Only about a third of the almost 1,200 women in a study talked about reconstruction with their surgeons when making decisions about breast cancer surgery. But the women who did talk about reconstruction were 4 times more likely to choose mastectomy over lumpectomy (breast-conserving surgery).
Reconstruction was more likely to be discussed with younger, more educated women who were diagnosed with larger cancers. It's possible that women with more education may do more to learn about their options for surgery and may be the ones to bring up the topic of reconstruction.
It's important to know that the women in the study were all from either Detroit or Los Angeles -- two large cities. So these results may not be a snapshot of what is happening in the whole United States. Also, this study was a retrospective study. This means that the researchers contacted the women after they had recovered from the surgery and asked them to remember what they talked about with their surgeons. In a study like this, people sometimes don't accurately remember everything that happened.
For women diagnosed with a cancer smaller than 4 centimeters that was removed with clear margins (no cancer cells were found in the tissue surrounding the cancer), lumpectomy followed by radiation therapy is likely to be equally as effective as mastectomy. Although most women who have a choice prefer the less invasive lumpectomy, the choice depends on many factors, including:
- whether the time commitment needed for radiation therapy (5 to 7 weeks, 5 days per week, of treatment) makes mastectomy a better option for you
- your interest in reconstructive surgery
- how important it is that you keep your breast
- whether removing the entire breast would help YOU worry less about the possibility of the breast cancer coming back
About 75% of women who have mastectomies go on to have breast reconstruction. If you're considering mastectomy as an alternative to lumpectomy and radiation, you and your doctor also should discuss breast reconstruction. Even if you are leaning toward lumpectomy and radiation, it's important to talk to your doctor about reconstruction while considering your options. Some women have breast reconstruction after lumpectomy to restore balance to the size and contour of their breasts.
For more information on the timing and types of breast reconstruction, visit the breastcancer.org Reconstruction section.