Motiviranost žena i stav kirurga prema primarnoj rekonstrukciji dojke nakon mastektomije zbog karcinoma dojke

doctoral thesis

• Title (english): Motivation of Women and Attitude of Surgeon to Immediate Breast Reconstruction after Mastectomy for Breast Cancer
• Author: Marcel Židak; VIAF: 305756228
• Mentor: Gordana Cerjan-Letica (mentor)
• Mentor: Zdenko Stanec (komentor); MBZ: 54660
• Committee member: August Mijić (predsjednik povjerenstva)
• Committee member: Miroslav Bekavac-Bešlin (član povjerenstva)
• Committee member: Mario Zovak (član povjerenstva)
• Committee member: Rudolf Gregurek (član povjerenstva)
• Committee member: Zoran Zoričić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Chair of General and Social Subjects); Zagreb
• Defense date and country: 2014-10-02, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Suvremeni pristup u lijeĉenju raka dojke ukljuĉuje mastektomiju i primarnu rekonstrukciju dojke (rekonstrukcija u istom aktu s mastektomijom). Cilj istraţivanja je utvrditi sociodemografske i kliniĉke ĉimbenike koji utjeĉu na odluku ţena u odabiru primarne rekonstrukcije dojke i istraţiti stav kirurga obzirom na subspecijalnost prema primarnoj rekonstrukciji dojke.
Provedeno je monocentrično, prospektivno istraživanje u razdoblju od siječnja 2012. do listopada 2013. godine u žena oboljelih od raka dojke (n=100; veličina uzorka određena je analizom snage uzorka) obzirom na utjecaj sociodemografskih i kliničkih faktora na odluku o primarnoj rekonstrukciji dojke nakon mastektomije i multicentrična prospektivna studija stava kirurga (n=21) koji se bave liječenjem raka dojke obzirom na primarnu rekonstrukciju dojke nakon mastektomije. Učinjena je komparativna analiza stavova kirurga i ispitanica, te komparativna analiza trenda istraživanih varijabli usporedbom sa sličnim istraživanjem provedenim 2005.- 2006. godine. Metode korištene u ovom istraživanju ukljuĉuju upitnike, intervju i pregled medicinske dokumentacije. Čimbenici koji predviđaju pristanak na primarnu rekonstrukciju dojke su dob (p=0,0001), mjesto rođenja (p=001), obrazovanje (p=0,007), radni status (p=0,0002), bračni status (p=0,009) i iskustvo raka dojke u obitelji. Razlozi zbog kojih se odbija primarna rekonstrukcija su strah povrata bolesti i dob. Istraživani stavovi u odnosu na socio-demografske i kliničke varijable nisu značajnije promijenjeni u razdoblju 2005.-2006. te 2012.-2013. godine. Svi kirurzi koji operiraju dojku radi malignih bolesti ne rekonstruiraju dojku. Primarnu rekonstrukciju rade samo plastiĉni kirurzi. Razlog zbog kojeg kirurzi ne rade primarnu rekonstrukciju je onkološka (ne)sigurnost.
Socio-demografski i klinički čimbenici značajni su i stabilni prediktori stava žena prema primarnoj rekonstrukciji dojke. Kirurška subspecijalnost prediktor je stava kirurga prema primarnoj rekonstrukciji dojke nakon mastektomije.

Abstract (english)

Aim of the study. Modern approach to the treatment of breast cancer includes mastectomy and immediate breast reconstruction (single act breast reconstruction following mastectomy). The aim of the research was to determine the socio-demographic and clinical factors that influence the decision of women in the selection of immediate breast reconstruction and explore the viewpoint of surgeons for immediate breast reconstruction, in respect to their subspecialty.
Methods. A prospective monocentric study was conducted among women with breast cancer (Jan 2012 - Oct 2013; n=100; sample size was determined by power analysis) to determine socio-demographic and clinical factors in the decision-making process of the patients. Also, a multicentre prospective study was conducted regarding the opinions of surgeons (n=21) involved in the treatment of breast cancer, with emphasis on immediate breast reconstruction. Comparative analysis of both the opinions of surgeons and patients was performed and the results compared to a similar research conducted in 2005 - 2006. Methods included questionnaires, interviews and medical documentation reviews.
Results. Variables which determined the consent to immediate breast reconstruction were age (p=0,0001), place of birth (p=0,01), education (p=0,007), employment status (p=0,0002), marital status (p=0,009) and family history of breast cancer. Reasons for the rejection of immediate breast reconstruction were fear of recurrence and patient’s advanced age. Researched attitudes towards immediate breast reconstruction regarding sociodemographic and clinical variables in the decision-making process did not change significantly between the surveys in 2005-2006 and 2012-2013. All surgeons who perform mastectomies for breast cancer do not reconstruct the breast. Immediate breast reconstructions are only performed by plastic and reconstructive surgeons. The main reason why most surgeons do not perform immediate breast reconstructions is oncologic (un)certainty.
Conclusion. Sociodemographic and clinical characteristics of women are significant and stable predictors of attitude toward immediate breast reconstruction after mastectomy. Surgical subspecialty is a strong predictor of one’s attitude toward immediate breast reconstruction following mastectomy.

• Keywords: rak dojke; kirurško liječenje; primarna rekonstrukcija dojke; socio-demografske varijable; kliničke varijable; samosvijest; kirurška subspecijalnost
• Keywords (english): breast cancer; surgery; immediate breast reconstruction; socio-demografic variables; clinical variables; body image; surgical subspecialty
• Language: croatian
• URN:NBN: urn:nbn:hr:127:811484
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina (doktor/doktorica znanosti, područje biomedicine i zdravstvo, polje dentalna medicina)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-05-09 10:53:38