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Are Patients With Breast Cancer Satisfied With Their Decision Making?

Jane E. Lacovara
Jill Arzouman
Christina J. Kim
Janice A. Degan
Margaret Horner
CJON 2011, 15(3), 320-323 DOI: 10.1188/11.CJON.320-323

Choosing between lumpectomy with radiation versus mastectomy is difficult for women with early-stage breast cancer, and doubt can decrease women's confidence and satisfaction. As a result, the current study surveyed satisfaction before and after surgery in a convenience sample of women with early-stage breast cancer from a single practice. All women received either total mastectomy or lumpectomy plus radiation based on their informed choice of surgical options. The surgeon and the principal investigator educated patients about both surgeries at the time of consent. Participants answered a survey about satisfaction with their decision making before their chosen surgical procedure and again by telephone six months later. Participants felt that they had made an informed choice at the time of decision (87%) and at follow-up (93%). In addition, most women were satisfied with their choice of surgical procedure at time of decision (87%) as well as six months after surgery (96%). This study allowed women to significantly participate in their care through surgical decision making, which improved satisfaction. Nurses are uniquely positioned to support women with early-stage breast cancer in their decision-making process.

References 

Agency for Healthcare Research and Quality. (2010). Surgery choices for women with early-stage breast cancer. Retrieved from <a target="_blank" href='http://www.ahrq.gov/consumer/brcanchoice.htm#Learn'>http://www.ahrq.gov/...

Connelly, L. (2008). Pilot studies. <i>Medsurg Nursing, 17</i>, 411-412.

Hawley, S.T., Lantz, P.M., Janz, N.K., Salem, B., Morrow, M., Schwartz, K., … Katz, S.J. (2007). Factors associated with patient involvement in surgical treatment decision making for breast cancer. <i>Patient Education and Counseling, 65</i>, 387-395. doi: 10.1016/j.pec.2006.09.010

Janz, N.K., Wren, P.A., Copeland, L.A., Lowery, J.C., Goldfarb, S.L., & Wilkins, E.G. (2004). Patient-physician concordance: Preferences, perceptions, and factors influencing the breast cancer surgical decision. <i>Journal of Clinical Oncology, 22</i>, 3091-3098. doi: 10.1200/JCO.2004.09.069

Koedoot, N., Molenaar, S., Oosterveld, P., Bakker, P., de Graeff, A., Nooy, M., & de Haes, H. (2001). The decisional conflict scale: Further evaluation in two samples of Dutch oncology patients. <i>Patient Education and Counseling, 45</i>, 187-193.

Lacovara, J.E., & Arzouman, J. (2006, October). <i>Do patients feel satisfied with their decision making related to a lumpectomy with radiation versus mastectomy for the treatment of stage 0, I, II ductal or lobular carcinoma of the breast?</i> Telecast presented at the Nursing Grand Rounds of the University of Arizona, Tucson.

Lacovara, J.E., & Ray, J. (2007). Deciphering the diagnostics of breast cancer. <i>Medsurg Nursing, 16</i>, 391-399.

Lally, R.M. (2009). In the moment: Women speak about surgical treatment decision making days after a breast cancer diagnosis [Online exclusive]. <i>Oncology Nursing Forum, 36</i>, E257-E265. doi: 10.1188/09.ONF.E257-E265

National Cancer Institute. (2011). Mastectomy no better than lumpectomy for women with small breast tumors. Retrieved from <a target="_blank" href='http://www.cancer.gov/clinicaltrials/results/summary/2002/mastectomy-ver...

National Guideline Clearinghouse. (2010). Management of breast cancer in women. Retrieved from <a target="_blank" href='http://www.guideline.gov/content.aspx?id=15458&search=management+of+brea...

O'Connor, A.M. (1995). Validation of a decisional conflict scale. <i>Medical Decision Making, 15</i>, 25-30. doi: 10.1177/0272989X9501500105

Sepucha, K.R., Belkora, J.K., Aviv, C., Mutchnik, S., & Esserman, L. (2003). Improving the quality of decision making in breast cancer: Consultation planning template and consultation recording template. <i>Oncology Nursing Forum, 30</i>, 99-106. doi: 10.1188/03.ONF.99-106

Surveillance Epidemiology and End Results. (2011). SEER stat fact sheets: Breast. Retrieved from <a target="_blank" href='http://seer.cancer.gov/statfacts/html/breast.html'>http://seer.cancer.go...

Whelan, T., Levine, M., Willan, A., Gafni, A., Sanders, K., Mirsky, D., … Dubois, S. (2004). Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: A randomized trial. <i>JAMA, 292</i>, 435-441. doi: 10.1001/jama.292.4.435