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Breast Cancer: Women Often Reject Lumpectomy

Many Opt for Mastectomy When Offered the Choice
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WebMD Health News

Aug. 18, 2005 -- Women with breast cancer often opt for mastectomy instead of lumpectomy when offered a choice between the two treatments, an eye-opening new study shows.

The research could explain why so many women with early-stage breast cancer still end up having their breasts removed despite no differences in survival rate compared with women who undergo lumpectomy plus radiation.

The prevailing wisdom has been that physicians tend to steer patients toward more aggressive surgical treatment of breast cancer despite medical recommendations favoring breast-conserving lumpectomy. But the newly published study suggests the opposite is true.

"We found that surgeons were mainly recommending the less invasive treatment and that patients tended to have a good deal of involvement in the decision process," researcher Steven J. Katz, MD, MPH, of the University of Michigan tells WebMD.

"We also found that greater patient involvement was associated with greater use of mastectomy."Fight Breast Cancer YOUR Way: Learn About Treatment Options

1 in 3 Women Get Mastectomy

Roughly a third of women facing breast cancer surgery have their entire breast removed (mastectomy) instead of breast-sparing lumpectomy plus radiation.

In an effort to find out why, Katz and colleagues surveyed 1,844 women in Los Angeles and Detroit with a recent breast cancer diagnosis. The findings are reported in the Aug. 20 issue of the Journal of Clinical Oncology.

Overall, about 30% of the women had mastectomy as initial treatment. A total of 41% reported that they made the surgical decision, and 37% said they made it with their surgeon. Only one out of five reported that their surgeon made the treatment decision, with or without their input.

Among white women, 27% of those who made their own decision about surgery ended up having a mastectomy, compared to just 5% of women who said their surgeon made the decision, and 17% of women who said the decision was a shared one.

African-American women were more likely to receive a mastectomy than patients of other ethnic groups when the decision was perceived to have been made by the surgeon.

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