Of the 1,984 patients, 19.1 percent sought a second opinion about surgical options prior to treatment. "This was more common for women with a higher education level and for those advised to undergo mastectomy (33.4 percent) vs. those advised to have BCS (15.6 percent) or those who did not receive a recommendation for one procedure over another (21.2 percent)," the authors write.
They also found that 11.9 percent of patients who received an initial BCS recommendation received a second opinion for mastectomy; 12.1 percent of the patients who consulted a second surgeon received a discordant opinion. Among the 1,459 women for whom BCS was attempted, additional surgery was required in 37.9 percent of patients. Mastectomy was most common in patients with stage II cancer.
"The results of this study suggest that most surgeons in 2 large, diverse urban regions appropriately recommended local therapy options for patients with breast cancer. The majority of women who received a surgeon recommendation for initial mastectomy reported a clinical contraindication to breast conservation," the authors write.
"Our results also suggest that patient preferences may play an important role in shaping the pattern of surgical treatment for breast cancer. One-third of patients appear to choose mastectomy as initial treatment when not given a specific recommendation for BCS or mastectomy by their surgeon, accounting for about one-quarter of total mastectomy use. Patients may prefer mastectomy for peace of mind or to avoid radiation."
"In conclusion, findings of this survey of women with breast cancer demonstrate that the etiology [cause] of current mastectomy rates is multifactorial, but that BCS is recommended by surgeons and attempted in a majority of patients," the researchers write. "Our findings suggest that a combined approach of education for patients and health care professionals targeting specific areas may improve decision making."
Source-Eurekalert
RAS