Many Women Don’t Understand Treatment Risks and Benefits

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A study found that half of more than 1,100 women diagnosed with early-stage breast cancer didn't understand how lumpectomy followed by radiation therapy compared to mastectomy in:

  • lowering the risk of the cancer coming back
  • the risk of dying from the cancer

The researchers also found that African American and Hispanic women were less likely than white women to understand how the two types of surgery compared. Women whose doctors didn't discuss both surgical options were much less likely to know how the two surgeries compared. This lack of understanding was seen no matter which type of surgeon provided care (general surgeon or breast cancer surgeon) or where care was given (community hospital or large cancer center).

Women diagnosed with early-stage breast cancer may choose to have a mastectomy instead of lumpectomy and radiation because they think removing the whole breast makes it less likely that the cancer will come back. But research has shown that small, early-stage breast cancers (only one tumor that is smaller than 4 to 5 centimeters) removed by lumpectomy 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 breast cancer surgery without really understanding the differences between the two types of surgery. This might be part of the reason why more women have mastectomy than lumpectomy and radiation therapy in some parts of the United States.

When you and your doctor are deciding on the best breast cancer treatment plan for you, you may want to ask 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 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 (breast reconstruction or getting pregnant)?

So you can remember and review what you and your doctor talk about, you might want to take notes while you're talking to your doctor. You also might want to 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 how and why your treatment plan was developed. 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 is a responsibility both you and your doctor share. 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.

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