Research carried out at the Ulleval University Hospital in Oslo, Norway, has revealed that breast cancer surgeons do not always offer a choice between mastectomy and breast-conserving surgery to women with early stage breast cancer, even when either option is medically appropriate.
Mrs. Inger Schou Bredal told the 3rd European Breast Cancer Conference in Barcelona today (Wednesday 22 March) that, in addition, the womens perceptions of when they had been offered a choice by the surgeon differed significantly from the surgeons perceptions of when they had offered a choice. The sex of the surgeon also made a difference, with female surgeons basing their recommendations on their assessment of the womens need for security, while male surgeons put more emphasis on how important they felt the breast was for the womens feelings of femininity.
Mrs. Schou Bredal, a doctoral student in nursing science at the hospital, asked 194 women with early stage breast cancer and 25 surgeons to complete questionnaires. The aim was to discover whether womens perceptions of receiving a choice between mastectomy (MAS) and breast-conserving surgery (BCS) matched the surgeons perceptions of giving a choice, and to assess if factors influencing the womens choice of surgery were the same as the factors which influenced the surgeons recommendations.
She found that even when surgeons considered that it was medically appropriate to give 81% of women a choice, they only offered a choice in 62% of cases. Amongst the patients, 59% of the women felt they had been offered a choice between MAS and BCS. In only 38% of cases was there complete agreement between the womens assessment of receiving a choice and the surgeons of giving a choice.
Factors that most influenced the womens choices were fear of cancer recurrence (in 89% of cases), the necessity of further treatment (72%) and the surgeons recommendations (70%). For surgeons, medical assessment (in 97% of cases)
Contact: Emma Mason
Federation of European Cancer Societies