This study and paper attempts to identify if breast cancer patients are truly informed regarding their treatment choices. What the authors conclude is that 415 of breast cancer patients are not presented with the option of breast conserving therapy or mastectomy, but are told to have one or the other. The authors found that breast surgeons are more likely to offer breast conservation but that women who are “well informed” are more likely to choose a mastectomy.

As a breast surgical oncologist, I want what is best for all breast cancer patients and this includes what the authors describe as a “preference-sensitive decision,” i.e. the decision is informed and concordant with patient preferences. The authors state that they found patients had breast cancer knowledge deficits, that patients were more likely to be told the advantages of breast conservation and that many patients were not asked their preference for treatment. The authors suggest that more communication aids be used.

Here at the Knoxville Comprehensive Breast Center, we believe in “preference-sensitive” decision making. We educate all of our patients and family members about their breast cancer, their treatment options and then ask the patient to make a decision. Some patients want their physician to make the decision for them, in which case our job is to better understand their wants, needs and desires to help them make the best treatment decision. We use many teaching aids but most importantly we have a team of physician, nurses and staff that teach and listen to our patients. As the government cuts reimbursement to medical practices, practices like ours that specialize in breast cancer can do a better job of preparing our patients for their breast cancer treatments, as suggested by this paper.

KCBC breast cancer patients are well informed and receive treatments that reflect their desires for a long, fulfilling life.

Source: Clara N Lee, MD, MPP, Yuchiao Chang, PhD, Nesochi Adimorah, BA, Jeff K Belkora, PhD, Beverly Moy, MD, MPH, Ann H Partridge, MD, MPH, DavidW Ollila, MD, Karen R Sepucha, PhD