The use of thematic maps may help provide greater clues as to why some women with early-stage breast cancer choose breast conserving therapy (BCT) instead of mastectomy, according to Canadian researchers. Their report, published in Clinical Medicine Insights: Oncology, suggest thematic maps may be useful tools for providing visual depictions of decision-making factors for patients and clinicians.

“Experienced oncology nurses have probably come across all of the reasons women choose a therapy brought up in this article. However, the thematic maps introduced in this article may provide a new lens to think about how some women come to their treatment decisions,” said lead study author Jeffrey Gu, MD, who is with the University of Saskatchewan, Saskatoon, Canada.

THE STUDY

Studies have demonstrated that breast conserving therapy (BCT) and mastectomy offer equivalent survival in women with early-stage breast cancer (ESBC). Yet, in Canada, mastectomy rates for women with ESBC across the country have varied greatly in recent years. The researchers wanted to better investigate why. They explored the decision-making of women in Saskatchewan with ESBC and identified key themes underlying their choice of mastectomy or BCT. For this analysis, the researchers interviewed 13 women who underwent mastectomy and 12 women who underwent BCT.

The study showed that women who opted for mastectomy or BCT made their decisions for different reasons. The researchers analyzed data using thematic analysis and developed thematic maps. Three themes emerged among women who opted for mastectomy: concern about cancer recurrence, perceived consequences of BCT treatment, and perception of breast tumor size.  Conversely, the women opting for BCT described 3 different themes: mastectomy was too radical, feminine identity, and surgeon influence. “This usually meant the patient asked the surgeon what they would recommend and went with that,” said Dr Gu.