Reconstruction Options Rarely Discussed With Breast Cancer Surgeons

Only a third of patients with breast cancer consulted breast reconstruction options with their surgeon before their initial surgery, according to a new study.

Researchers of the University of Michigan health system (U-M, Ann Arbor, USA) reviewed 1,178 women from the Detroit (MI, USA) and Los Angeles (CA, USA) metropolitan areas that 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 regarding a mastectomy.
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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. The study was published in the December 21, 2007, online version of the journal Cancer.

"To many women, breast reconstruction is a symbol of hope that they can get past this cancer diagnosis,” said lead author Amy Alderman, M.D., M.P.H., an assistant professor of plastic surgery at the U-M Medical School. "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 researchers urge general surgeons to discuss lumpectomy, mastectomy, and mastectomy reconstruction options at a point when a patient is considering her choices, as the choice could have significant impact on a woman's quality of life, sexuality, and body image. General surgeons could refer patients to plastic surgeons to discuss options before the initial surgery. Decision aids should also incorporate information about reconstruction.


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