Breast cancer treatment choices in Hong Kong Chinese women

Abstract

Introduction: Survival following early-stage breast cancer is comparable for women treated with breast conserving surgery (BCS) and those with mastectomy. However, in a previous retrospective review of BCS in Hong Kong Chinese women, we found the rate of BCS is low (21.9%) as compared to that of Western countries. An in-depth qualitative interview study was conducted which aims to examine the influence of clinical, socio-cultural, provider communication and other factors on treatment decision-making processes. Methods: Patients with early-stage breast cancer completed surgical treatment in a university hospital were randomly selected in the study. A one-toone, tape-recorded, in-depth, semi-structured interview was conducted with each patient. A questionnaire with four dimensions of social concern was developed; these dimensions were self-image and sexuality, survival and cure concerns, concerns on subsequent treatments, and role of family or friends. Results: 20 patients with early breast cancer were recruited into the study. 9 patients had mastectomy, 9 had breast conservation and 2 had mastectomy followed by reconstruction. Demographic data and stage of the disease were comparable among these three groups. Survival and cure concerns were significantly more important than the other dimensions in treatment decisionmaking processes (p < 0.000). Surgeons’ recommendation on the treatment was also a significant factor influencing treatment choice in patients with breast conservation (p = 0.032). Conclusions: Rate of breast conservation is low among Chinese women. Surgeons’ recommendations, especially with emphasis on survival and cure concerns, may help to encourage more Chinese patients to choose breast conservation.