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    Breast Cancer: Know the Surgery Options

    Study Shows Many Patients Aren't Told About Breast Reconstruction
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    Dec. 21, 2007 -- Most women facing breast cancer surgery are not told that mastectomy with breast reconstruction is an option, a new study shows.

    Researchers surveyed almost 1,200 early-stage breast cancer patients eligible for breast-conserving lumpectomy or mastectomy.

    They found that only one in three were told by their general surgeon that breast reconstruction was an option.

    Patients who did have the discussion with their surgeon were four times more likely to choose breast removal over lumpectomy.

    Studies show that survival rates are the same among early-stage breast cancer patients, whether they have breast-conserving surgery with radiation or mastectomy.

    Plastic surgeon Amy Alderman, MD, who led the study team, says women need to be fully informed of their surgical choices before they decide on a treatment course.

    "The point is we have three great surgical choices -- lumpectomy, mastectomy, and mastectomy with reconstruction," she says. "There are pros and cons to each of these choices, and we as physicians have a responsibility to help patients understand this."

    Surgical Choices

    Alderman says mastectomy with breast reconstruction often results in better cosmetic outcomes than breast-conservation surgery.

    "I see a lot of patients who are quite unhappy with their cosmetic appearance after the lumpectomy and I can't do anything about it after they have had radiation," she says.

    The women included in the University of Michigan Medical Center study all had surgery for stage I, stage II, or stage III breast cancer around 2002.

    Only 33% said they discussed breast reconstruction with their general surgeon during the initial surgical decision-making process.

    Younger patients and more highly educated patients were more likely to be told about breast reconstruction.

    Female surgeons and those who worked in cancer centers were the most likely to discuss mastectomy with breast reconstruction, says Alderman.

    The study will be published in the Feb. 1, 2008 issue of the journal Cancer.

    Presenting the Options

    Oncologist Otis Brawley, MD, tells WebMD that cancer specialists may be better equipped than general surgeons to present all the options to breast cancer patients.

    Brawley serves as chief medical officer for the American Cancer Society and is a professor of oncology and hematology at Emory University in Atlanta.

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