Jeffrey Gu

May 2018

  • PGY4
  • Residency Program: University of Saskatchewan
  • Supervisors: Dr. Gary Groot, Dr. Rachel-Engler Stringer,

Jeffrey Gu is a general surgery resident at University of Saskatchewan. He is also enrolled in the Clinical Investigator Program and near completion of his PhD in Community Health and Epidemiology. His thesis research is investigating why Saskatchewan women choose mastectomy versus breast conservation therapy. Jeffrey has been privileged to present some of his work at national and international breast cancer and decision-making conferences.

Aside from decision-making, Jeff has had a longstanding interested in advanced laparoscopy, and after completing residency he plans on pursuing a fellowship in Minimally Invasive Surgery, Advanced Endoscopy, and Foregut Surgery.

Research Summary

It is well established that breast conservation therapy (BCT) and mastectomy offer equivalent survival in early stage breast cancer (ESBC) (Stage I and II). The therapy choice can be viewed as preference sensitive care, a decision that is made between the patient and care provider. The Saskatchewan mastectomy rate of 65% is drastically different form the Canadian average of 39%, with little data or research to explain this regional variation. The aim of our research was to better understand women’s choice between mastectomy and BCT for ESBC in Saskatchewan. Our research is composed of a systematic review and a sequential mixed-methods study. We have also developed a new conceptual framework to examine why women choose mastectomy versus BCT to guide the other research components.

There were previously no published systematic reviews on this topic, and conducting a review has helped synthesize the current literature and identify gaps in knowledge. Furthermore, the systematic review was important for informing our survey development. The mixed methods study began with an exploratory qualitative study followed by a province-wide survey. The initial qualitative component of the mixed-methods study has identified influencing factors in decision-making and deepened our understanding of their relationships with choice between mastectomy or BCT in ESBC. The second quantitative phase of the research utilized a province wide survey to capture a wider sample of the population, and identify further relationships that were not examined in the qualitative phase. The results of this survey are still pending.

We hope results from this research will improve our understanding of this complicated decision-making process across Canada and therefore provide surgeons and administrators with the knowledge they need for future policy review, quality improvement opportunities, and ultimately optimizing patient care.

Selected Publications:

Gu J, Groot G, Boden C, Busch A, Holtslander L, Lim H. Review of Factors Influencing Women’s Choice of Mastectomy Versus Breast Conserving Therapy in Early Stage Breast Cancer: A Systematic Review. Clinical Breast Cancer. January 2018.

Gu J, Groot G, Holtslander L, Engler-Stringer R. Understanding Women’s Choice of Mastectomy Versus Breast Conserving Therapy in Early-Stage Breast Cancer. Clinical Medicine Insights: Oncology 11 (2017).