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Chen X, Qin Y, Chaimongkol N. Effectiveness of a phone-based support program on self-care self-efficacy, psychological distress, and quality of life among women newly diagnosed with breast cancer: A randomized controlled trial. Eur J Oncol Nurs 2024; 71:102643. [PMID: 38889503 DOI: 10.1016/j.ejon.2024.102643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/02/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE This study aimed to determine the effectiveness of a Phone-Based Support Program (PBSP) for newly diagnosed women with breast cancer. METHODS A two-group repeated measures randomized controlled trial was designed. Participants included 94 patients aged 18-60 years who were newly diagnosed with breast cancer and undergoing chemotherapy in a tertiary hospital in China. They were randomly assigned to the intervention and the control groups. Participants in the intervention group were enrolled in a four-session PBSP, consisting of four interactive sections: learning, discussion, ask-the-expert, and personal stories, plus the routine care. Outcomes included patients' self-care self-efficacy, psychological distress (including symptom distress, anxiety, and depression), and quality of life. These were assessed at three time points: pre-intervention (T1), post-intervention (T2), and follow-up (T3) by using the self-care self-efficacy scale, the M.D. Anderson Symptom Inventory, the hospital anxiety and depression scale, and the global health status scale. RESULTS After completion of the intervention, participants in the intervention group had significantly (p < .001) higher self-care self-efficacy (T2: Mdiff = 11.49, T3: Mdiff = 22.33), better quality of life (T2: Mdiff = 8.18, T3: Mdiff = 17.19), lower symptom distress (T2: Mdiff = -26.68, T3: Mdiff = -54.76), less anxiety (T2: Mdiff = -2.52, T3: Mdiff = -5.11), and less depression (T2: Mdiff = -3.61, T3: Mdiff = -6.71) than those in the control group. CONCLUSION These findings indicate that the PBSP is effective. Healthcare professionals, especially nurses, could utilize it to enhance self-care self-efficacy and quality of life, as well as decrease psychological distress among women newly diagnosed breast cancer. REGISTRATION The Thai Clinical Trial Registry #TCTR20230321010.
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Affiliation(s)
- Xi Chen
- The First People's Hospital of Yancheng in Jiangsu, Tinghu District, Yancheng City, Jiangsu Province, China.
| | - Yang Qin
- Jiangsu Vocational College of Medicine in Jiangsu, Yancheng City, Jiangsu Province, China.
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Melucci AD, Erlick MR, Loria A, Russell MM, Temple LK, Poles GC. Surgical Informed Consent: A Scoping Review of Physician-facing Decision Support Tools. ANNALS OF SURGERY OPEN 2023; 4:e259. [PMID: 37600865 PMCID: PMC10431347 DOI: 10.1097/as9.0000000000000259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Objectives Physician-facing decision support tools facilitate shared decision-making (SDM) during informed consent, but it is unclear whether they are comprehensive in the domains they measure. In this scoping review, we aimed to (1) identify the physician-facing tools used during SDM; (2) assess the patient-centered domains measured by these tools; (3) determine whether tools are available for older adults and for use in various settings (elective vs. emergent); and (4) characterize domains future tools should measure. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews, Embase, Medline, and Web of Science were queried for articles published between January 2000 and September 2022. Articles meeting inclusion criteria underwent title and abstract review. Eligible studies underwent data abstraction by two reviewers. Results Of 4365 articles identified, 160 were eligible. Tools to aid in surgical SDM focus on elective procedures (79%) and the outpatient setting (71%). Few tools are designed for older adults (5%) or for nonelective procedures (9%). Risk calculators were most common, followed by risk indices, prognostic nomograms, and communication tools. Of the domains measured, prognosis was more commonly measured (85%), followed by alternatives (28%), patient goals (36%), and expectations (46%). Most tools represented only one domain (prognosis, 33.1%) and only 6.7% represented all four domains. Conclusions and Implications Tools to aid in the surgical SDM process measure short-term prognosis more often than patient-centered domains such as long-term prognosis, patient goals, and expectations. Further research should focus on communication tools, the needs of older patients, and use in diverse settings.
