A woman diagnosed with early breast cancer often leaves her doctor's office with a tough decision to make. Should she have the cancer removed or have her entire breast removed? No matter what she chooses, doctors and researchers agree, her chance of surviving is the same -- even if the cancer returns.
But more than 15 years after so-called breast-conserving surgery became a proven option, about half of the roughly 130,000 U.S. women diagnosed with early stage breast cancer each year still opt for mastectomy over lumpectomy.
D.C. breast cancer activist and mastectomy patient Zora Brown says the new patient education brochure " is a document we can use."
(Juana Arias -- The Washington Post)
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Some researchers and breast cancer advocates say this means many women are getting mastectomies they don't need. So, working with the National Cancer Institute (NCI), they've developed a free booklet designed to help the newly diagnosed choose between the two surgeries. The 21-page brochure "Surgery Choices for Women with Early Stage Breast Cancer," to become available this month, aims to put a complex decision in the patient's hands from the outset.
The booklet is needed, said Washington epidemiologist Diana Zuckerman, one of its authors, in part because not every physician is up-to-date on the science of breast cancer. "If a woman asks her doctor, depending on who her doctor is, she may not get the best possible advice," said Zuckerman, president of the National Center for Women & Families.
"Not everybody reads that research, and the people giving advice are not always experts in the field."
Plus, said Zuckerman, women often need time after diagnosis to make a hard choice on treatment.
"These women are in their doctor's office and the doctor says, 'You can do this or you can do that.' They get home and they can't remember anything because they are so stressed out . . . . It's not that any of this information is a secret. It's putting it all together in a booklet which is quite different."
Said Washington breast cancer activist Zora Brown, founder of the Breast Cancer Resource Committee, "This is a document we can use."
Facing the Odds
When doctors found Brown's cancer more than 20 years ago, lumpectomy was an emerging treatment and there were no long-term data on its efficacy. Today, the now-routine operation is acknowledged as offering the same survival rate -- about 70 percent of women living at least 10 years after surgery -- as mastectomy, the surgery Brown chose.
Still, many women are confused by the odds of a recurrence -- odds that differ between the two operations. Although mastectomy patients are less likely to get cancer again, they don't live any longer, on average. That is because not all breast cancers are equally aggressive. Some tumors grow very slowly and never become fatal, while others are lethal even with early detection. So, the odds of dying may have as much to do with unpredictable nature of a single tumor as it does with the number of tumors.
