Decision aids for breast and nodal surgery in patients with early breast cancer: Development and a pilot study
Identifieur interne : 007717 ( Istex/Corpus ); précédent : 007716; suivant : 007718Decision aids for breast and nodal surgery in patients with early breast cancer: Development and a pilot study
Auteurs : Rachael Harwood ; Charles Douglas ; David ClarkSource :
- Asia‐Pacific Journal of Clinical Oncology [ 1743-7555 ] ; 2011-06.
Abstract
Aim: As survival rates for aggressive and conservative breast and lymph node surgery are similar, surgical treatment decisions for patients with early‐stage breast cancer should take patient preference into account. Decision aids have been demonstrated to increase patient knowledge and satisfaction with decision making, while decreasing decisional conflict. Hundreds of decision aids exist; however, few address lymph node surgery in any detail, and none acknowledge that there is a choice comparable to that between mastectomy and breast‐conserving therapy.
Url:
DOI: 10.1111/j.1743-7563.2010.01375.x
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type="first">Rachael</forename><surname>HARWOOD</surname></persName><affiliation>Faculty of Medicine, The University of Newcastle</affiliation><affiliation>Dr Rachael Harwood B Med Sci (Hons), 2/50 Flett St, Taree, NSW 2430, Australia. Email: rachael.c.harwood@studentmail.newcastle.edu.au</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Charles</forename><surname>DOUGLAS</surname></persName><affiliation>Faculty of Medicine, The University of Newcastle</affiliation><affiliation>The Breast Centre, Newcastle, New South Wales, Australia<address><country key="AU"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">David</forename><surname>CLARK</surname></persName><affiliation>The Breast Centre, Newcastle, New South Wales, Australia<address><country key="AU"></country></address></affiliation></author><idno type="istex">FD5EDF7DE3AB9DD75862447B52A0A2430E447BFA</idno><idno type="DOI">10.1111/j.1743-7563.2010.01375.x</idno><idno type="unit">AJCO1375</idno><idno type="toTypesetVersion">file:AJCO.AJCO1375.pdf</idno></analytic><monogr><title level="j" type="main">Asia‐Pacific Journal of Clinical Oncology</title><title level="j" type="alt">ASIA-PACIFIC JOURNAL CLINICAL ONCOLOGY</title><idno type="pISSN">1743-7555</idno><idno type="eISSN">1743-7563</idno><idno type="book-DOI">10.1111/(ISSN)1743-7563</idno><idno type="book-part-DOI">10.1111/ajco.2011.7.issue-2</idno><idno type="product">AJCO</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">7</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="114">114</biblScope><biblScope unit="page" to="122">122</biblScope><biblScope unit="page-count">9</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2011-06"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head><p><hi rend="bold">Aim: </hi> As survival rates for aggressive and conservative breast and lymph node surgery are similar, surgical treatment decisions for patients with early‐stage breast cancer should take patient preference into account. Decision aids have been demonstrated to increase patient knowledge and satisfaction with decision making, while decreasing decisional conflict. Hundreds of decision aids exist; however, few address lymph node surgery in any detail, and none acknowledge that there is a choice comparable to that between mastectomy and breast‐conserving therapy.</p><p><hi rend="bold">Methods: </hi> A systematic process was employed to develop decision aids for mastectomy versus breast‐conserving therapy, axillary dissection versus sentinel node biopsy, and options following a positive sentinel node biopsy. The first two of these decision aids were evaluated in a small pilot study. Choice of operation, knowledge and decisional conflict and satisfaction were compared with outcomes in an historical control group.</p><p><hi rend="bold">Results: </hi> Women reported favorably on the decision aids. The numbers in the pilot group were too small to allow definitive conclusions to be drawn, but suggested a possible reduction in decisional conflict, and possibly increase in decisional satisfaction, knowledge and choice of axillary clearance (rather than sentinel node biopsy) in the intervention group.</p><p><hi rend="bold">Conclusion: </hi> These decision aids could improve decision making for the surgical treatment of early breast cancer. A prospective randomized, control trial is needed to further evaluate the impact of these decision aids, particularly in the case of nodal surgery.