Women often uninformed about breast reconstruction

NEW YORK (Reuters Health) – Though most women with breast
cancer are aware they have the option for breast reconstruction
soon after surgery, few may fully understand the details of the
procedure, a new study suggests.

This was particularly the case, researchers found, for
black women, who were more likely to say they did not know
enough about breast reconstruction or to feel that the
procedure was not recommended.

In addition, only a minority of women — 38 percent — had
breast reconstruction immediately or soon after undergoing a
mastectomy, according to findings published in the journal
Cancer.

This is in line with past studies finding that, although
many breast cancer patients can have breast reconstruction at
the same time as their mastectomy or soon after, relatively few
women make that choice.

Most often, women in the current study said they opted not
to have reconstruction because they wanted to avoid more
surgery.

But there were also signs that many of the 646 patients
were not fully informed about the procedure, according to the
study team, led by Dr. Monica Morrow of Fox Chase Cancer Center
in Philadelphia.

Although 78 percent said they had discussed breast
reconstruction with their cancer surgeon or a plastic surgeon,
only 11 percent were able to correctly answer three basic
questions about the procedure.

For example, three-quarters of the women incorrectly
believed that breast reconstruction makes it hard to detect
cancer recurrences. This is a “critical factor” in the decision
to undergo reconstruction, the authors note.

When the researchers looked at the results based on race,
they further found that black women were less likely than white
women to give correct answers to the questions on breast
reconstruction.

They were also somewhat more likely to say they didn’t know
enough about breast reconstruction, or to think that the
procedure was not recommended or discouraged by their surgeon.

Exactly why women — and black women in particular — lack
knowledge and interest in early breast reconstruction is
unclear, according to Morrow’s team. But the findings suggest a
need to better inform newly diagnosed women about
reconstruction, the researchers write.

Breast reconstruction is not the right choice for all women
who undergo mastectomy, however. And no one knows what
percentage of mastectomy patients “should” have the procedure,
the study authors note.

Experts recommend that women discuss the pros and cons of
reconstruction with their doctors before they have a
mastectomy.

SOURCE: Cancer, December 1, 2005.