메뉴 건너뛰기




Volumn 263, Issue 1, 2016, Pages 178-183

Prospective study of surgical decision-making processes for contralateral prophylactic mastectomy in women with breast cancer

Author keywords

Breast cancer; Contralateral prophylactic mastectomy; Decision making; Surgical

Indexed keywords

BRCA1 PROTEIN; BRCA2 PROTEIN; EPIDERMAL GROWTH FACTOR RECEPTOR 2;

EID: 84953840470     PISSN: 00034932     EISSN: 15281140     Source Type: Journal    
DOI: 10.1097/SLA.0000000000001216     Document Type: Article
Times cited : (56)

References (51)
  • 1
    • 78049453040 scopus 로고    scopus 로고
    • Trends in contralateral prophylactic mastectomy for unilateral cancer: A report from the National Cancer Data Base, 1998-2007
    • Yao K, Stewart AK, Winchester DJ, et al. Trends in contralateral prophylactic mastectomy for unilateral cancer: a report from the National Cancer Data Base, 1998-2007. Ann Surg Oncol. 2010;17:2554-2562.
    • (2010) Ann Surg Oncol. , vol.17 , pp. 2554-2562
    • Yao, K.1    Stewart, A.K.2    Winchester, D.J.3
  • 2
    • 34548444028 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy for patients with unilateral breast cancer
    • Tuttle T, Habermann E, Abraham A, et al. Contralateral prophylactic mastectomy for patients with unilateral breast cancer. Expert Rev Anticancer Ther. 2007;7:1117-1122.
    • (2007) Expert Rev Anticancer Ther , vol.7 , pp. 1117-1122
    • Tuttle, T.1    Habermann, E.2    Abraham, A.3
  • 3
    • 36849075170 scopus 로고    scopus 로고
    • Increasing use of contralateral prophylactic mastectomy for breast cancer patients: A trend toward more aggressive surgical treatment
    • Tuttle TM, Habermann EB, Grund EH, et al. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25:5203-5209.
    • (2007) J Clin Oncol. , vol.25 , pp. 5203-5209
    • Tuttle, T.M.1    Habermann, E.B.2    Grund, E.H.3
  • 4
    • 63049108940 scopus 로고    scopus 로고
    • Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ
    • Tuttle TM, Jarosek S, Habermann EB, et al. Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. J Clin Oncol. 2009;27:1362-1367.
    • (2009) J Clin Oncol. , vol.27 , pp. 1362-1367
    • Tuttle, T.M.1    Jarosek, S.2    Habermann, E.B.3
  • 5
    • 84881026627 scopus 로고    scopus 로고
    • Increasing use of elective mastectomy and contralateral prophylactic surgery among breast conservation candidates: A 14-year report from a comprehensive cancer center
    • Dragun AE, Pan J, Riley EC, et al. Increasing use of elective mastectomy and contralateral prophylactic surgery among breast conservation candidates: a 14-year report from a comprehensive cancer center. Am J Clin Oncol. 2013;36:375-380.
    • (2013) Am J Clin Oncol. , vol.36 , pp. 375-380
    • Dragun, A.E.1    Pan, J.2    Riley, E.C.3
  • 6
    • 84921705323 scopus 로고    scopus 로고
    • Prophylactic mastectomy for the prevention of breast cancer
    • Lostumbo L, Carbine N, Wallace J, et al. Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev. 2004;11:CD002748.
    • (2004) Cochrane Database Syst Rev. , vol.11 , pp. CD002748
    • Lostumbo, L.1    Carbine, N.2    Wallace, J.3
  • 7
    • 77949967128 scopus 로고    scopus 로고
    • Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients
    • Bedrosian I, Hu CY, Chang GJ. Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients. J Natl Cancer Inst. 2010;102:401-409.
