Are full mastectomies on the decline today?

Breast cancer no longer automatically results in breast removal -- but researchers say they are surprised to find why so many of the procedures are still conducted.

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“In this study, one-third of patients appear to choose mastectomy as initial treatment when not given a specific recommendation for mastectomy by their surgeons. Researchers speculate that patients may prefer mastectomy for ‘peace of mind’ or to avoid radiation and are often strongly influenced by concerns about disease recurrence and fear.

“Women need to understand that although it intuitively seems obvious that a bigger surgery is a better surgery, it may not be the case,” noted the study. “There are some patients for whom mastectomy is the best medical treatment.”

However, “women need to make sure that if they are choosing mastectomy,”that they understand it is not going to improve the likelihood of breast cancer survival,” wrote Morrow and Katz.

“Our results and those from other studies we performed suggest that surgeons face special challenges in how they discuss treatment options and elicit the treatment preferences of their patients with breast cancer. Our results reinforce that both patient preferences and surgeon recommendations are powerful determinants of treatment,” said Katz, who is a professor of internal medicine and health management and policy at the University of Michigan.

“This study suggests that breast-conserving surgery has been appropriately adopted by surgeons and for most women — if they are given a specific reason why they are not a good candidate for breast-conserving surgery — a second opinion is not likely to change that,” Morrow says.

 

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Rob Kerby, Senior Editor
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