TY - JOUR
T1 - Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer
AU - Knuttel, Floortje M.
AU - van den Bosch, Maurice A. A. J.
AU - Young-Afat, Danny A.
AU - Emaus, Marleen J.
AU - van den Bongard, Desirée H. J. G.
AU - Witkamp, Arjen J.
AU - Verkooijen, Helena M.
PY - 2017
Y1 - 2017
N2 - Background Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients’ preferences with regard to these new treatments have not been investigated. Objectives To assess preferences of patients with breast cancer and of healthy women regarding these new techniques, compared with conventional surgical treatments. Methods Six hypothetical breast cancer treatment-outcome scenarios were developed: three standard surgical scenarios (mastectomy, mastectomy with immediate implant-based reconstruction, and breast-conserving therapy [BCT]) and three minimally invasive or noninvasive scenarios (radiofrequency ablation, magnetic resonance-guided high-intensity focused ultrasound ablation, and single-dose ablative radiotherapy). Participants rated treatment-outcome scenarios by visual analogue scale (VAS) and time trade-off (TTO). The Friedman and post hoc Wilcoxon signed-rank tests were used to test whether scores were significantly different from BCT. Results Seventy-one patients with breast cancer and 50 healthy volunteers participated. Overall, BCT was rated the highest in terms of VAS (0.80) and TTO (0.90) scores. After stratification, BCT ranked the highest in most subgroups, with the exception of healthy individuals, who had given the highest score to ablative boost (VAS, 0.80; TTO, 0.88). Mastectomy with immediate reconstruction was the least preferred in most subgroups. Conclusions This study showed no significant preference for minimally invasive treatment for breast cancer. Using hypothetical scenarios, breast cancer survivors attributed the highest scores to BCT, whereas healthy volunteers showed a slight preference for minimally invasive treatments.
AB - Background Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients’ preferences with regard to these new treatments have not been investigated. Objectives To assess preferences of patients with breast cancer and of healthy women regarding these new techniques, compared with conventional surgical treatments. Methods Six hypothetical breast cancer treatment-outcome scenarios were developed: three standard surgical scenarios (mastectomy, mastectomy with immediate implant-based reconstruction, and breast-conserving therapy [BCT]) and three minimally invasive or noninvasive scenarios (radiofrequency ablation, magnetic resonance-guided high-intensity focused ultrasound ablation, and single-dose ablative radiotherapy). Participants rated treatment-outcome scenarios by visual analogue scale (VAS) and time trade-off (TTO). The Friedman and post hoc Wilcoxon signed-rank tests were used to test whether scores were significantly different from BCT. Results Seventy-one patients with breast cancer and 50 healthy volunteers participated. Overall, BCT was rated the highest in terms of VAS (0.80) and TTO (0.90) scores. After stratification, BCT ranked the highest in most subgroups, with the exception of healthy individuals, who had given the highest score to ablative boost (VAS, 0.80; TTO, 0.88). Mastectomy with immediate reconstruction was the least preferred in most subgroups. Conclusions This study showed no significant preference for minimally invasive treatment for breast cancer. Using hypothetical scenarios, breast cancer survivors attributed the highest scores to BCT, whereas healthy volunteers showed a slight preference for minimally invasive treatments.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85010521521&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/28292493
U2 - https://doi.org/10.1016/j.jval.2016.10.013
DO - https://doi.org/10.1016/j.jval.2016.10.013
M3 - Article
C2 - 28292493
SN - 1098-3015
VL - 20
SP - 474
EP - 480
JO - Value in Health
JF - Value in Health
IS - 3
ER -