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Talks With Plastic Surgeon Urged Before Mastectomy

Where woman goes for treatment may influence breast reconstruction decision, study suggests

FRIDAY, Sept. 3, 2010 (HealthDay News) -- Breast cancer patients who've had a mastectomy are more likely to have breast reconstruction if a plastic surgeon is part of the treatment decision team, new research shows.

The study also found that where a woman goes for breast cancer treatment -- ranging from small private practices to large medical complexes -- affects the type of care she receives when it comes to breast reconstruction.

"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," lead author Dr. Steven J. Katz, professor of internal medicine at the University of Michigan Medical School and of health management and policy at the U-M School of Public Health, said in a university news release.

"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," Katz noted.

He and his colleagues surveyed 1,780 breast cancer patients and 291 surgeons about treatment choices, and found that about one-third of women who undergo mastectomy go on to have breast reconstruction.

There are many reasons why a woman may not have reconstruction, but the researchers concluded that 31 percent of the variation could be attributed solely to how often a woman's surgeon talked to a plastic surgeon prior to mastectomy.

"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," Katz said. "Patients should be particularly attentive to engaging their surgeons on the first visit about this important treatment option."

The study findings were released online Aug. 28 in advance of publication in the October print issue of the journal Medical Care.

More information

The American Cancer Society has more about breast reconstruction.

SOURCE: University of Michigan, news release, Sept. 1, 2010
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