by Amy Hatton, Natalie Heriot, John Zalcberg, Darshini
Ayton, Jill Evans, David Roder, Boon H. Chua, Jolyn Hersch, Jocelyn Lippey,
Jane Fox, Christobel Saunders, G.Bruce Mann, Jane Synnot, Robin J. Bell
The Breast: VOLUME 60, P123-130, DECEMBER
01, 2021
Highlights
•Factors other than the characteristics of the DCIS were
involved in decisions about management.
•There was a lack of understanding about diagnosis and
prognosis.
•There was inconsistent involvement by women in decision
making about management.
•Factors such as perception of mastectomy and radiotherapy
could act as barriers or facilitators in decision making.
Abstract
Whilst some of the diversity in management of women with
ductal carcinoma in situ (DCIS) may be explained by tumour characteristics, the
role of patient preference and the factors underlying those preferences have
been less frequently examined. We have used a descriptive qualitative study to
explore treatment decisions for a group of Australian women diagnosed with DCIS
through mammographic screening. Semi-structured telephone interviews were
performed with 16 women diagnosed with DCIS between January 2012 and December
2018, recruited through the LifePool dataset (a subset of BreastScreen
participants who have agreed to participate in research). Content analysis
using deductive coding identified three themes: participants did not have a
clear understanding of their diagnosis or prognosis; reported involvement in
decision making about management varied; specific factors including the
psychosexual impact of mastectomy and perceptions of radiotherapy, could act as
barriers or facilitators to specific decisions about treatment.
The treatment the women received was not simply determined
by the characteristics of their disease. Interaction with the managing
clinician was pivotal, however many other factors played a part in individual
decisions. Recognising that decisions are not purely a function of disease
characteristics is important for both women with DCIS and the clinicians who
care for them.