    • (2010) J Natl Cancer Inst , vol.102 , pp. 401-409
    • Bedrosian, I.1    Hu, C.Y.2    Chang, G.J.3
  • 8
    • 84890312421 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy and survival: Report from the National Cancer Data Base; 1998-2002
    • Yao K, Winchester DJ, Czechura T, et al. Contralateral prophylactic mastectomy and survival: report from the National Cancer Data Base; 1998-2002. Breast Cancer Res Treat. 2013;142:465-476.
    • (2013) Breast Cancer Res Treat , vol.142 , pp. 465-476
    • Yao, K.1    Winchester, D.J.2    Czechura, T.3
  • 9
    • 84865044946 scopus 로고    scopus 로고
    • Comparison of patient characteristics and outcomes of contralateral prophylactic mastectomy and unilateral total mastectomy in breast cancer patients
    • Chung A, Huynh K, Lawrence C, et al. Comparison of patient characteristics and outcomes of contralateral prophylactic mastectomy and unilateral total mastectomy in breast cancer patients. Ann Surg Oncol. 2012;19:2600-2606.
    • (2012) Ann Surg Oncol. , vol.19 , pp. 2600-2606
    • Chung, A.1    Huynh, K.2    Lawrence, C.3
  • 10
    • 0032734171 scopus 로고    scopus 로고
    • Clinical and histological predictors of contralateral breast cancer
    • Kollias J, Ellis IO, Elston CW, et al. Clinical and histological predictors of contralateral breast cancer. Eur J Surg Oncol. 1999;25:584-589.
    • (1999) Eur J Surg Oncol. , vol.25 , pp. 584-589
    • Kollias, J.1    Ellis, I.O.2    Elston, C.W.3
  • 11
    • 76549143348 scopus 로고
    • Bilateral primary breast cancer; a prospective clinicopathological study
    • Robbins GF, Berg JW. Bilateral primary breast cancer; a prospective clinicopathological study. Cancer. 1964;17:1501-1527.
    • (1964) Cancer , vol.17 , pp. 1501-1527
    • Robbins, G.F.1    Berg, J.W.2
  • 12
    • 0027220318 scopus 로고
    • Contralateral breast cancer: Clinical characteristics and impact on prognosis
    • Healey EA, Cook EF, Orav EJ, et al. Contralateral breast cancer: clinical characteristics and impact on prognosis. J Clin Oncol. 1993;11:1545-1552.
    • (1993) J Clin Oncol. , vol.11 , pp. 1545-1552
    • Healey, E.A.1    Cook, E.F.2    Orav, E.J.3
  • 13
    • 0024425899 scopus 로고
    • Contralateral breast carcinoma: An assessment of risk and prognosis in stage I (T1N0M0) and stage II (T1N1M0) patients with 20-year follow-up
    • Rosen PP, Groshen S, Kinne DW, et al. Contralateral breast carcinoma: an assessment of risk and prognosis in stage I (T1N0M0) and stage II (T1N1M0) patients with 20-year follow-up. Surgery. 1989;106:904-910.
    • (1989) Surgery , vol.106 , pp. 904-910
    • Rosen, P.P.1    Groshen, S.2    Kinne, D.W.3
  • 14
    • 84901665189 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy: An opportunity for shared decision making
    • Rosenberg SM, Partridge AH. Contralateral prophylactic mastectomy: an opportunity for shared decision making. JAMA Surg. 2014;149:589-590.
    • (2014) JAMA Surg , vol.149 , pp. 589-590
    • Rosenberg, S.M.1    Partridge, A.H.2
  • 15
    • 34547741530 scopus 로고    scopus 로고
    • Predictors and outcomes of contralateral prophylactic mastectomy among breast cancer survivors
    • Graves KD, Peshkin BN, Halbert CH, et al. Predictors and outcomes of contralateral prophylactic mastectomy among breast cancer survivors. Breast Cancer Res Treat. 2007;104:321-329.
    • (2007) Breast Cancer Res Treat , vol.104 , pp. 321-329
    • Graves, K.D.1    Peshkin, B.N.2    Halbert, C.H.3
  • 16
    • 84884178677 scopus 로고    scopus 로고
    • Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: A cross-sectional survey
    • Rosenberg SM, Tracy MS, Meyer ME, et al. Perceptions, knowledge, and satisfaction with contralateral prophylactic mastectomy among young women with breast cancer: a cross-sectional survey. Ann Intern Med. 2013;159:373-381.
