Navigation Links
Surgeons and health care settings influence type of breast cancer surgery women undergo
Date:4/30/2014

TORONTO, April 30, 2014 Breast cancer is one of the few major illnesses for which physicians may not recommend a specific treatment option. North American women are more likely to opt for precautionary breast surgery when physicians don't specifically counsel against it, according to a new study.

The research, presented today at the American Society of Breast Surgeons Annual Meeting in Las Vegas, also demonstrates how clarity during consultations and the capability of clinical facilities also play important roles influencing a woman's breast cancer treatment choices.

There is more than one type of preventative breast surgery but this study looked only at cases where cancer has been diagnosed in only one breast. This form prophylactic breast surgery, called a contralateral prophylactic mastectomy, entails removing the healthy breast at the same time as the cancerous breast. The procedure can reduce the risk of breast cancer recurrence in women who have a strong family history of breast or ovarian cancers and in women who have a genetic mutation that makes breast cancer more likely.

"While effective for such groups," explained Dr. Andrea Covelli, lead author and a University of Toronto general surgery resident whose research work was supervised by Dr. Nancy Baxter of St. Michael's Hospital. "The number of prophylactic mastectomies across North America has risen among women without these underlying conditions among women who have only an average risk of developing cancer in their non-cancerous breast."

Previous national studies have shown that instances of prophylactic breast surgery among early-stage, average risk women have increased nearly twelvefold in the United States over the last decade. In Canada, rates increased by 140 per cent between 2008 and 2010.

Dr. Covelli interviewed 45 surgeons in North America to identify factors that determine the course of treatment.

In the United States, some states legislate that surgeons present all treatment options to patients. The research found that surgeons complied in the 20 states with such legislation but generally surgeons did not recommend one procedure over another. Instead, they encouraged patient choice. Canadian surgeons discussed similar surgical options with their patients. However, they more often specifically recommended breast-conserving surgery and counseled against prophylactic mastectomies.

"We learned that surgeon's recommendations and detailed consultations influenced women's decisions for breast cancer treatment," said Dr. Covelli. "Consultations were especially important when it came to MRI findings. When MRI results were presented without detailed explanations, women were more likely to opt for prophylactic mastectomies."

MRI exams have a high rate of false-positive results so patients who were given their exam results without detailed explanations were often concerned about new disease in addition to the recently diagnosed tumour.

Findings show that MRI exams were ordered less frequently in Canada than in the United States. It also showed that Canada's surgeons often had more opportunity to discuss potential for inaccuracies with patients.

If women were being treated at health care facilities with access to immediate reconstruction, they were also more likely to choose prophylactic surgery.

"The availability of immediate breast reconstruction was another main factor in patients' decisions," said Dr. Covelli.

Immediate reconstruction was associated with the choice of prophylactic mastectomy and is more widely available in the United States than in Canada. In both countries, many patients requested a prophylactic mastectomy after returning from a consult with a reconstructive surgeon.

"We need to look at what happens during that consult to better understand patient decision-making," said Dr. Covelli. "Patients should ask for their doctor's opinion if helpful to them. Most surgeons have years of experience treating breast cancer and can provide valuable counsel and advice."


'/>"/>

Contact: Geoff Koehler
koehlerg@smh.ca
416-864-6060 x6537
St. Michael's Hospital
Source:Eurekalert  

Related medicine news :

1. Clinical news alert from the American Academy of Orthopaedic Surgeons
2. NYU Langone experts present research, clinical advances at neurosurgeons meeting
3. Slicing mitotic spindle with lasers, nanosurgeons unravel old pole-to-pole theory
4. Clinical news alert: Journal of the American Academy of Orthopaedic Surgeons May highlights
5. Surgeons Seek Repeal of Transplant Ban Between HIV-Positive People
6. Greater availability of neurosurgeons could reduce risk of death from motor vehicle accidents
7. Adding More Neurosurgeons Could Cut Traffic Deaths: Study
8. General surgeons identify postoperative complications posing strongest readmission risk
9. Young Surgeons May Be Easily Distracted
10. In US first, Johns Hopkins surgeons implant brain pacemaker for Alzheimers disease
11. General thoracic surgeons emerge as leading providers of complex, noncardiac thoracic surgery
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Surgeons and health care settings influence type of breast cancer surgery women undergo
(Date:6/25/2016)... ... ... temporary closing of Bruton Memorial Library on June 21 due to a possible lice infestation, ... aspect of head lice: the parasite’s ability to live away from a human host, and ... necessary one in the event that lice have simply gotten out of control. , As ...
(Date:6/25/2016)... ... 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the ... to iHire in recognition of their exemplary accomplishments in worksite health promotion. , The ... Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one ...
(Date:6/24/2016)... PASADENA, CA (PRWEB) , ... June 24, 2016 , ... Marcy was in a crisis. ... he would lash out at his family verbally and physically. , “When something upset him, ... table, he would use it. He would throw rocks at my other children and say ...
(Date:6/24/2016)... ... 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join ... wage raise to $12 an hour by 2020 and then adjusting it yearly to increase ... of the minimum wage, assure the wage floor does not erode again, and make future ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... the Frederick area economy by obtaining investment capital for emerging technology companies. ... years that have already resulted in more than a million dollars of capital ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)...  In a startling report released today, National Safety Council ... a comprehensive, proven plan to eliminate prescription opioid overdoses. ... states are tackling the worst drug crisis in recorded U.S. history, ... Kentucky , New Mexico , ... the 28 failing states, three – Michigan , ...
(Date:6/23/2016)... 2016 Bracket , a leading clinical trial ... clinical outcomes platform, Bracket eCOA (SM) 6.0, at the ... – 30, 2016 in Philadelphia , Pennsylvania.  ... Assessment product of its kind to fully integrate with RTSM, ... eCOA 6.0 is a flexible platform for electronic clinical outcomes ...
(Date:6/23/2016)...  Guerbet announced today that it has been named ... . One of 12 suppliers to receive ... support of Premier members through exceptional local customer service ... to lower costs. ... outstanding customer service from Premier," says Massimo Carrara ...
Breaking Medicine Technology: