The Study Of The Social Psychology Factors That Affect The Choice Of Modus Operandi In Chinese Patients With Early-Stage Breast Cancer

PrefaceBreast cancer is a common malignancy in female. The incidence rate has occupied the first in female malignancy and the tendency of incidence age has become younger and younger. The most common treatment of early-stage breast cancer was modified radical mastectomy(MRM) before the 80s of the 20th century. With the further cognition of the pathogenesis and biological characteristics in breast cancer, patients desire body integrity and beauty more than before, and breast-conserving surgery(BCS) develop gradually. Compared with MRM, BCS reserves breast and reduces psychological problems of body image attention, sexual dysfuction and other post-operation. Many of the evidence-based medicine articals prove that BCS and MRM have no significant difference on survival rate or fatal rate.BCS synthetic treatment has became preferred way among Euramerican countries, and even became standardized treatment for early-stage breast cancer. More than 60% of the breast cancer patients in phaseâ… orâ…¡accepted BCS in developed region of Euramerican countries, while 40% in Japan. In China, however, the data of multiple center study showed that BCS only accounted for 9% of all the breast cancer operations and 19.5% of whom were fit for BCS. It was seen that most of the breast cancer patients in phaseâ… orâ…¡were still conducted MRM.ObjectiveFor the patients with early-stage breast cancer, breast-conserving surgery(BCS) has the same regional recurrent rate and survival rate with modified radical mastectomy(MRM), and BCS will bring better social psychology consequence to the patients. But there is different utilized rate of BCS in different countries. Chinese women with early-stage breast cancer prefer MRM to BCS. This article aims to study the social psychology factors that affect the choice of operation method in Chinese patients with early-stage breast cancer.MethodsFrom July 2008 to July 2009, fifty-one patients who consistent to the indication of BCS were selected in the breast surgery of Shengjing Hospital of the China medical university. The instruments includes self-edit investigate questionnaire, Hamilton anxiety scale(HAMA) and Hamilton depression scale(HAMD). After determining the operation method, the patients were standard told by doctors before operation.Results1.Comparing the difference between the BCS team and the MRM team, there is no significant difference in the basic information of demography but the breast shape. Most of the semi-globular type and cop type breast (66.7%) choose BCS, whereas ptosis type and platypelloid type breast (66.7%) choose MRM.2.The scores between HAMA and HAMD are not significantly different. The mean value of HAMA in the RMR team is 15.94, in the BCS team is 15.39, p=0.693; the mean value of HAMD are separately 19.21 and 19.78, p=0.749.3.In the Reasons affected modus operandi choice investigate questionnaire, worrying about recurrent, surgery doctors, cosmetology effect, worrying about the troubles of continuously radio-chemotherapy and other patients'choices affect the choice of operation method, but economy problems do not affect the choice. In the MRM team, the most effective factor is worrying about recurrent, followed by other patients'choices, worrying about the troubles of continuously radio-chemotherapy and spouse. In the BCS team, the most effective factor is surgery doctors, followed by affected stature and spouse.4.When choosing the modus operandi, the main considered factors are worrying about recurrent(34,22.22%), other patients'choices(31,20.28%), worrying about the troubles of continuously radio-chemotherapy(17,11.11%), surgery doctors(16,10.46%) and worrying about the cosmetology effect(13,8.49%).ConclusionsIn the basic information of demography, the factors such as age, academic career or occupation do not affect the choice of the operation method but the breast shape. The factors such as worrying about recurrent, surgery doctors, worrying about the cosmetology effect, worrying about the troubles of continuously radio-chemotherapy and other patients'choices affect the choice of the operation method in the patients with early-stage breast cancer. When choosing the modus operandi, the most important factors that affect the choice of the modus operandi are worrying about recurrent, other patients'choices and worrying about the troubles of continuously radio-chemotherapy. The economy problems do not significantly affect the choice.