Recio-Saucedo Alejandra, Gerty Sue, Foster Claire, Eccles Diana, Cutress Ramsey I
University of Southampton, Faculty of Health Sciences, Southampton SO17 1BJ, UK.
Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton and University Hospital Southampton Foundation Trust, Tremona Road, Southampton SO16 6YA, UK.
Breast. 2016 Feb;25:1-13. doi: 10.1016/j.breast.2015.11.001. Epub 2015 Nov 30.
Young women with breast cancer have poorer prognosis, greater lifetime risk of local recurrence, contralateral recurrence, and distant disease, regardless of surgery received. Here we systematically review published evidence relating to the information requirements and preferences of young women diagnosed with early-stage breast cancer offered a choice between mastectomy and Breast Conservation Surgery (BCS). Findings will inform the development of a surgical decision aid for young women.
Eight databases were searched to identify research examining information requirements of young women facing breast oncological surgery treatment decisions (MESH headings). Twelve studies met the inclusion criteria. Data were extracted and summarised in a narrative synthesis.
Findings indicate that young women prefer greater and more detailed information regarding treatment side effects, sexuality, and body image. Younger age of diagnosis leads to an increased risk perception of developing a second breast cancer. Young women's choices are influenced by factors associated with family and career. Information is required in a continuum throughout the treatment experience and not only at diagnosis when treatment decisions are made. Young women show differing levels of participation preferences.
Young women find decision-making challenging when the characteristics of diagnosis provide a surgical choice between mastectomy and breast conservation surgery. Efforts should be made to provide information regarding sexuality, body image, reconstruction, fertility and likelihood of familial predisposition. Further research is needed to identify the specific level and information requirements of this young-onset group. The low number of studies indicate a need to design studies targeting specifically this age group of breast cancer patients.
无论接受何种手术，患有乳腺癌的年轻女性预后较差，局部复发、对侧复发及远处转移的终生风险更高。在此，我们系统回顾已发表的证据，这些证据涉及被诊断为早期乳腺癌的年轻女性在乳房切除术和保乳手术（BCS）之间做出选择时的信息需求和偏好。研究结果将为针对年轻女性的手术决策辅助工具的开发提供参考。
检索了八个数据库，以识别研究乳腺癌手术治疗决策（医学主题词）的年轻女性信息需求的研究。十二项研究符合纳入标准。数据通过叙述性综合分析进行提取和总结。
研究结果表明，年轻女性更希望获得关于治疗副作用、性功能和身体形象方面更详细的信息。诊断时年龄越小，患第二原发性乳腺癌的风险认知越高。年轻女性的选择受与家庭和职业相关因素的影响。在整个治疗过程中都需要信息，而不仅仅是在做出治疗决策的诊断时。年轻女性表现出不同程度的参与偏好。
当诊断特征提供乳房切除术和保乳手术之间的手术选择时，年轻女性发现决策具有挑战性。应努力提供有关性功能、身体形象、重建、生育能力和家族易感性可能性的信息。需要进一步研究以确定这一年轻发病群体的具体信息需求水平。研究数量较少表明需要设计专门针对这一年龄组乳腺癌患者的研究。
