High mastectomy rates due to patients' choices, study finds.

2004 JUL 1 - (NewsRx.com & NewsRx.net) -- As surgeons develop ways to make breast cancer treatment less invasive and less disfiguring, mastectomy rates have remained surprisingly high, causing many researchers to suspect doctors are not giving their patients these options.

But a new study shows it's the patients who are choosing the more aggressive surgery.

Researchers at the University of Michigan Comprehensive Cancer Center and Wayne State University found that women with breast cancer who said they made their own treatment decision were more likely to have a mastectomy than women who said their surgeon made the decision. Among women who had a mastectomy, fewer than a third received reconstructive surgery to create a new breast.

Results of the study were presented in early June 2004 at the annual meeting of the American Society of Clinical Oncology in New Orleans.

Breast-conserving surgery, called lumpectomy, is a less invasive option for women with breast cancer. The surgery involves removing only the tumor and a small margin of tissue around it, and cosmetic results can be almost unnoticeable. Meanwhile, advances in reconstructive surgery have allowed doctors to improve the cosmetic results of mastectomy, which removes the whole breast.

Despite these advances, mastectomy rates have remained persistently high.

"Our research found that it's the patients who seem to prefer mastectomy to breast-conserving therapy. Increasing patients' involvement in treatment decisions may actually drive mastectomy rates even higher," says study author Steven Katz, MD, MPH, associate professor of internal medicine at the U-M Medical School and of health management policy at the U-M School of Public Health.