    • (2013) Ann Intern Med. , vol.159 , pp. 373-381
    • Rosenberg, S.M.1    Tracy, M.S.2    Meyer, M.E.3
  • 17
    • 33846908291 scopus 로고    scopus 로고
    • Quality of life after contralateral prophylactic mastectomy in newly diagnosed high-risk breast cancer patients who underwent BRCA1 (2 gene testing
    • Tercyak KP, Peshkin BN, Brogan BM, et al. Quality of life after contralateral prophylactic mastectomy in newly diagnosed high-risk breast cancer patients who underwent BRCA1 (2 gene testing. J Clin Oncol. 2007;25:285-291.
    • (2007) J Clin Oncol. , vol.25 , pp. 285-291
    • Tercyak, K.P.1    Peshkin, B.N.2    Brogan, B.M.3
  • 18
    • 0032869353 scopus 로고    scopus 로고
    • Issues of regret in women with contralateral prophylactic mastectomies
    • Montgomery LL, Tran KN, Heelan MC, et al. Issues of regret in women with contralateral prophylactic mastectomies. Ann Surg Oncol. 1999;6:546-552.
    • (1999) Ann Surg Oncol. , vol.6 , pp. 546-552
    • Montgomery, L.L.1    Tran, K.N.2    Heelan, M.C.3
  • 19
    • 83055170009 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy: Long-term consistency of satisfaction and adverse effects and the significance of informed decision-making, quality of life, and personality traits
    • Frost MH, Hoskin TL, Hartmann LC, et al. Contralateral prophylactic mastectomy: long-term consistency of satisfaction and adverse effects and the significance of informed decision-making, quality of life, and personality traits. Ann Surg Oncol. 2011;18:3110-3116.
    • (2011) Ann Surg Oncol. , vol.18 , pp. 3110-3116
    • Frost, M.H.1    Hoskin, T.L.2    Hartmann, L.C.3
  • 20
    • 33751096981 scopus 로고    scopus 로고
    • An informed decision? Breast cancer patients and their knowledge about treatment
    • Fagerlin A, Lakhani I, Lantz PM, et al. An informed decision? Breast cancer patients and their knowledge about treatment. Patient Educ Couns. 2006;64:303-312.
    • (2006) Patient Educ Couns. , vol.64 , pp. 303-312
    • Fagerlin, A.1    Lakhani, I.2    Lantz, P.M.3
  • 21
    • 63249097868 scopus 로고    scopus 로고
    • Cancer screening adherence: Does physicianpatient communication matter?
    • Fox SA, Heritage J, Stockdale SE, et al. Cancer screening adherence: does physicianpatient communication matter? Patient Educ Couns. 2009;75:178-184.
    • (2009) Patient Educ Couns. , vol.75 , pp. 178-184
    • Fox, S.A.1    Heritage, J.2    Stockdale, S.E.3
  • 22
    • 55649086259 scopus 로고    scopus 로고
    • Impact of physician-patient discussions on patient satisfaction
    • Chen JY, Tao ML, Tisnado D, et al. Impact of physician-patient discussions on patient satisfaction. Med Care. 2008;46:1157-1162.
    • (2008) Med Care , vol.46 , pp. 1157-1162
    • Chen, J.Y.1    Tao, M.L.2    Tisnado, D.3
  • 23
    • 32944480048 scopus 로고    scopus 로고
    • Satisfaction after contralateral prophylactic mastectomy: The significance of mastectomy type, reconstructive complications, and body appearance
    • Frost MH, Slezak JM, Tran NV, et al. Satisfaction after contralateral prophylactic mastectomy: the significance of mastectomy type, reconstructive complications, and body appearance. J Clin Oncol. 2005;23:7849-7856.