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Affiliation(s)
- Alexa D. Melucci
- From the Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Mariah R. Erlick
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Anthony Loria
- From the Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Marcia M. Russell
- Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA
- Department of Surgery, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Larissa K. Temple
- From the Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Gabriela C. Poles
- From the Department of Surgery, University of Rochester Medical Center, Rochester, NY
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Maes-Carballo M, Martín-Díaz M, García-García M, Reinoso-Hermida A, Mignini L, Teixeira-Arcaya RP, Khan KS, Bueno-Cavanillas A. Decision Aids for Decision Making about Locally Advance Breast Cancer: A Systematic Review. Cancer Invest 2023; 41:1-13. [PMID: 36591950 DOI: 10.1080/07357907.2023.2164895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/03/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
Locally advanced breast cancer (LABC) is a subset of breast cancer with locoregional progression without distant metastasis. The multimodality treatment (surgery, chemotherapy, radiotherapy, hormonal and targeted therapy if required) could significantly improve results in this specific group of patients. The complex and multiple options of treatment with similar mortality rates but different outcomes depending on the patient's desires, preferences and social environment require aid to facilitate the individual patient's decisions (e.g. Decision Aids (DAs) targeting patients considering primary or adjuvant treatment in LABC). In this context, DAs have been proven fundamental to help patients and clinicians share and agree on the best value option. The current systematic review aimed to evaluate the existing DAs related to these patients with LABC and identify current status and possible improvement areas (possible scarcity and heterogeneity of instruments, the status of their development, explanation of their purpose,…). No previous systematic reviews have been published on this topic. Following Prospero registration no: CRD42021286173, studies about LABC DAs were identified, without data or language restrictions, through a systematic search of bibliographic databases in December 2021. Quality was assessed using Qualsyst criteria (range 0.0-1.0). The quality of the 17 selected studies ranged from 0.46 to 0.95. Of them, 14/17 (82%) were DAs about treatment, only one (6%) about diagnosis, and 2/17 (12%) about the employment of DAs. No screening or follow-up DAs were retrieved. Twelve (70.6%) DAs were online tools. They varied broadly regarding their characteristics and purposes. Most of the studies focused on developing and testing different DAs (5/17; 29.4%) and their impact (7/17; 41.2%). Only 4/17 (23.5%) analysed their implementation and cost. These instruments have proven to improve patient's knowledge and decision-making, decrease patient anxiety, and patients tend to undergo treatment. However, nowadays, there is still a need for further research and consensus on methodology to develop practical DAs.
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Affiliation(s)
- Marta Maes-Carballo
- Department of General Surgery, Breast Cancer Unit, Complexo Hospitalario de Ourense, Ourense, Spain
- Department of General Surgery, Hospital Público de Verín, Ourense, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Manuel Martín-Díaz
- Department of General Surgery, Hospital Santa Ana de Motril, Granada, Spain
| | - Manuel García-García
- Department of General Surgery, Breast Cancer Unit, Complexo Hospitalario de Ourense, Ourense, Spain
- Departmento de Cirugía General, Unidad de Mastología de Grupo Oroño, Rosario, Argentina
| | - Ayla Reinoso-Hermida
- Department of General Surgery, Breast Cancer Unit, Complexo Hospitalario de Ourense, Ourense, Spain
| | - Luciano Mignini
- Departmento de Cirugía General, Unidad de Mastología de Grupo Oroño, Rosario, Argentina
| | | | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Biosanitaria IBS, Granada, Spain
