A study found that half of more than 1,000 women diagnosed with early-stage breast cancer didn't understand how lumpectomy followed by radiation compared to mastectomy in lowering the risk of the cancer coming back. The researchers also found that African American and Hispanic women were less likely than white women to understand how the two surgeries compared, no matter where they received their care.
Most of the women (75%) in this study were told about both types of surgery. The women whose doctors didn't discuss both options with them were much less likely to know how the two surgeries compared.
Women diagnosed with early-stage breast cancer may choose to have a mastectomy instead of lumpectomy and radiation because they think removing all of the breast makes it less likely that the cancer will come back. But research has shown that small early-stage breast cancers (under 4 centimeters) removed by lumpectomy that is then followed by radiation therapy have the same risk of coming back within 5 years as small early-stage cancers removed by mastectomy.
This study suggests that many women make choices about surgery without really understanding how the options compare. This might explain why more women have mastectomy than lumpectomy and radiation therapy in some parts of the United States, even though both choices are usually equally effective.
When you and your doctor are deciding on the best breast cancer treatment plan for you, consider asking your doctor the following questions:
- What are ALL of my options, both medical and surgical?
- How do the options compare in their:
- ability to treat the breast cancer?
- ability to reduce the risk of the cancer coming back?
- short-term and long-term risks and complications?
- affect on my quality of life?
- How does each option affect my future choices (for example, future breast reconstruction or getting pregnant)?
So that you can remember and review what you and your doctor have discussed, you might want to write things down while you're talking with your doctor (or bring a friend to help listen and take notes for you). You also can ask your doctor if you can record the discussion.
Talk to your doctor about all of the assumptions that have been made in choosing the best treatments for you. You also might consider getting a second opinion to see if the treatment plan you've been given is recommended by the second doctor.
Making the most informed decisions about your treatment plan is a shared responsibility between you and your doctor. Ask as many questions as you need to until you're comfortable with your choices. There's only one of YOU and you deserve the best care possible.