    • (2005) J Clin Oncol. , vol.23 , pp. 7849-7856
    • Frost, M.H.1    Slezak, J.M.2    Tran, N.V.3
  • 24
    • 0031689183 scopus 로고    scopus 로고
    • Synchronous elective contralateral mastectomy and immediate bilateral breast reconstruction in women with early-stage breast cancer
    • Gershenwald JE, Hunt KK, Kroll SS, et al. Synchronous elective contralateral mastectomy and immediate bilateral breast reconstruction in women with early-stage breast cancer. Ann Surg Oncol. 1998;5:529-538.
    • (1998) Ann Surg Oncol. , vol.5 , pp. 529-538
    • Gershenwald, J.E.1    Hunt, K.K.2    Kroll, S.S.3
  • 25
    • 32944482399 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy: Efficacy, satisfaction, and regret
    • Schwartz MD. Contralateral prophylactic mastectomy: efficacy, satisfaction, and regret. J Clin Oncol. 2005;23:7777-7779.
    • (2005) J Clin Oncol. , vol.23 , pp. 7777-7779
    • Schwartz, M.D.1
  • 26
    • 33644788336 scopus 로고    scopus 로고
    • Women's decision-making roles regarding contralateral prophylactic mastectomy
    • Nekhlyudov L, Bower M, Herrinton LJ, et al. Women's decision-making roles regarding contralateral prophylactic mastectomy. J Natl Cancer Inst Monogr. 2005;35:55-60.
    • (2005) J Natl Cancer Inst Monogr , vol.35 , pp. 55-60
    • Nekhlyudov, L.1    Bower, M.2    Herrinton, L.J.3
  • 27
    • 0032033812 scopus 로고    scopus 로고
    • A decision aid for women considering hormone therapy after menopause: Decision support framework and evaluation
    • O'Connor AM, Tugwell P, Wells GA, et al. A decision aid for women considering hormone therapy after menopause: decision support framework and evaluation. Patient Educ Couns. 1998;33:267-279.
    • (1998) Patient Educ Couns. , vol.33 , pp. 267-279
    • O'Connor, A.M.1    Tugwell, P.2    Wells, G.A.3
  • 29
    • 34548564513 scopus 로고    scopus 로고
    • Society of Surgical Oncology: Position statement on prophylactic mastectomy. Approved by the Society of Surgical Oncology Executive Council, March 2007
    • Giuliano AE, Boolbol S, Degnim A, et al. Society of Surgical Oncology: position statement on prophylactic mastectomy. Approved by the Society of Surgical Oncology Executive Council, March 2007. Ann Surg Oncol. 2007;14:2425-2427.
    • (2007) Ann Surg Oncol. , vol.14 , pp. 2425-2427
    • Giuliano, A.E.1    Boolbol, S.2    Degnim, A.3
  • 30
    • 0018777479 scopus 로고
    • Impact of Event Scale: A measure of subjective stress
    • Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41:209-218.
    • (1979) Psychosom Med. , vol.41 , pp. 209-218
    • Horowitz, M.1    Wilner, N.2    Alvarez, W.3
  • 31
    • 0019611441 scopus 로고
    • The measurement of uncertainty in illness
    • Mishel MH. The measurement of uncertainty in illness. Nurs Res. 1981;30:258-263.
    • (1981) Nurs Res. , vol.30 , pp. 258-263
    • Mishel, M.H.1
  • 32
    • 0020843292 scopus 로고
    • Parents' perception of uncertainty concerning their hospitalized child
    • Mishel MH. Parents' perception of uncertainty concerning their hospitalized child. Nurs Res. 1983;32:324-330.
    • (1983) Nurs Res. , vol.32 , pp. 324-330
    • Mishel, M.H.1
  • 33
    • 0021475374 scopus 로고
    • Predictors of psychosocial adjustment in patients newly diagnosed with gynecological cancer
    • Mishel MH, Hostetter T, King B, et al. Predictors of psychosocial adjustment in patients newly diagnosed with gynecological cancer. Cancer Nurs. 1984;7:291-299.
