Most breast cancer surgeons don't talk to patients about reconstruction options, U-M study finds

December 21, 2007

ANN ARBOR, Mich. -- Only a third of patients with breast cancer discussed breast reconstruction options with their surgeon before their initial surgery, according to a new study from the University of Michigan Comprehensive Cancer Center.

What's more, women who did discuss reconstruction up front were four times more likely to have a mastectomy compared to those women who did not discuss reconstruction.

"The surgical decision making for breast cancer is really centered on patient preference. Long-term outcomes are the same regardless of whether a woman is treated with a lumpectomy or a mastectomy. But that choice could have significant impact on a woman's quality of life, sexuality and body image. It's important for women to understand all of their surgical options - including breast reconstruction - so they can make the best choice for themselves," says study author Amy Alderman, M.D., M.P.H., assistant professor of plastic surgery at the U-M Medical School.

The study appears Dec. 21 in the online version of the journal Cancer, and will appear in the Feb. 1 print edition.

The study looked at 1,178 women from the Detroit and Los Angeles metropolitan areas who had undergone surgery for breast cancer. Patients were contacted about three months after diagnosis and were asked whether they had discussed breast reconstruction with their surgeon before their surgery. Patients were also asked whether knowing about reconstruction options affected their decision to receive a mastectomy.

The researchers found that younger and more educated women were more likely to discuss reconstruction with their surgeon. They also found that this discussion significantly affected a woman's treatment decision, with women who knew about reconstruction options four times more likely to choose a mastectomy.

Breast reconstruction can be performed immediately after a mastectomy, which removes the entire breast. This type of reconstruction leads to better aesthetic outcomes and psychological benefits for the patient, compared to delayed reconstruction, previous studies have shown.

"To many women, breast reconstruction is a symbol of hope that they can get past this cancer diagnosis. Reconstruction is not necessarily the right option for every woman and not everyone is going to choose reconstruction, but I think it's important that every woman is informed of what the benefits of reconstruction can be for their physical and emotional well being," Alderman says.

The researchers urge general surgeons to include discussion of all surgical options - lumpectomy, mastectomy and mastectomy with reconstruction - at a point when a patient is considering her choices. General surgeons could refer patients to plastic surgeons to discuss options before the initial surgery. Decision aids should also incorporate information about reconstruction, the researchers write.

"Patients need to be educated consumers of their health care. If a physician does not bring up an option, the patient needs to ask. She needs to either ask the physician to provide the information or ask for a referral to a specialist who can provide the information. Women need to be proactive about their health care," Alderman says.
-end-
Some 180,000 Americans will be diagnosed with breast cancer this year. For information about treatment options, visit mcancer.org or call the U-M Cancer AnswerLine at 800-865-1125.

In addition to Alderman, study authors were Sarah T. Hawley, Ph.D., U-M Medical School and Ann Arbor VA Health Care System; Jennifer Waljee, M.D., U-M Medical School; Mahasin Mujahid, Ph.D., U-M School of Public Health; Monica Morrow, M.D., Fox Chase Cancer Center; and Steven J. Katz, M.D., M.P.H., U-M Medical School and Ann Arbor VA Health Care System.

Funding for the study was from the National Cancer Institute.

Reference: Cancer, published online Dec. 21, 2007; print issue date: Feb. 1, 2008.

University of Michigan Health System

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.