After Breast Cancer, Many Women Lack Options

Dec. 21, 2007— -- Women diagnosed with an early stage of breast cancer face enough tough decisions, like choosing between prolonged therapies or major surgery. Yet, new research indicates doctors aren't even talking about every option available to women before a decision on how to proceed is made.

A new survey reports only one out of three breast cancer patients said they had talked with their doctors about plastic surgery options to reconstruct a lost breast.

The study, published in the Journal of the American Cancer Society, surveyed nearly 1,200 early stage breast cancer patients in Detroit and Los Angeles. The women who learned about breast reconstruction were four times more likely to choose mastectomy over lumpectomy.

Rebecca Larson, 31, was diagnosed with breast cancer in 2006. "I had no idea what my options for reconstruction were at diagnosis, or even before the first mastectomy," Larson said.

"No one talked to me, and my plastic surgeon was left out of the loop until well after the initial surgery," she added.

Cut out the tumor and get radiation, or get a mastectomy and remove the breast. Both treatments have high five-year survival rates. Both come with their own trade-offs of time, self-esteem and peace of mind, experts say.

Doctor's Discussion

The popularity of breast reconstruction surgery nationwide shows inconsistencies within geographic regions. In Hawaii, 8 percent of women who get a mastectomy have immediate reconstructive surgery. In Iowa, the figure is 11 percent; in New Mexico, it is 22 percent.

"If you think of it, women aren't that different," said Dr. Amy Alderman, lead author of the reconstruction study in cancer, and a plastic surgeon at the University of Michigan Medical Center.

Alderman's research tries to determine if surgeon preferences, rather than patient preferences, are driving reconstruction disparities. She thinks the wide variations in plastic surgery rates may come from regional medical communities' attitudes toward breast reconstruction.