Surgery For Breast Cancer Analysis Of Factors Influencing The Choice Of Breast-conserving

Objective:Breast-conserving surgery has become the preferred surgical method for early breast cancer patients in the world,but there are still some patients in China who eligible for breast-conserving surgery choosing mastectomy.This study analyzed the factors related to the selection of breast-conserving surgery in patients with early breast cancer who were eligible for breast-conserving surgery,in order to help improve the rate of breast-sparing surgery.Methods:531 patients who were diagnosed with breast cancer in the Affiliated Hospital of Southwest Medical University from July 1,2017 to October 31,2019 and met the inclusion criteria were selected as subjects?Relevant questionnaires were distributed to eligible patients.The questionnaire survey was formulated based on factors found in relevant domestic and foreign research and clinical work that had an impact on the choice of surgical methods for patients(see Appendix 1).Before filling out the scale,the researchers explained the purpose of the study to each patient,and after obtaining the consent of the patients,a questionnaire was issued.In the process of filling in the questionnaire,uniform guidance language was used to explain the answering requirements to the patients,and the patients completed the questionnaires independently.For patients who could not answer the questions by themselves,the patient answered the questions and the investigator filled in the model.All scales were recovered promptly after completion.The results of the questionnaire survey were summarized and analyzed by SPSS 22.0.The classification data were described by relative Numbers,and the differences between groups were analyzed by single factor analysis using?2 test.Significant factors in single factor analysis were assigned and multivariate analysis was performed by binary logistic regression.In this article,P<0.05 was considered statistically significan..Results:A total of 524 questionnaires were distributed in this study and495 valid questionnaires were returned.The effective recovery rate was 94.4%.Among them,275 patients underwent breast-conserving surgery and 220patients underwent mastectomy.After univariate analysis of the factors affecting the surgical methods of patients,it was found that in general demographic data,the age(?2=9.560,P=0.008),work status(?2=6.807,P=0.009),place of residence(?2=3.993,P=0.046),distance from the treatment center(?2=27.605,P<0.001)were the factors affecting patient's chose for breast-conserving surgery.In the clinical data,Clinical stage(2=15.364,P<0.001),family history of cancer(2=8.681,P=0.003),previous history of benign breast disease(2=4.991,P=0.025)were the factors affecting patient's chose for breast-conserving surgery.In the importance of the factors affecting the choice of surgical methods for patients,surgeons recommendation(?~2=9.174,P=0.027),body image(?~2=11.737,P=0.008,radiotherapy factors(?~2=9.277,P=0.026),treatment cost(?~2=7.946,P=0.047)were the factors affecting patient's chose for breast-conserving surgery.Multivariate analysis using binary Logistic Regression showed that,Age(OR=0.293,95%CI 0.149~0.576,P<0.001),Distance from the treatment center(OR=0.226,95%CI 0.098~0.517,P<0.001),radiotherapy factors(OR=0.090,95%CI was 0.037~0.218,P<0.001)were associated with selective breast-conserving surgery.work status(OR=3.496,95%CI is 1.256~9.729,P=0.017),family history of cancer(OR=5.603,95%CI is 2.336~13.440,P<0.001),Importance of surgeon recommendations(OR=3.365,95%CI is1.622~6.980,P=0.001),and The importance of self-image(OR=11.935,95%CI is 5.340~26.677,P<0.001)were associated with selective mastectomy.Conclusion:Younger patients,living close to the treatment center,and understand and realize that the importance of radiotherapy were tended to choose breast-conserving surgery.The work,a family history of cancer,surgeons recommendation of surgical resection,considering self-image as important factors were tended to choose mastectomy.For patients who are suitable for breast preservation but choose mastectomy,objective and comprehensive suggestions should be given from a professional perspective,And strengthen the psychological counseling to patients,so that patients understand the advantages of breast preservation,so as to choose the most appropriate surgical method according to their own situation.