    • (1984) Cancer Nurs. , vol.7 , pp. 291-299
    • Mishel, M.H.1    Hostetter, T.2    King, B.3
  • 34
    • 0020819172 scopus 로고
    • Adjusting the fit: Development of uncertainty scales for specific clinical populations
    • Mishel MH. Adjusting the fit: development of uncertainty scales for specific clinical populations. West J Nurs Res. 1983;5:355-370.
    • (1983) West J Nurs Res. , vol.5 , pp. 355-370
    • Mishel, M.H.1
  • 35
    • 0025937739 scopus 로고
    • Psychological side effects of breast cancer screening
    • Lerman C, Trock B, Rimer BK, et al. Psychological side effects of breast cancer screening. Health Psychol. 1991;10:259-267.
    • (1991) Health Psychol. , vol.10 , pp. 259-267
    • Lerman, C.1    Trock, B.2    Rimer, B.K.3
  • 36
    • 0030280004 scopus 로고    scopus 로고
    • Breast cancer worry and screening: Some prospective data
    • McCaul KD, Schroeder DM, Reid PA. Breast cancer worry and screening: some prospective data. Health Psychol. 1996;15:430-433.
    • (1996) Health Psychol. , vol.15 , pp. 430-433
    • McCaul, K.D.1    Schroeder, D.M.2    Reid, P.A.3
  • 37
    • 0141885276 scopus 로고    scopus 로고
    • Fear of cancer recurrence in patients undergoing definitive treatment for prostate cancer: Results from CaPSURE
    • Mehta SS, Lubeck DP, Pasta DJ, et al. Fear of cancer recurrence in patients undergoing definitive treatment for prostate cancer: results from CaPSURE. J Urol. 2003;170:1931-1933.
    • (2003) J Urol. , vol.170 , pp. 1931-1933
    • Mehta, S.S.1    Lubeck, D.P.2    Pasta, D.J.3
  • 38
    • 38349189492 scopus 로고    scopus 로고
    • Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer
    • Hart SL, Latini DM, Cowan JE, et al. Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer. Support Care Cancer. 2008;16:161-169.
    • (2008) Support Care Cancer , vol.16 , pp. 161-169
    • Hart, S.L.1    Latini, D.M.2    Cowan, J.E.3
  • 39
    • 0031756591 scopus 로고    scopus 로고
    • Patient regrets after bilateral prophylactic mastectomy
    • Borgen PI, Hill AD, Tran KN, et al. Patient regrets after bilateral prophylactic mastectomy. Ann Surg Oncol. 1998;5:603-606.
    • (1998) Ann Surg Oncol. , vol.5 , pp. 603-606
    • Borgen, P.I.1    Hill, A.D.2    Tran, K.N.3
  • 40
    • 0030683557 scopus 로고    scopus 로고
    • Quality of life for adult leukemia survivors treated on clinical trials of Cancer and Leukemia Group B during the period 1971-1988: Predictors for later psychologic distress
    • Greenberg DB, Kornblith AB, Herndon JE, et al. Quality of life for adult leukemia survivors treated on clinical trials of Cancer and Leukemia Group B during the period 1971-1988: predictors for later psychologic distress. Cancer. 1997;80:1936-1944.
    • (1997) Cancer , vol.80 , pp. 1936-1944
    • Greenberg, D.B.1    Kornblith, A.B.2    Herndon, J.E.3
  • 41
    • 0028866830 scopus 로고
    • Increasing patient involvement in choosing treatment for early breast cancer
    • Street RL Jr, Voigt B, Geyer C Jr, et al. Increasing patient involvement in choosing treatment for early breast cancer. Cancer. 1995;76:2275-2285.
    • (1995) Cancer , vol.76 , pp. 2275-2285
    • Street, R.L.1    Voigt, B.2    Geyer, C.3
  • 42
    • 18344379887 scopus 로고    scopus 로고
    • Use of an educational computer program before genetic counseling for breast cancer susceptibility: Effects on duration and content of counseling sessions
    • Green MJ, Peterson SK, Baker MW, et al. Use of an educational computer program before genetic counseling for breast cancer susceptibility: effects on duration and content of counseling sessions. Genet Med. 2005;7:221-229.
