Factors Influencing the Decision for Breast Conservative Surgery among Breast Cancer Patients
Keywords:
Breast cancer, Breast conservative surgery, Decision-making, Mastectomy,, Recurrence, TumorAbstract
Background: Breast cancer is a leading cause of cancer-related morbidity and mortality among women. While breast
conservative surgery (BCS) offers a survival equivalent to mastectomy with superior cosmetic outcomes, its uptake in
Bangladesh remains variable and influenced by a complex set of factors.
Objectives: To identify and analyze the key factors influencing the decision to undergo breast conservative surgery among
breast cancer patients.
Methods: A prospective interventional study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU),
Dhaka, from January 2021 to December 2022. A purposive sample of 33 breast cancer patients was recruited. Data were
collected through face-to-face interviews using a structured questionnaire. Statistical analysis was performed using SPSS
version 23.0. Results: The mean age was 45.2±8.7 years. Key findings revealed that higher education (p=0.049), smaller
tumor size (p<0.001), and 'good' pre-consultation knowledge (p<0.001) significantly predicted BCS choice. The surgeon's
recommendation was profoundly influential. Fear of recurrence was the primary reason for mastectomy (76.5%), while desire
for better cosmesis drove BCS choice (83.3%). A lack of detailed information was the most cited barrier (63.6%) to BCS.
Conclusion: The decision for breast conservative surgery (BCS) is multifactorial. Enhancing patient education, addressing
fears of recurrence, and ensuring effective surgeon communication are crucial to increasing BCS uptake in Bangladesh and
aligning practice with oncological standards.
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