Patient values in breast cancer surgical decision-making - The WhySurg study

Marie Fefferman; Kristine Kuchta; Kyra Nicholson; Deanna Attai; David Victorson; Catherine Pesce; Katherine Kopkash; Elizabeth Poli; Thomas W Smith; Katharine Yao

doi:10.1016/j.amjsurg.2023.10.010

Patient values in breast cancer surgical decision-making - The WhySurg study

Am J Surg. 2024 Jan:227:137-145. doi: 10.1016/j.amjsurg.2023.10.010. Epub 2023 Oct 4.

Authors

Affiliations

¹ Department of Surgery, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA; Department of Surgery, Division of Surgical Oncology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL, 60201, USA.
² Biostatistical Core, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL, 60201, USA.
³ Department of Surgery, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.
⁴ Department of Medical Social Sciences, Northwestern University, 633 Clark St, Evanston, IL, 60208, USA.
⁵ Department of Surgery, Division of Surgical Oncology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL, 60201, USA.
⁶ Department of Surgery, Division of Surgical Oncology, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL, 60201, USA. Electronic address: kyao@northshore.org.

PMID: 37858372
DOI: 10.1016/j.amjsurg.2023.10.010

Abstract

Background: The objective of this study was to describe patient values and personality traits associated with breast surgery choice for patients with breast cancer.

Methods: A survey based on qualitative patient interviews and the Big-Five personality trait profile was distributed to Love Research Army volunteers aged 18-70 years old who underwent breast cancer surgery from 2009 to 2020. Multivariable logistic regression analysis was used to determine independent patient values and personality traits for the choice of breast-conserving surgery (BCS), unilateral mastectomy (UM) and bilateral mastectomy (BM).

Results: 1497 participants completed the survey. Open-mindedness was associated with UM and sociability was associated with BM. A majority of patients prioritized cancer outcomes. Compared to BM patients, BCS and UM patients were significantly more likely to choose values associated with maintaining their self-image, optimizing surgical recovery, and following their doctor's recommendation.

Conclusions: Other values besides cancer outcomes differentiate patient surgical choice for BCS or mastectomy.

Keywords: Big-Five Inventory; Breast cancer; Breast surgery; Decision-making; Personality.

MeSH terms

Adolescent
Adult
Aged
Breast Neoplasms* / surgery
Female
Humans
Mastectomy
Mastectomy, Segmental
Middle Aged
Self Concept
Surveys and Questionnaires
Young Adult