Important Decisions in Breast Cancer Surgery

According to the American Cancer Society, 209,060 Americans were diagnosed with breast cancer in 2010, and 40,230 died from the disease. When patients are diagnosed with breast cancer, they often feel well enough to continue living their life as they were previously. The treatment options for breast cancer, however, have potentially significant effects on quality of life and life expectancy. Researchers from the Cancer Surveillance and Outcomes Research Team (CanSORT), a multidisciplinary collaboration among five centers across the country, surveyed 1,780 breast cancer patients and their surgeons in the Los Angeles and Detroit metropolitan areas about treatment choices. The focus of this research was to determine if where patients go for care can impact key surgical choices that are related to local therapy, specifically mastectomy (with or without reconstruction) versus lumpectomy. Results of the study were published in the October 2010 issue of Medical Care. Consistent, Standardized Care Previous research has shown that surgical treatment of breast cancer depends largely on surgeon recommendations and patient preferences. A major finding in the study published in Medical Care was that the use of mastectomy over breastconserving lumpectomy varied little by surgeon and was based on patients’ clinical picture and characteristics rather than on practice characteristics (Table). “Primarily, women who were not eligible for lumpectomy or who preferred mastectomy received the more aggressive surgery,” says Steven J. Katz, MD, MPH, who was the study’s lead investigator. “This supports previous research by the CanSORT team, showing that surgeons generally are consistent with their approach when discussing treatment options, contraindications, and recommendations.” Where a woman goes for breast cancer treatment can vary widely, ranging from small private...