Study: Half of Patients Make Poor Decisions About Breast Reconstruction

Surprising number of mastectomy patients are uninformed about their reconstruction choices

(Columbus, Ohio) – After receiving a devastating breast cancer diagnosis, women have a lot of tough decisions to make about treatment options. Those who choose to have a mastectomy then face another difficult decision: whether or not to have breast reconstruction surgery. A new study finds that an surprising number of women aren’t making decisions that balance medical knowledge with personal outcomes preferences. Patients also cannot correctly answer questions about the surgery and possible complications.

    “We determined that a patient made a high-quality decision if she met two criteria. She was able to answer at least half of the general knowledge questions about breast reconstruction correctly, and she made a decision that matched her goals,” said Dr. Clara Lee, lead author of the study and a plastic surgeon at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Institute. “Surprisingly, we found that 57 percent of women did not make a high-quality decision.”

    Dr. Lee and her team issued questionnaires to women before they had surgery and asked general knowledge questions about breast reconstruction. “Knowledge about complications was shockingly low at an average of 14 percent in the whole group,” said Dr. Lee. “So, women who had reconstruction may have actually been quite concerned about complications, but didn’t have the information to factor that into their decision.”

    They also asked women to rate how important things like appearance, recovery time and having fewer surgeries were to them. Dr. Lee was surprised to find that nearly half of the women ultimately made a decision that did not match their personal goals. “It’s important for women to step back and reflect on what’s truly important to them,” she said. “That can be really tough when you’ve just learned that you have breast cancer and you need major surgery, but I encourage women to seek information from their surgeons and to take their time considering what the best decision is for them.”

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Cindy Carnahan (right) is going through the process of breast reconstruction at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. Plastic surgeon Dr. Clara Lee (left) helped Cindy understand her options after learning she’d need a mastectomy to fight her breast cancer.

Cindy Carnahan teaches a painting party in Cambridge, Ohio. She is now cancer free after having a mastectomy, and says her decision to have breast reconstruction has allowed her to put breast cancer behind her.

Dr. Clara Lee performs breast reconstruction surgery at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. In a recent study, she found that mastectomy patients often make uninformed decisions about whether or not reconstruction is right for them.

Dr. Clara Lee performs breast reconstruction surgery at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. In a recent study, she found that mastectomy patients often make uninformed decisions about whether or not reconstruction is right for them.

After learning she would need a mastectomy, Cindy Carnahan read as much as she could about breast reconstruction and asked her doctors a lot of questions before deciding that surgery was the right choice for her.