不同手术类型的复发率有所不同。61%的人觉得他们的医护人员对他们有手术偏好，认为临床问题决定了这些偏好，但他们仍然知道选择权在自己手中。提供手术选择的程度以及让患者意识到这是他们的选择，可能是该单位乳房切除术率高的原因。