NCI Cancer Bulletin: A Trusted Source for Cancer Research NewsNCI Cancer Bulletin: A Trusted Source for Cancer Research News
November 2, 2004 • Volume 1 / Number 42 E-Mail This Document  |  Download PDF  |  Bulletin Archive/Search  |  Subscribe

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Community UpdateCommunity Update

New Booklet Helps Women Make Decisions About Breast Surgery

Treatment for early-stage breast cancer usually includes radiation therapy followed by either partial or complete removal of the affected breast or breasts. Many women do not understand the repercussions of these surgeries and many are not aware that survival rates are virtually equal for both types of surgery. Perhaps that's why more than one-third of these women do not decide, and instead defer to their physician to choose the surgical procedure. Nearly half end up choosing mastectomy (complete breast removal) over lumpectomy (breast-conserving surgery), the latter of which removes only the cancerous tissue within the affected breast.

To help women weigh the pros and cons of their surgical options and take a more active role in their breast cancer treatment, NCI's Office of Education and Special Initiatives (OESI) has produced the booklet, Surgery Choices for Women with Early-Stage Breast Cancer. The booklet was developed by a partnership of several federal agencies, including the Agency for Healthcare Research and Quality (AHRQ), NCI's Office of Women's Health, NIH's Office of Research on Women's Health, and the Department of Health and Human Services, as well with the nonfederal National Research Center for Women & Families.

"Research indicates that, when faced with a diagnosis of breast cancer and the need to make critical life-impacting decisions, even the most educated patient would rather receive information that is brief yet thorough and extremely clear," said Leonora Johnson, OESI director.

Surgery Choices for Women with Early-Stage Breast Cancer The development of the 24-page booklet began with a technical report from a scientific meeting on early-stage breast cancer treatment, sponsored by AHRQ and NCI. The final product, which is written in easy-to-understand language, was reviewed and edited by the Food and Drug Administration (FDA) and pilot tested with women in Denver, Baltimore, and selected rural areas of the country. A unique feature of the booklet is the "Compare Your Choices" chart, which helps patients compare surgery options. The chart includes information on surgery side effects, additional treatments, and the chance of cancer recurrence for each surgery type.

"Surgery Choices for Women with Early-Stage Breast Cancer was not developed to discourage women from choosing mastectomy or to encourage them toward lumpectomy," noted Ms. Johnson. "Rather, it gives an overview of early-stage breast cancer, with a balanced description of breast-sparing surgical options, including lumpectomy, partial mastectomy, and segmental mastectomy; full-breast removal options, including total mastectomy, modified radical mastectomy, and double mastectomy; and reconstructive breast surgery, including breast implants and tissue flap surgery.

"It's clear that many women don't realize that they may have a choice between types of mastectomy or breast-sparing surgery without compromising their treatment outcome, length of survival, or chance of recurrence," said Dr. Rosaly Correa-de-Araujo, AHRQ's senior advisor on women's health. "It's critical that we make this resource available to women with early-stage breast cancer."

Ms. Johnson also pointed out that "studies suggest that women prefer to get this kind of resource from their physician, surgeon, or other treatment team member in a setting where their options can be further discussed and explained. For this reason, we're developing a complementary product that can be used in consultations between women and their doctors."

Surgery Choices for Women with Early-Stage Breast Cancer can be viewed online at To order free copies of the booklet, call 1-800-4-CANCER or visit Promotional materials for the booklet are available at