Breast cancer treatment knowledge lacking

By Joene Hendry

NEW YORK (Reuters Health) - Many women poorly understand the risks and benefits of breast cancer treatment options, researchers report.

"Information may be delivered but not understood," Dr. Sarah T. Hawley told Reuters Health, especially when women are of racial or ethnic minorities.

Thus, healthcare providers should reiterate information and offer advice that is sensitive to cultural, racial, and ethnic backgrounds, said Hawley, of the University of Michigan Health Center, Ann Arbor.

Patients should not hesitate to ask for explanations. Hawley suggests that women have a trusted individual attend surgeon visits or request culturally tailored or additional resources regarding their condition.

Hawley and colleagues collected survey and medical data from 1,132 breast cancer patients who ranged in age from 29 to 79 years, and had undergone either mastectomy or breast-conserving surgery (also referred to as lumpectomy) with radiation for either localized breast cancer or invasive breast cancer that had not spread to distant locations of the body.

Seventy-three percent of the women were white, 18 percent African American, 9 percent Latina or other ethnicity. About two thirds had some college education, the researchers report in the journal Health Services Research.

The investigators merged these data with those from 277 surgeons (15 percent female) in practice for an average of 17 years. Half of the surgeons performed 50 or more breast-related procedures annually.

The researchers then compared associations between surgeons, treatment settings, and the patients' knowledge of survival and recurrence risk after breast cancer treatments.

Across racial and ethnic groups, 73 percent of the women had surgeons who discussed both mastectomy and breast-conserving options with them; these women were more informed, Hawley said. Another 21 percent heard only of the latter and 6 percent heard only of the former.

Still, overall knowledge was lacking, especially among minority women. Nearly half the women did not know whether survival or recurrence rates were the same after mastectomy or breast-conserving surgery and, overall, minority women were less uninformed than white women.

Having a high-volume, experienced surgeon did not improve knowledge, regardless of race or ethnicity, Hawley's group found.

SOURCE: Health Services Research, August 2008.