Most U.S. breast cancer patients know little about reconstructive surgery risks: study

WASHINGTON, May 3 (Xinhua) -- More than half of breast cancer patients undergoing mastectomy in the United States do not know enough about risks associated with reconstructive surgery, suggesting a trend toward overtreatment, a new study said Wednesday.

"This is very concerning to us, because it means that some women did not get the treatment they truly preferred, and quite a few had more treatment than they preferred," said Clara Lee, principal investigator of the study and a breast reconstructive surgeon at the Ohio State University Comprehensive Cancer Center.

Breast reconstruction after mastectomy has the potential to improve a person's body image and quality of life, but such a surgery carries risks, such as bleeding, infection and poor healing of incisions.

In the study, the researchers surveyed 126 breast cancer patients about their decisions to do breast reconstruction after mastectomy.

All patients had stage I-III invasive ductal/lobular breast cancer, ductal carcinoma in situ or were having preventive mastectomies. The majority, or 73 percent, had early-stage disease.

The patients were asked about what they know about mastectomy and mastectomy with reconstruction, such as effects of surgery on appearance and associated risks, as well as their individual preferences in making such a choice.

It turned out that only 43 percent of the patients in the study demonstrated an understanding of at least half of the important facts about reconstruction and made a choice that was consistent with their preferences.

Understanding of surgical complications was particularly low, with only 14 percent of patients demonstrating strong knowledge of associated risks.

"Many women were quite concerned about complication risks, but they didn't actually know how high the risk was. This may explain some of the overtreatment that we saw," Lee said.

The research suggested that doctors should help women make decisions based on a full understanding of treatment choices and associated risks alongside their personal goals for surgery.

"As breast cancer providers, we need to talk about the pros and cons of surgery to help women make treatment choices," Lee said. "We need to connect patients with decision aids to help them really think through what is most important to them."