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">axillary dissection</term><term xml:id="k2">breast cancer</term><term xml:id="k3">breast‐conserving surgery</term><term xml:id="k4">decision aid</term><term xml:id="k5">mastectomy</term><term xml:id="k6">sentinel node biopsy</term></keywords><classCode scheme="tocHeading1">Original articles</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/FD5EDF7DE3AB9DD75862447B52A0A2430E447BFA/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Asia</publisherName><publisherLoc>Melbourne, Australia</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1743-7563</doi><issn type="print">1743-7555</issn><issn type="electronic">1743-7563</issn><idGroup><id type="product" value="AJCO"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="ASIA-PACIFIC JOURNAL CLINICAL ONCOLOGY">Asia‐Pacific Journal of Clinical Oncology</title></titleGroup></publicationMeta><publicationMeta level="part" position="06102"><doi origin="wiley">10.1111/ajco.2011.7.issue-2</doi><numberingGroup><numbering type="journalVolume" number="7">7</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2011-06">June 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="5" status="forIssue"><doi origin="wiley">10.1111/j.1743-7563.2010.01375.x</doi><idGroup><id type="unit" value="AJCO1375"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">Original articles</title></titleGroup><copyright>© 2011 Blackwell Publishing Asia Pty Ltd</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.4.9 mode:FullText" date="2011-05-18"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-01-24"></event><event type="firstOnline" date="2011-01-24"></event><event type="publishedOnlineFinalForm" date="2011-05-18"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-01"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-15"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="114">114</numbering><numbering type="pageLast" number="122">122</numbering></numberingGroup><correspondenceTo>Dr Rachael Harwood B Med Sci (Hons), 2/50 Flett St, Taree, NSW 2430, Australia. Email: <email>rachael.c.harwood@studentmail.newcastle.edu.au</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:AJCO.AJCO1375.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Accepted for publication 26 November 2010.</unparsedEditorialHistory><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="3"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="21"></count><count type="wordTotal" number="3733"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Decision aids for breast and nodal surgery in patients with early breast cancer: Development and a pilot study</title><title type="shortAuthors">R Harwood <i>et al</i>.</title><title type="short">Decision aids for breast cancer patients</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>Rachael</givenNames><familyName>HARWOOD</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1 #a2"><personName><givenNames>Charles</givenNames><familyName>DOUGLAS</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>David</givenNames><familyName>CLARK</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Faculty of Medicine, The University of Newcastle</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="AU"><unparsedAffiliation>The Breast Centre, Newcastle, New South Wales, Australia</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">axillary dissection</keyword><keyword xml:id="k2">breast cancer</keyword><keyword xml:id="k3">breast‐conserving surgery</keyword><keyword xml:id="k4">decision aid</keyword><keyword xml:id="k5">mastectomy</keyword><keyword xml:id="k6">sentinel node biopsy</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p><b>Aim: </b> As survival rates for aggressive and conservative breast and lymph node surgery are similar, surgical treatment decisions for patients with early‐stage breast cancer should take patient preference into account. Decision aids have been demonstrated to increase patient knowledge and satisfaction with decision making, while decreasing decisional conflict. Hundreds of decision aids exist; however, few address lymph node surgery in any detail, and none acknowledge that there is a choice comparable to that between mastectomy and breast‐conserving therapy.</p><p><b>Methods: </b> A systematic process was employed to develop decision aids for mastectomy versus breast‐conserving therapy, axillary dissection versus sentinel node biopsy, and options following a positive sentinel node biopsy. The first two of these decision aids were evaluated in a small pilot study. Choice of operation, knowledge and decisional conflict and satisfaction were compared with outcomes in an historical control group.</p><p><b>Results: </b> Women reported favorably on the decision aids. The numbers in the pilot group were too small to allow definitive conclusions to be drawn, but suggested a possible reduction in decisional conflict, and possibly increase in decisional satisfaction, knowledge and choice of axillary clearance (rather than sentinel node biopsy) in the intervention group.