    • (2005) Genet Med. , vol.7 , pp. 221-229
    • Green, M.J.1    Peterson, S.K.2    Baker, M.W.3
  • 43
    • 3242763836 scopus 로고    scopus 로고
    • Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility: A randomized controlled trial
    • Green MJ, Peterson SK, Baker MW, et al. Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility: a randomized controlled trial. JAMA. 2004;292:442-452.
    • (2004) JAMA , vol.292 , pp. 442-452
    • Green, M.J.1    Peterson, S.K.2    Baker, M.W.3
  • 45
    • 20344381538 scopus 로고    scopus 로고
    • The norms and stability of new measures of the multidimensional body image construct
    • Cash TF, Grasso K. The norms and stability of new measures of the multidimensional body image construct. Body Image. 2005;2:199-203.
    • (2005) Body Image , vol.2 , pp. 199-203
    • Cash, T.F.1    Grasso, K.2
  • 46
    • 85018529448 scopus 로고    scopus 로고
    • Decision AIDS for people facing health treatment or screening decisions
    • Stacey D, Legare F, Col NF, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014;1:CD001431.
    • (2014) Cochrane Database Syst Rev. , vol.1 , pp. CD001431
    • Stacey, D.1    Legare, F.2    Col, N.F.3
  • 47
    • 84926416428 scopus 로고    scopus 로고
    • Decision making and factors influencing long-term satisfaction with prophylactic mastectomy in women with breast cancer
    • Soran A, Ibrahim A, Kanbour M, et al. Decision making and factors influencing long-term satisfaction with prophylactic mastectomy in women with breast cancer. Am J Clin Oncol. 2015;38:179-183.
    • (2015) Am J Clin Oncol. , vol.38 , pp. 179-183
    • Soran, A.1    Ibrahim, A.2    Kanbour, M.3
  • 48
    • 79957967253 scopus 로고    scopus 로고
    • Clinical management factors contribute to the decision for contralateral prophylactic mastectomy
    • King TA, Sakr R, Patil S, et al. Clinical management factors contribute to the decision for contralateral prophylactic mastectomy. J Clin Oncol. 2011;29:2158-2164.
    • (2011) J Clin Oncol. , vol.29 , pp. 2158-2164
    • King, T.A.1    Sakr, R.2    Patil, S.3
  • 49
    • 80052143006 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy in breast cancer patients who test negative for BRCA mutations
    • Howard-McNatt M, Schroll RW, Hurt GJ, et al. Contralateral prophylactic mastectomy in breast cancer patients who test negative for BRCA mutations. Am J Surg. 2011;202:298-302.
    • (2011) Am J Surg , vol.202 , pp. 298-302
    • Howard-McNatt, M.1    Schroll, R.W.2    Hurt, G.J.3
  • 50
    • 76749096756 scopus 로고    scopus 로고
    • The increasing use of prophylactic mastectomy in the prevention of breast cancer
    • Tuttle TM, Abbott A, Arrington A, et al. The increasing use of prophylactic mastectomy in the prevention of breast cancer. Curr Oncol Rep. 2010;12:16-21.
    • (2010) Curr Oncol Rep , vol.12 , pp. 16-21
    • Tuttle, T.M.1    Abbott, A.2    Arrington, A.3
  • 51
    • 73349089359 scopus 로고    scopus 로고
    • Contralateral prophylactic mastectomy for unilateral breast cancer: An increasing trend at a single institution
    • Jones NB, Wilson J, Kotur L, et al. Contralateral prophylactic mastectomy for unilateral breast cancer: an increasing trend at a single institution. Ann Surg Oncol. 2009;16:2691-2696.
    • (2009) Ann Surg Oncol. , vol.16 , pp. 2691-2696
    • Jones, N.B.1    Wilson, J.2    Kotur, L.3


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.