Investigation of Approval Degree of Breast Conserving Therapy and Breast Reconstruction of Women with Breast Diseases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xin ^1,2 , ZHANG Purong ² , CHEN Jie ¹ , ZHENG Jie ² ,  LQing ¹

1.Department of Thyroid and Breast Surgery, West China Hospital, Chengdu 610041, China;;
2.Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu 610041, China;

Corresponding author：

LQing, Email: lqlq1963@163.com

Keywords：

Breast conserving operation; Breast reconstruction; Approval degree; Questionnaire

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Objective To study the cause of the low rate of breast conservation and reconstruction by investigating the approval degree of breast conserving therapy and breast reconstruction of women with breast diseases, to help the breast surgeons make better communication with the patients and make more pertinent choices of therapeutic methods. Methods The age, occupation, educational background, the attitudes towards breast conserving therapy and breast reconstruction， and the choice of operative method of breast reconstruction of 139 patients with breast cancer and 224 patients with benign breast disease were investigated by questionnaire. Results In breast cancer group, 23.9% （28/117） of patients chose breast conserving therapy and 35.9%（42/117） of patients chose breast reconstruction, while the rates of breast conservation and reconstruction were 53.3% （106/199） and 63.8% （127/199） in benign breast disease group. In both groups, the higher rates of breast conservation and reconstruction were associated with better educational background (in breast cancer group: P=0.029， P=0.296; in benign breast disease group: P=0.081, P=0.019） and lower age (all P lt;0.05). Patients engaged in commerce showed higher rates of breast conservation and reconstruction （in breast cancer group: P=0.013, P=0.042； in benign breast disease group: P=0.032, P=0.044）. Age, occupation or educational background was not related with the choice of operative method of breast reconstruction （P gt;0.05). Conclusions Patients with lower age, better educational background, and better job condition have ber desire of breast conservation and reconstruction. Breast surgeons should enhance communication with those patients about relevant information of breast conservation and reconstruction to make the more pertinent choice of therapeutic methods.

Citation： ZHANG Xin ,ZHANG Purong,CHEN Jie,ZHENG Jie,LQing. Investigation of Approval Degree of Breast Conserving Therapy and Breast Reconstruction of Women with Breast Diseases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1240-1244. doi: Copy

1.	Veronesi U, Salvadori B, Luini A, et al. Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1 973 patients [J]. Eur J Cancer, 1995； 31A(10): 1567-1569.
2.	Caffo O, Amichetti M, Ferro A, et al. Pain and quality of life after surgery for breast cancer [J]. Breast Cancer Res Treat, 2003； 80(1): 39-48.
3.	Bergen PI, Heerdt AS, Moore MP, et al. Breast conservation therapy for invasive carcinoma of the breast [J]. Curr Prold Surg, 1995; 32（3）: 191-248.
4.	林本耀. 乳腺癌保乳治疗学 [M]. 北京: 清华大学出版社, 2004: 113-116.
5.	张保宁. 早期乳腺癌保乳手术的相关问题 [J]. 中国肿瘤, 2007； 16（10）： 758-760.
6.	Lam WW, Fielding R, Ho EY. Predicting psychological morbidity in Chinese women after surgery for breast carcinoma [J]. Cancer, 2005； 103(3): 637-646.
7.	Engel J, Kerr J, Schlesinger-Raab A, et al. Quality of life following breast-conserving therapy or mastectomy: results of 5-year prospective study [J]. Breast J, 2004； 10(3): 223-231.
8.	孙强，陈凛，陈杰，等. 乳腺癌术后乳房缺损患者的心理调查 [J]. 中华整形外科杂志， 2003； 19(4)： 294-296.
9.	Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial [J]. J Natl Cancer Ins, 2004； 96(5): 376-387.
10.	张疆莉, 祁富生, 白清林. 乳腺癌患者社会心理特征的研究 [J]. 中国神经精神疾病杂志, 2002； 28(5): 330-332.
11.	Tomatis L. Between the body and mind: the involvement of psychological factors in the development of multifactorial diseases [J]. Eur J Cancer, 2001； 37(Suppl 8): S148-S152.
12.	Shapiro SL, Lopez AM, Schqartz GE, et al. Quality of life and breast cancer: relationship to psychosocial variables [J]. J Clin Psychol, 2001； 57(4): 501-519.
13.	Northous LL, Caffey M, Deichelbohrer L, et al. The quality of life of African American women with breast cancer [J]. Res Nurs Health, 1999, 22(6): 449-460.
14.	Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer [J]. N Engl J Med, 1995； 333（22）: 1456-1461.
15.	Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastetomy, lumpectomy, and lumpectomy plus irradiction for the treatment of breast cancer [J]. N Engl J Med, 2002； 347(16): 1233-1241.
16.	Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and surgery in early breast cancer -an overview of the randomized trials [J]. N Engl J Med, 1995； 333（22）: 1444-1456.
17.	张保宁. 乳腺癌保乳手术的研究进展 [J]. 中国普外基础与临床杂志, 2005； 12(3): 204-206.
18.	Nour A. Breast-conserving therapy in low-literacy patients in a developing country [J], Breast J， 2003； 9(2): 71-73.
19.	沈镇宙，邵志敏. 现代乳腺肿瘤学进展 [M]. 上海：上海科学技术文献出版社， 2002： 117-119.
20.	Dusková M, Kanková H, Tvrdek M, et al. Breast reconstruction as an integral part of a breast carcinoma therapy (a self-present final report of a reseach project IGA MZ CR) [J]. Acta Chir Plast, 2001； 43(2): 42-53.
21.	Jensen JA. Should improved mastectomy and reconstruction alter the primary management of breast cancer? [J]. Plast Reconstr Surg, 1999； 103(4): 1308-1310.
22.	Slavin SA, Schnitt SJ, Duda RB, et al. Skin-sparing mastectomy and immediate reconsruction: Oncologic risks and aesthetic results in patients with early-stage breast cancer [J]. Plast Reconstr Surg, 1998; 102(1): 49-62.
23.	Birdsell DC, Jenkins H, Berkel H. Breast cancer diagnosis and survival in women with or without breast implants [J]. Plast Reconstr Surg, 1993； 92(5): 795-800.
24.	Pusic A， Thompson TA， Kerrigan CL， et al. Surgical options options the early-stage breast cancer: factors with patient choice and postopretivequality of life [J]. Plast Reconstr Surg， 1999； 104(5): 1325-1333.
25.	栩轶，师兰香. 原发性乳腺癌患者对改良根治术后乳腺重建认同程度的调查研究 [J]. 解放军护理杂志， 2003； 20(3): 30-31.

