Reconstruction surgery rarely discussed with breast cancer patients

March 31, 2016

The analysis shows that only one in three patients eligible for mastectomy or breast conserving surgery have such discussions. The study is published in the February 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

The option of breast reconstruction has increased treatment choices for women with breast cancer. Women with early stage disease who are not likely to need post-mastectomy radiation are considered eligible for reconstruction at the time of surgery. However, little is known about how often surgeons discuss breast reconstruction with patients.

Led by Dr. Amy Alderman of the University of Michigan Medical Center, researchers surveyed a 1,178 women aged 79 years or younger who had undergone a surgical procedure for stage I, II, or III breast cancer between December 2001 to January 2003.

The researchers found only 33 percent of patients had a general surgeon discuss breast reconstruction with them during the surgical decision-making process for their cancer. Surgeons were significantly more likely to have this discussion with younger, more educated patients. Patients who discussed reconstruction with their surgeon were more willing to consider having a mastectomy and were more than 4 times likely to undergo the surgery. The findings suggest that discussing reconstruction will impact women?s decisions regarding initial surgery for their breast cancer.

According to the authors, these results have important implications for patient care and policy. "This research suggests that patients should be informed of all options in order to be educated consumers of healthcare and ensure maximal breast cancer treatment decision quality," they conclude. "Our results suggest a need for comprehensive breast cancer treatment decision aids, including information on initial surgery and other treatment options such as reconstruction."

cancer

???The next step is to move Avastin into the initial treatment of breast cancer in hopes that it will prevent recurrence in the first place,??? said Dr. Miller.

Avastin is a human monoclonal antibody that acts to reduce the development of blood vessels that feed tumors. Cancer tumors need an increasing supply of blood to grow and the development of the blood vessels to supply the tumor is a process called angiogenesis. Avastin already has been approved by the Food and Drug Administration for treatment of colorectal and lung cancer.

The first clinical study with Avastin in humans was done in 1997 at Indiana University School of Medicine by George W. Sledge Jr., M.D., a pioneer in the field of antiangiogenic research. Dr. Sledge, a breast cancer specialist and the Ballve-Lantero Professor of Oncology, also conducted a 1998 Avastin study for breast cancer patients. Both early studies produced positive results.

iu/