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Study on the Effect of Positive Psychological Intervention Based on PERMA Model on Perioperative Patients with AIDS Complicated with Breast Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9788122. [PMID: 35979048 PMCID: PMC9377935 DOI: 10.1155/2022/9788122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
Objective. To study the effect of positive psychological intervention based on PERMA model on perioperative AIDS patients complicated with breast cancer. Methods. A total of 120 perioperative patients with AIDS complicated with breast cancer treated in our hospital from January 2021 to December 2021 were randomly divided into research group (
) and control group (
). The research group received positive psychological intervention based on PERMA model, while the control group received routine nursing. The scores of disease uncertainty scale (MUIS), Frankl treatment compliance scale, cancer-related fatigue scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and quality of life scale EORTCQLQ-C30 (v3.0) were studied. Results. After 12-week nursing, the MUIS score of the research group was lower than that of the control group, and the difference was statistically significant (
). After 12 weeks of nursing, the score of Frankl treatment compliance scale in the research group was higher than that in the control group, and the difference was statistically significant (
). Following 12-week nursing, the scores of SAS and SDS in the research group were lower than those in the control group, and the difference was statistically significant (
). After 12 weeks of nursing, the score of cancer-related fatigue scale in the research group was lower than that in the control group, and the difference was statistically significant (
). The EORTCQLQ-C30 (v3.0) scale-symptom domain score in the research group was lower than that in the control group following 12-week nursing, and the difference was statistically significant (
). After 12 weeks of nursing, the EORTCQLQ-C30 (v3.0) scale-overall health domain score and functional domain score in the research group were higher than those in the control group, and the difference was statistically significant (
). Conclusion. The application value of positive psychological intervention based on PERMA model in perioperative patients with AIDS complicated with breast cancer is more significant. It contributes more to treatment compliance and improves negative feelings of anxiety and depression.
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Jansen J, Serafimovska A, Glassey R, Zdenkowski N, Saunders C, Porter D, Butow P. The implementation of a decision aid for women with early-stage breast cancer considering contralateral prophylactic mastectomy: A pilot study. PATIENT EDUCATION AND COUNSELING 2022; 105:74-80. [PMID: 34034935 DOI: 10.1016/j.pec.2021.04.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Despite little survival benefit and potential for harm, contralateral prophylactic mastectomy (CPM) rates are increasing amongst early-stage breast cancer patients at low contralateral breast cancer risk. We developed a CPM decision aid (DA) and conducted a pilot implementation. METHODS Surgeons and oncologists recruited eligible patients considering CPM. Consenting patients received the DA, completed a questionnaire and participated in a semi-structured interview. Clinicians were interviewed at study close. RESULTS Eleven clinicians and 31 patients participated. Three themes emerged: perceived utility and impact of the DA, disagreement regarding timing of delivery and target population, and implementation strategies. Both women and clinicians found the DA valuable, indicating it confirmed rather than changed preferences. Women (all of whom raised CPM themselves), preferred offering the DA early in treatment discussions whilst clinicians favoured targeting women who enquired about CPM. CONCLUSION A DA about CPM is feasible and acceptable, but questions remain about the role of DAs in these types of decisions where one option has limited medical benefit. PRACTICE IMPLICATIONS Some women have a high need to make an informed choice about CPM. Tools to support this could include a DA with a clear recommendation against CPM and an explanation why.