1. Veronesi U, Salvadori B, Luini A, et al. Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1 973 patients [J]. Eur J Cancer, 1995； 31A(10): 1567-1569.
2. Caffo O, Amichetti M, Ferro A, et al. Pain and quality of life after surgery for breast cancer [J]. Breast Cancer Res Treat, 2003； 80(1): 39-48.
3. Bergen PI, Heerdt AS, Moore MP, et al. Breast conservation therapy for invasive carcinoma of the breast [J]. Curr Prold Surg, 1995; 32（3）: 191-248.
4. 林本耀. 乳腺癌保乳治疗学 [M]. 北京: 清华大学出版社, 2004: 113-116.
5. 张保宁. 早期乳腺癌保乳手术的相关问题 [J]. 中国肿瘤, 2007； 16（10）： 758-760.
6. Lam WW, Fielding R, Ho EY. Predicting psychological morbidity in Chinese women after surgery for breast carcinoma [J]. Cancer, 2005； 103(3): 637-646.
7. Engel J, Kerr J, Schlesinger-Raab A, et al. Quality of life following breast-conserving therapy or mastectomy: results of 5-year prospective study [J]. Breast J, 2004； 10(3): 223-231.
8. 孙强，陈凛，陈杰，等. 乳腺癌术后乳房缺损患者的心理调查 [J]. 中华整形外科杂志， 2003； 19(4)： 294-296.
9. Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial [J]. J Natl Cancer Ins, 2004； 96(5): 376-387.
10. 张疆莉, 祁富生, 白清林. 乳腺癌患者社会心理特征的研究 [J]. 中国神经精神疾病杂志, 2002； 28(5): 330-332.
11. Tomatis L. Between the body and mind: the involvement of psychological factors in the development of multifactorial diseases [J]. Eur J Cancer, 2001； 37(Suppl 8): S148-S152.
12. Shapiro SL, Lopez AM, Schqartz GE, et al. Quality of life and breast cancer: relationship to psychosocial variables [J]. J Clin Psychol, 2001； 57(4): 501-519.
13. Northous LL, Caffey M, Deichelbohrer L, et al. The quality of life of African American women with breast cancer [J]. Res Nurs Health, 1999, 22(6): 449-460.
14. Fisher B, Anderson S, Redmond CK, et al. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer [J]. N Engl J Med, 1995； 333（22）: 1456-1461.
15. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastetomy, lumpectomy, and lumpectomy plus irradiction for the treatment of breast cancer [J]. N Engl J Med, 2002； 347(16): 1233-1241.
16. Early Breast Cancer Trialists’ Collaborative Group. Effects of radiotherapy and surgery in early breast cancer -an overview of the randomized trials [J]. N Engl J Med, 1995； 333（22）: 1444-1456.
17. 张保宁. 乳腺癌保乳手术的研究进展 [J]. 中国普外基础与临床杂志, 2005； 12(3): 204-206.
18. Nour A. Breast-conserving therapy in low-literacy patients in a developing country [J], Breast J， 2003； 9(2): 71-73.
19. 沈镇宙，邵志敏. 现代乳腺肿瘤学进展 [M]. 上海：上海科学技术文献出版社， 2002： 117-119.
20. Dusková M, Kanková H, Tvrdek M, et al. Breast reconstruction as an integral part of a breast carcinoma therapy (a self-present final report of a reseach project IGA MZ CR) [J]. Acta Chir Plast, 2001； 43(2): 42-53.
21. Jensen JA. Should improved mastectomy and reconstruction alter the primary management of breast cancer? [J]. Plast Reconstr Surg, 1999； 103(4): 1308-1310.
22. Slavin SA, Schnitt SJ, Duda RB, et al. Skin-sparing mastectomy and immediate reconsruction: Oncologic risks and aesthetic results in patients with early-stage breast cancer [J]. Plast Reconstr Surg, 1998; 102(1): 49-62.
23. Birdsell DC, Jenkins H, Berkel H. Breast cancer diagnosis and survival in women with or without breast implants [J]. Plast Reconstr Surg, 1993； 92(5): 795-800.
24. Pusic A， Thompson TA， Kerrigan CL， et al. Surgical options options the early-stage breast cancer: factors with patient choice and postopretivequality of life [J]. Plast Reconstr Surg， 1999； 104(5): 1325-1333.
25. 栩轶，师兰香. 原发性乳腺癌患者对改良根治术后乳腺重建认同程度的调查研究 [J]. 解放军护理杂志， 2003； 20(3): 30-31.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Investigation of Approval Degree of Breast Conserving Therapy and Breast Reconstruction of Women with Breast Diseases

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