Women Facing Breast Cancer Surgery Are Not Offered Reconstructive Options

Approximately 180,000 Americans will be diagnosed with breast cancer this year. According to a new study released by the University of Michigan Comprehensive Cancer Center, only about a third of women facing breast cancer talk to their surgeons about options for breast reconstruction before their initial surgery. The study revealed that women who did discuss reconstruction options prior to their initial surgery more likely to have a mastectomy, or removal of the entire breast, than women who did not discuss reconstruction.

The results of the study are significant to developing treatment protocol for women facing breast surgery. Women should not only be informed that their options for surgery may include lumpectomy, mastectomy and mastectomy with reconstruction, but they should be informed of these options early in the decision-making process. If women do not receive the information they need, they should seek referrals to specialists and take a proactive approach to their healthcare.

The benefit of having breast reconstruction performed immediately after a mastectomy is that it leads to a better looking outcome physically. In addition, immediate breast reconstruction following a mastectomy is also psychologically beneficial to the patient. Thus, breast reconstruction immediately following a mastectomy compared to delayed reconstruction leads to a better overall outcome for the patient.

In a press release issued by the University of Michigan Comprehensive Cancer Center, study author Amy Alderman, M.D., M.P.H, said, "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."

To gather data for this study, researchers contacted 1,178 breast cancer patients in the Detroit and Los Angeles metropolitan areas who had undergone surgery for breast cancer. These patients were asked both whether they had discussed breast reconstruction with their surgeons prior to their surgery and whether knowing about reconstruction options affect their decision to receive a mastectomy.

In analyzing the date, the researchers determined that age and level of education played a role in whether women discussed reconstruction options with their surgeon. Younger, more educated women were more likely to discuss breast reconstruction with their surgeons than other demographic groups.

Further, researchers found that the discussion about breast reconstruction significantly affected a woman's decision about the type of treatment she underwent. Women who were advised about the options for breast reconstruction were four times more likely to choose a mastectomy than women who were unaware of the options for breast reconstruction.

According to Alderman, "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."

"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.

Sources:

Cancer, "Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer," Amy Alderman, Sarah T. Hawley, Jennifer Waljee, Monica Morrow, and Steven J. Katz, published online Dec. 21, 2007; print issue date: Feb. 1, 2008.

University of Michigan Comprehensive Cancer Center, "Most breast cancer surgeons don't talk to patients about reconstruction options, U-M study finds," Nicole Fawcett.