A study from the University of Michigan (U-M) Comprehensive Cancer Center reports that only one third of patients with breast cancer discuss breast reconstruction options with their surgeon before their initial surgery. The study also reports that women who do discuss reconstruction up front are four times more likely to have a mastectomy compared to women who do not discuss reconstruction.

"The surgical decision making for breast cancer is really centered on patient preference," says study author Amy Alderman, MD, MPH, assistant professor of plastic surgery at the U-M Medical School. "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."

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 3 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.

"To many women, breast reconstruction is a symbol of hope that they can get past this cancer diagnosis," Alderman says. "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."

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.

[www.medicalnewstoday.com, December 23, 2007]