Reconstruction surgery rarely discussed with breast cancer patients

A new study finds that most general surgeons do not discuss reconstruction with patients before surgical breast cancer treatment.

The analysis shows that only one in three patients eligible for mastectomy or breast conserving surgery have such discussions. The study is published in the February 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

The option of breast reconstruction has increased treatment choices for women with breast cancer. Women with early stage disease who are not likely to need post-mastectomy radiation are considered eligible for reconstruction at the time of surgery. However, little is known about how often surgeons discuss breast reconstruction with patients.

Led by Dr. Amy Alderman of the University of Michigan Medical Center, researchers surveyed a 1,178 women aged 79 years or younger who had undergone a surgical procedure for stage I, II, or III breast cancer between December 2001 to January 2003.

The researchers found only 33 percent of patients had a general surgeon discuss breast reconstruction with them during the surgical decision-making process for their cancer. Surgeons were significantly more likely to have this discussion with younger, more educated patients. Patients who discussed reconstruction with their surgeon were more willing to consider having a mastectomy and were more than 4 times likely to undergo the surgery. The findings suggest that discussing reconstruction will impact women?s decisions regarding initial surgery for their breast cancer.

According to the authors, these results have important implications for patient care and policy. "This research suggests that patients should be informed of all options in order to be educated consumers of healthcare and ensure maximal breast cancer treatment decision quality," they conclude. "Our results suggest a need for comprehensive breast cancer treatment decision aids, including information on initial surgery and other treatment options such as reconstruction."