在科学不确定的领域中，外科医生对乳腺癌治疗的信念和影响。
Breast cancer treatment beliefs and influences among surgeons in areas of scientific uncertainty.
机构信息
Department of Surgery, University of Virginia, Charlottesville, VA, USA.
出版信息
Am J Surg. 2010 Apr;199(4):491-9. doi: 10.1016/j.amjsurg.2009.04.005.
BACKGROUND
Breast cancer treatment beliefs in areas of scientific uncertainty may contribute to widely variable practices. We sought to better describe surgeons' beliefs and to identify the relative importance of different information sources on surgeons' decision-making.
METHODS
A total of 2,188 American College of Surgeons (ACoS) members were surveyed on their treatment beliefs in 4 controversial areas and on the perceived influence of various information sources on their decision-making. Responses were analyzed by sex, practice type, oncology training, professional society membership, and breast cancer patient volume.
RESULTS
Nine hundred twenty-three responses were received, with 459 eligible for analysis. Responses diverged most regarding significance of positive sentinel lymph node biopsy (SNLB) and role of post-lumpectomy radiation for low-risk ductal carcinoma-in-situ (DCIS). Overall, expert opinion ranked as the most influential information source.
CONCLUSIONS
Axillary dissection after positive SLNB and post-lumpectomy radiation in low-risk DCIS denoted areas of greater uncertainty. Breast cancer opinion leaders have substantial influence when standard practice is uncertain.
背景
在科学不确定的领域，乳腺癌治疗信念可能导致实践的广泛差异。我们试图更好地描述外科医生的信念，并确定不同信息来源对其决策的相对重要性。
方法
对 2188 名美国外科医师学会（ACoS）成员就 4 个有争议的领域的治疗信念以及对各种信息来源对其决策的影响的看法进行了调查。根据性别、手术类型、肿瘤学培训、专业学会会员资格和乳腺癌患者数量对回答进行了分析。
结果
共收到 923 份回复，其中 459 份符合分析要求。对于前哨淋巴结活检（SNLB）阳性的意义和低危导管原位癌（DCIS）术后放疗的作用，回复意见分歧最大。总的来说，专家意见被认为是最有影响力的信息来源。
结论
在 SNLB 阳性和低危 DCIS 术后乳房切除术的情况下进行腋窝清扫表示存在更大的不确定性。当标准实践不确定时，乳腺癌意见领袖具有很大的影响力。
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