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Affiliation(s)
- J Jansen
- Department of Family Medicine, School Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences (FHML), Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - A Serafimovska
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Australia
| | - R Glassey
- School of Medicine, University of Western Australia, Perth, Australia
| | - N Zdenkowski
- Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia; Breast Cancer Trials, Newcastle, Australia
| | - C Saunders
- School of Medicine, University of Western Australia, Perth, Australia
| | | | - P Butow
- Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, University of Sydney, Australia
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Yung A, Kay J, Beale P, Gibson KA, Shaw T. Computer-Based Decision Tools for Shared Therapeutic Decision-making in Oncology: Systematic Review. JMIR Cancer 2021; 7:e31616. [PMID: 34544680 PMCID: PMC8579220 DOI: 10.2196/31616] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Therapeutic decision-making in oncology is a complex process because physicians must consider many forms of medical data and protocols. Another challenge for physicians is to clearly communicate their decision-making process to patients to ensure informed consent. Computer-based decision tools have the potential to play a valuable role in supporting this process. OBJECTIVE This systematic review aims to investigate the extent to which computer-based decision tools have been successfully adopted in oncology consultations to improve patient-physician joint therapeutic decision-making. METHODS This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist and guidelines. A literature search was conducted on February 4, 2021, across the Cochrane Database of Systematic Reviews (from 2005 to January 28, 2021), the Cochrane Central Register of Controlled Trials (December 2020), MEDLINE (from 1946 to February 4, 2021), Embase (from 1947 to February 4, 2021), Web of Science (from 1900 to 2021), Scopus (from 1969 to 2021), and PubMed (from 1991 to 2021). We used a snowball approach to identify additional studies by searching the reference lists of the studies included for full-text review. Additional supplementary searches of relevant journals and gray literature websites were conducted. The reviewers screened the articles eligible for review for quality and inclusion before data extraction. RESULTS There are relatively few studies looking at the use of computer-based decision tools in oncology consultations. Of the 4431 unique articles obtained from the searches, only 10 (0.22%) satisfied the selection criteria. From the 10 selected studies, 8 computer-based decision tools were identified. Of the 10 studies, 6 (60%) were conducted in the United States. Communication and information-sharing were improved between physicians and patients. However, physicians did not change their habits to take advantage of computer-assisted decision-making tools or the information they provide. On average, the use of these computer-based decision tools added approximately 5 minutes to the total length of consultations. In addition, some physicians felt that the technology increased patients' anxiety. CONCLUSIONS Of the 10 selected studies, 6 (60%) demonstrated positive outcomes, 1 (10%) showed negative results, and 3 (30%) were neutral. Adoption of computer-based decision tools during oncology consultations continues to be low. This review shows that information-sharing and communication between physicians and patients can be improved with the assistance of technology. However, the lack of integration with electronic health records is a barrier. This review provides key requirements for enhancing the chance of success of future computer-based decision tools. However, it does not show the effects of health care policies, regulations, or business administration on physicians' propensity to adopt the technology. Nevertheless, it is important that future research address the influence of these higher-level factors as well. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021226087; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021226087.
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Affiliation(s)
- Alan Yung
- Research in Implementation Science and eHealth, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Judy Kay
- Human Centred Technology Cluster, School of Computer Science, The University of Sydney, Sydney, Australia
| | - Philip Beale
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
| | - Kathryn A Gibson
- Department of Rheumatology, Liverpool Hospital, Ingham Research Institute, University of New South Wales, Sydney, Australia
| | - Tim Shaw
- Research in Implementation Science and eHealth, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sydney Catalyst Translational Cancer Research Centre, The University of Sydney, Sydney, Australia
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Scheepens JCC, Veer LV', Esserman L, Belkora J, Mukhtar RA. Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability. Breast 2021; 56:61-69. [PMID: 33621798 PMCID: PMC7907889 DOI: 10.1016/j.breast.2021.02.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/29/2021] [Accepted: 02/06/2021] [Indexed: 12/26/2022] Open
Abstract
The uptake of contralateral prophylactic mastectomy (CPM) has increased steadily over the last twenty years in women of all age groups and breast cancer stages. Since contralateral breast cancer is relatively rare and the breast cancer guidelines only recommend CPM in a small subset of patients with breast cancer, the drivers of this trend are unknown. This review aims to evaluate the evidence for and acceptability of CPM, data on patient rationales for choosing CPM, and some of the factors that might impact patient preferences. Based on the evidence, future recommendations will be provided. First, data on contralateral breast cancer risk and CPM rates and trends are addressed. After that, the evidence is structured around four main patient rationales for CPM formulated as questions that patients might ask their surgeon: Will CPM reduce mortality risk? Will CPM reduce the risk of contralateral breast cancer? Can I avoid future screening with CPM? Will I have better breast symmetry after CPM? Also, three different guidelines regarding CPM will be reviewed. Studies indicate a large gap between patient preferences for radical risk reduction with CPM and the current approaches recommended by important guidelines. We suggest a strategy including shared decision-making to enhance surgeons’ communication with patients about contralateral breast cancer and treatment options, to empower patients in order to optimize the use of CPM incorporating accurate risk assessment and individual patient preferences. Contralateral prophylactic mastectomy rates have increased over the last 20 years. Patients may want CPM to reduce risk of contralateral breast cancer and mortality. Patients do not always have the tools available to make a well-informed decision. Patient and surgeon’s shared decision-making could optimize the use of CPM.
