A new study found that when breast cancer surgeons regularly confer with plastic surgeons before surgery, their patients are more likely to have breast reconstruction.
The researchers at the University of Michigan Comprehensive Cancer Center surveyed breast cancer patients (1,780) and their surgeons (291) in Detroit and Los Angeles about treatment choices. They found that women who were not eligible for lumpectomy or who preferred mastectomy received the more aggressive surgery, which supports previous research that showed surgeons are fairly consistent in their approach to mastectomy use.
They found that breast reconstruction is not as consistent. About a third of women who undergo mastectomy go on to have breast reconstruction. There are numerous reasons why a woman may not have reconstruction, but the researchers found that 31 percent of the variation could be attributed to how often the patient’s surgeon talked to a plastic surgeon prior to the first surgery.
“Breast reconstruction is a very complex treatment issue that requires a lot of discussion. Our results suggest that discussion can be quite different depending on where a patient gets initial treatment,” says lead study author Dr. Steven J. Katz, who is a professor of internal medicine at the U-M Medical School and of health management and policy at the U-M School of Public Health.
“Patients with similar characteristics or preferences may get a different story from different surgeons—and this depends largely on whether a plastic surgeon is on the treatment decision team from the get-go. Plastic surgeons are the ones with the expertise to explain the increasingly complicated procedure options,” Dr. Katz adds.
“This is a deeply intimate and important decision that women have to make. It should be made with the right information about reconstruction options in consultation with a plastic surgeon involved up front in the treatment planning,” says Dr. Katz.
The abstract of the study, which will appear in the October issue of the journal Medical Care, is available online: “Does It Matter Where You Go for Breast Surgery?: Attending Surgeon’s Influence on Variation in Receipt of Mastectomy for Breast Cancer.”