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    Breast Cancer: Women Often Choose Mastectomy

    Surgeon, Family Opinions Affect Patients' Decisions
    By
    WebMD Health News
    Reviewed by Louise Chang, MD

    Sept. 1, 2009 -- Thirty-eight-year-old mother of three Ellyn Davidson says she knew within seconds of hearing her breast cancer diagnosis two years ago that she wanted her breasts removed, even though she could have opted for breast-conserving surgery.

    “My doctor called to tell me I had cancer at 9:30 on a Thursday night and after the initial shock, I said, “I’m going to get rid of my breasts, then,'” she tells WebMD. “He started to tell me about other things we could do, but I think he could tell my mind was pretty much made up.”

    Davidson knew the cure rate was about the same with the two surgeries for her early-stage cancer, but she wanted to be as aggressive as possible in treating her disease.

    A new survey of women with breast cancer shows that Davidson’s reaction was not atypical.

    Many Women Chose Mastectomy

    Women with early-stage breast cancer who said they were most involved in the decision-making process were also the most likely to have a mastectomy.

    Women who said they relied on the opinion of their surgeon or a family member or friend to decide which surgery to have were more likely to choose breast-conserving surgery with lumpectomy.

    This was true for all racial and ethnic groups surveyed, including African-American women and Latina women, says lead researcher Sarah T. Hawley, PhD, MPH, of the University of Michigan Health System.

    “There appears to be a subset of women who prefer mastectomy,” Hawley says. “This choice is based on their attitudes about the two surgeries. We just want to make sure those attitudes are based on accurate knowledge.”

    A total of 1,651 women with early-stage breast cancer who were candidates for mastectomy or breast-conserving surgery answered the survey. The women lived in Los Angeles or Detroit and 49% were white, 27% were African-American, and 24% were Latina.

    About three-fourths of the surveyed women ended up having breast-conserving surgery, Hawley says.

    The responses also revealed that:

    • Women who expressed the most concern about their cancer returning or the effects of radiation with breast-conserving surgery were more likely to choose mastectomy than women who expressed less concern about these things.
    • Women who reported that body image and their spouse’s opinion were important in their decision-making process were more likely to choose breast-conserving surgery.
    • Most women reported having a family member or friend accompany them during their surgical consultations.

    The findings appear in this week’s issue of the Journal of the National Cancer Institute.

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