Lack of patient-provider discussion contributes to disparities in use of breast reco...( CHICAGO (April 2 2008) In a new stu...),Health

CHICAGO (April 2, 2008) In a new study examining disparities in postmastectomy breast reconstruction, researchers at Brigham and Womens Hospital (BWH) and Dana-Farber Cancer Institute (DFCI) in Boston, Mass., concluded that lack of patient-provider discussion may contribute to socioeconomic, age and race-related inconsistencies in the use of breast reconstruction after mastectomy. However, the study also found that reconstruction was more likely to occur after the surgeon discussed options with the patient, suggesting that efforts are required to increase and improve these conversations. The full study appears in the April issue of the Journal of the American College of Surgeons.

Breast reconstructive surgery is an expensive elective procedure, but for many women it is a vital component of surgical care for breast cancer. The choice to have breast reconstruction is a complex decision that is influenced by access to care, patient preference and the providers interaction with the patient.

Patient preferences should be respected, but an informative discussion of reconstruction is required to help patients understand and weigh the risks and benefits of this procedure, said Caprice C. Greenberg, MD, Instructor of Surgery in the Center for Surgery and Public Health at BWH and the Center for Outcomes and Policy Research at DFCI. We learned that physicians need to improve communications with patients and whenever possible, universally address the issue of reconstruction with all women undergoing a mastectomy, regardless of age, race or socioeconomic status.

Using the National Initiative on Cancer Care Quality database, researchers evaluated 626 patients who underwent mastectomy for breast cancer. The data had been collected in a study commissioned by the American Society of Clinical Oncology (ASCO) and undertaken by researchers at the Rand Corporation and the Harvard School of Public Health. Researchers reviewed data collected via survey
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