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Affiliation(s)
- Josien C C Scheepens
- University of California, San Francisco, Department of Laboratory Medicine, 2340 Sutter St., Box 0808, San Francisco, CA, 94115, USA
| | - Laura van 't Veer
- University of California, San Francisco, Department of Laboratory Medicine, 2340 Sutter St., Box 0808, San Francisco, CA, 94115, USA
| | - Laura Esserman
- University of California, San Francisco, Department of Surgery, 1825 4th Street, 3rd Floor, Box 1710, San Francisco, CA, 94143-1710, USA
| | - Jeff Belkora
- University of California, San Francisco, Institute for Health Policy Studies and Department of Surgery, 3333 California Street, Suite 265, San Francisco, CA, 94118, USA
| | - Rita A Mukhtar
- University of California, San Francisco, Department of Surgery, 1825 4th Street, 3rd Floor, Box 1710, San Francisco, CA, 94143-1710, USA.
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Pesce C, Jaffe J, Kuchta K, Yao K, Sisco M. Patient-reported outcomes among women with unilateral breast cancer undergoing breast conservation versus single or double mastectomy. Breast Cancer Res Treat 2020; 185:359-369. [PMID: 33033966 DOI: 10.1007/s10549-020-05964-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/01/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE More women with unilateral early stage breast cancer are electing bilateral mastectomy (BM). Many cite anxiety, fear of recurrence, and certain aesthetic desires in their decision-making. Yet conflicting data exist regarding how these factors both inform and are modulated by medical decision-making, especially among women eligible for breast conservation (BCT). This study sought to assess the trajectories of women undergoing various surgical procedures for breast cancer. METHODS We performed a prospective longitudinal study of women with unilateral, non-hereditary breast cancer who underwent BCT, unilateral mastectomy (UM), or BM. Women completed surveys before surgery and at 1, 9, and 15 months postop. Surveys included questions about treatment preferences, decisional control, the HADS-A anxiety scale, the Fear of Relapse/Recurrence Scale (FRRS), and the BREAST-Q. The Kruskal-Wallis test was used to compare outcomes between BCT, UM, and BM groups at each time point. RESULTS 203 women were recruited and 177 (87.2%) completed 15-month follow-up. Of these, 101 (57.0%) underwent BCT, 33 (18.6%) underwent UM, and 43 (24.2%) underwent BM. Generalized anxiety and FRRS scores were similar between BCT, UM, and BM groups and declined uniformly after surgery. Although baseline breast satisfaction was similar between groups, at 15 months, it was significantly lower in BM patients than in BCT patients. Women who felt "very" confident and "very" informed before surgery had lower anxiety, lower fear of recurrence, better psychosocial well-being (PSWB), and greater breast satisfaction at 15 months. CONCLUSION While patients who undergo mastectomy have less long-term breast satisfaction, all patients can expect to experience similar improvements in anxiety and PSWB. Efforts should be made to ensure that patients are informed and confident regardless of which surgery is chosen, for this is the greatest predictor of better outcomes.
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Affiliation(s)
- Catherine Pesce
- Department of Surgery, Division of Surgical Oncology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Jennifer Jaffe
- Department of Surgery, Division of Surgical Oncology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Kristine Kuchta
- Biostatistical Core, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
| | - Katharine Yao
- Department of Surgery, Division of Surgical Oncology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Mark Sisco
- Department of Surgery, Division of Plastic Surgery, NorthShore University HealthSystem, Northbrook, IL, USA.
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