</p><p><b>Conclusion: </b> These decision aids could improve decision making for the surgical treatment of early breast cancer. A prospective randomized, control trial is needed to further evaluate the impact of these decision aids, particularly in the case of nodal surgery.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Decision aids for breast and nodal surgery in patients with early breast cancer: Development and a pilot study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Decision aids for breast cancer patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Decision aids for breast and nodal surgery in patients with early breast cancer: Development and a pilot study</title></titleInfo><name type="personal"><namePart type="given">Rachael</namePart><namePart type="family">HARWOOD</namePart><affiliation>Faculty of Medicine, The University of Newcastle</affiliation><affiliation>E-mail: rachael.c.harwood@studentmail.newcastle.edu.au</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Charles</namePart><namePart type="family">DOUGLAS</namePart><affiliation>Faculty of Medicine, The University of Newcastle</affiliation><affiliation>The Breast Centre, Newcastle, New South Wales, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David</namePart><namePart type="family">CLARK</namePart><affiliation>The Breast Centre, Newcastle, New South Wales, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Asia</publisher><place><placeTerm type="text">Melbourne, Australia</placeTerm></place><dateIssued encoding="w3cdtf">2011-06</dateIssued><edition>Accepted for publication 26 November 2010.</edition><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">3</extent><extent unit="references">21</extent><extent unit="words">3733</extent></physicalDescription><abstract>Aim: As survival rates for aggressive and conservative breast and lymph node surgery are similar, surgical treatment decisions for patients with early‐stage breast cancer should take patient preference into account. Decision aids have been demonstrated to increase patient knowledge and satisfaction with decision making, while decreasing decisional conflict. Hundreds of decision aids exist; however, few address lymph node surgery in any detail, and none acknowledge that there is a choice comparable to that between mastectomy and breast‐conserving therapy.</abstract><abstract>Methods: A systematic process was employed to develop decision aids for mastectomy versus breast‐conserving therapy, axillary dissection versus sentinel node biopsy, and options following a positive sentinel node biopsy. The first two of these decision aids were evaluated in a small pilot study. Choice of operation, knowledge and decisional conflict and satisfaction were compared with outcomes in an historical control group.</abstract><abstract>Results: Women reported favorably on the decision aids. The numbers in the pilot group were too small to allow definitive conclusions to be drawn, but suggested a possible reduction in decisional conflict, and possibly increase in decisional satisfaction, knowledge and choice of axillary clearance (rather than sentinel node biopsy) in the intervention group.</abstract><abstract>Conclusion: These decision aids could improve decision making for the surgical treatment of early breast cancer. A prospective randomized, control trial is needed to further evaluate the impact of these decision aids, particularly in the case of nodal surgery.</abstract><subject lang="en"><genre>keywords</genre><topic>axillary dissection</topic><topic>breast cancer</topic><topic>breast‐conserving surgery</topic><topic>decision aid</topic><topic>mastectomy</topic><topic>sentinel node biopsy</topic></subject><relatedItem type="host"><titleInfo><title>Asia‐Pacific Journal of Clinical Oncology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">1743-7555</identifier><identifier type="eISSN">1743-7563</identifier><identifier type="DOI">10.1111/(ISSN)1743-7563</identifier><identifier type="PublisherID">AJCO</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>7</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>114</start><end>122</end><total>9</total></extent></part></relatedItem><identifier type="istex">FD5EDF7DE3AB9DD75862447B52A0A2430E447BFA</identifier><identifier type="DOI">10.1111/j.1743-7563.2010.01375.x</identifier><identifier type="ArticleID">AJCO1375</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2011 Blackwell Publishing Asia Pty Ltd</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Asia</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Decision aids for breast and nodal surgery in patients with early breast cancer: Development and a pilot study
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