A recent study published in JAMA Surgery found that a significant number of female breast cancer patients undergo mastectomy without prior knowledge of the risks and potentially life-altering side effects associated with a subsequent reconstructive surgery. As part of the study, a team of researchers from the Ohio State University interviewed 126 adult breast cancer patients who underwent mastectomy. The researchers found that 73 percent of patients had early-stage breast cancer. The patients were asked about their knowledge regarding the effects of a subsequent reconstruction surgery on appearance and associated health risks.
The research team found that 57 percent of mastectomy patients had no prior knowledge of the risks associated with breast reconstruction surgery. The patients also had no idea of other surgery options available. In contrast, only 43 percent of patients had prior knowledge of at least half of the important facts about breast reconstruction surgery. These patients were also the only ones able to make informed medical decisions that were consistent with their preference.
“We found that less than half of the women had adequate medical knowledge about breast reconstruction and made a choice that aligned with their personal preferences. This is very concerning to us, because it means that some women did not get the treatment they truly preferred, and quite a few had more treatment than they preferred. Many women were quite concerned about complication risks, but they didn’t actually know how high the risk was. This may explain some of the over-treatment that we saw,” lead researcher Dr. Clara Lee was quoted in saying in DailyMail.co.uk.
Dr. Lee underscored on the importance of health care providers discussing the advantages and disadvantages of surgery to help patients make better health care decisions. The lead researcher also stressed that a shared decision-making between the patient and the surgeon would be especially useful in making informed decisions.
“Patients can choose to inform themselves as much as possible but it is not always clear what information is reliable and what is not. Ultimately the responsibility for making sure patients make informed decisions rests on surgeons and clinicians who work with these women. On the other hand there is only so much time in a consultation. So it’s important to also use decision aids — such as video or paper documentation — that improve knowledge but also encourage women to think about what is important for them and what questions they should raise with their doctors. For some women breast reconstruction is going to be very important… More and more clinics are emphasizing the survivorship aspect of breast cancer and offering psychological aspect – this is a positive development,” Dr. Lee added.
