Women and Breast-Cancer Surgery

Women and Breast-Cancer Surgery

When a woman is diagnosed with breast cancer, her top priority is to get the cancer out and reduce the odds that it will ever return. But for some women, just getting the cancer out doesn’t feel like enough.

According to a new study led by University of Michigan researchers, when women, not their surgeons, have control over the type of surgery they receive, they are more likely to choose a more aggressive surgery that removes the entire breast, even though survival rates are the same for surgery that removes only the tumor.

Study results appeared in the August 20 issue of the Journal of Clinical Oncology.

“The current policy assumes that the high rate of mastectomy, the more invasive treatment, is a result of two things: providers not following guidelines that favor breast-conserving therapy and patients not being involved in the treatment decision. What we find is the opposite: surgeons are strongly promoting lumpectomy, and most women say they were involved in the decision,” says Steven Katz, principal investigator of the study and an associate professor of health management and policy at the School of Public Health and of general medicine at the UM Medical School.

With breast-conserving surgery, or lumpectomy, followed by radiation therapy, there’s a higher risk of the cancer coming back than with mastectomy, surgery that removes the whole breast. But many of these recurrences are caught early and treated effectively, so overall survival rates are the same for either type of surgery.

In a paper published in June in Health Services Research, the researchers reported that women who said they were involved in the surgical decision-making process were less likely to have low satisfaction with their surgery or regret their decision, suggesting that how women make their surgery decision is more important than what decision they make.

“Our study results suggest that women are thinking very rationally about breast cancer surgery from their own perspectives, weighing a lot of different factors,” says Paula Lantz, co-principal investigator of the study and associate professor and chair of the SPH Department of Health Management and Policy. “When women are diagnosed with breast cancer, they are looking for as complete a solution as possible so they can continue on with their lives.”

Nancy Janz, professor and associate chair, SPH Department of Health Behavior and Health Education, was a co-author of both papers.

Reported by UMHS Public Relations.

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When women, not their surgeons, have control over the type of surgery they receive, they are more likely to choose a more aggressive surgery.