AN EXAMINATION OF WHY SASKATCHEWAN WOMEN CHOOSE MASTECTOMY VERSUS BREAST CONSERVATION THERAPY IN EARLY STAGE BREAST CANCER
Bibliographic record
Abstract
Introduction and Research Purpose\nBreast cancer is the most commonly diagnosed cancer in North America and the second most common cause of cancer death in women. For early stage breast cancer (ESBC), it is well established that breast conservation therapy (BCT) and mastectomy are equivalent treatments for survival. Treatment for ESBC can therefore be viewed as preference sensitive care, where decision-making between treatment options should vary according to patient preferences. In Canada, interprovincial mastectomy rates vary greatly from 25% to 68% between provinces with a national average of 38%. Saskatchewan has consistently reported the nation’s second highest mastectomy rate with the latest report showing 63%. There has been international research investigating why women choose mastectomy versus BCT, but there is limited data within Canada to explain these provincial variations. The aim of my thesis is to better understand Saskatchewan women’s choice between mastectomy and BCT in ESBC. In this dissertation, I have addressed the research objectives through four manuscripts outlined below\n\nManuscript 1:\nTo assess the current evidence, we conducted the first systematic review on the factors influencing women’s choice of mastectomy versus BCT in ESBC.\n\nManuscript 2:\nTo identify the factors that influence Saskatchewan women’s choice between BCT or mastectomy in ESBC, we conducted a province-based qualitative study which identified themes and subthemes influencing therapy choice. This was the first part of an exploratory mixed methods study.\n\nManuscript 3:\nTo help improve our understanding and organize our research, we created a conceptual framework of why women choose mastectomy versus BCT in ESBC. This framework was important in organizing our systematic review and guiding our survey.\n\nManuscript 4:\nFinally, to understand decision-making influences of Saskatchewan women with ESBC, we conducted a province wide survey. Creation of this survey was grounded on our previous work and the second portion of our mixed methods study.\n\nResults and Conclusion\nOur research demonstrates treatment choices for Saskatchewan women with ESBC were primarily influenced by disease stage and individual belief factors. These findings would suggest that women are making their treatment choices predominantly based on individual values and preferences. The use of mastectomy and BCT rates as an indicator of quality of care may be misleading. Instead, a shift in attention towards patient-centred care is more appropriate.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.002 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".