Discussion of treatment options for early-stage breast cancer: effect of provider specialty on type of surgery and satisfaction.
Discussion of treatment options for early-stage breast cancer: effect of provider specialty on type of surgery and satisfaction.
复制标题
早期乳腺癌治疗方案的讨论：提供者专业对手术类型和满意度的影响。
DOI：
10.1097/00005650-200107000-00005
复制
发表时间：
2001
期刊：
影响因子：
3
通讯作者：
Guadagnoli,E
中科院分区：
文献类型：
--
作者：
Keating,NL;Weeks,JC;Landrum,MB;Borbas,C;Guadagnoli,E
Objectives.To describe the physicians with whom breast cancer patients discuss treatment options and assess whether discussing surgical options with a medical oncologist is associated with type of surgery and satisfaction.Research Design.Medical record abstraction and survey.Subjects.Women with early-stage breast cancer numbering 2,426 in two states—Massachusetts, where the rate of breast-conserving surgery is high, and Minnesota, where it is lower.Measures.Receipt of breast-conserving surgery and satisfaction.Results.Women in Massachusetts discussed breast cancer treatments with more physicians than women in Minnesota (mean 3.5 vs. 2.8; P< 0.001) and more often discussed surgical options with a medical oncologist (52% vs. 28%; P< 0.001). Using propensity score analyses, in Massachusetts, discussing surgical options with a medical oncologist was not related to type of surgery (adjusted difference in rate of breast-conserving surgery: 3.9%, 95% CI− 3.6% to 11.5%) but was associated with greater satisfaction (adjusted difference: 8.1, 95% CI 2.0% to 14.2%). In Minnesota, discussing surgical options with a medical oncologist was associated with breast-conserving surgery (adjusted difference: 12.6%, 95% CI 5.6% to 19.7%) with no difference in satisfaction (adjusted difference:− 1.5%, 95% CI− 6.8% to 3.8%).Conclusions.Outcomes associated with discussing surgical treatments with a medical oncologist vary with local care patterns. Where breast-conserving surgery is standard care, seeing a medical oncologist is not related to type of surgery, but is associated with greater satisfaction. Where it is not the standard, seeing a medical oncologist is associated with more breast-conserving surgery and equivalent satisfaction. These findings suggest that collaborative care may benefit women with respect to treatment selection or satisfaction.
