ASSOCIATION FOR ACADEMIC SURGERY, 2008 A Woman's Influence to Choose Mastectomy as Treatment for Breast Cancer

Introduction. Over a 10-y period at our community hospital, more than 50% of women 40 y of age and younger underwent a mastectomy as first line breast cancer treatment. These results catapulted a study to identify personal and physical implications of a mas- tectomy and to determine if, in women of all ages, breast conservation therapy with close follow-up is a better alternative to mastectomy. Methods. Six hundred eight women underwent a mastectomy for breast cancer from 1989 to 2005 at our teaching institution; 77% (n 120) of 156 successfully contacted women agreed to participate in the study, and 70% (n 84) of them completed a questionnaire. Results. Most women discovered their breast cancer through mammography or self breast examination, 31% and 28%, respectively. Five patients were diag- nosed at Stage 0, 35 at Stage 1, 26 at Stage 2, 8 at Stage 3, 1 at Stage 4, and 9 patients had an unknown stage of disease. Sixty-three patients primarily discussed their treatment plan with a surgeon; 80 were satisfied with the time spent discussing their treatment. Twenty- four patients underwent various reconstruction pro- cedures; most (75%) were satisfied with their treat- ment and reconstruction choices. Conclusions. Mastectomy as a treatment choice for breast cancer did not have the negative personal and physical outcome that we had predicted. Personal choice and a surgeon's advice were the primary influ- encing factors on the women's treatment choice of mastectomy. Adequate preoperative discussion time and a multimodality cancer team can be most helpful