Lumpec/Mastect: Doctor's Gender Matters

Physician Gender Influences Type of Breast Cancer Surgery Advised for Older Women

Female physicians are more likely than their male counterparts to recommend lumpectomy over mastectomy for older women diagnosed with early-stage breast cancer, report Colorado-based investigators. Dr. Elizabeth M. Cyran, of the University of Colorado Health Sciences Center in Denver, and associates surveyed 198 women who were 65 to 84 years old when diagnosed with stage I or II breast cancer.

As reported in the February issue of the Archives of Surgery, 96 women were treated with lumpectomy and 102 with mastectomy. However, only 22 had clinical indications for mastectomy, such as multicentric disease or a large tumor. The recommendation of lumpectomy over mastectomy was strongly associated with age 75 years or older, a higher level of education, having a female physician, and having a greater amount of information provided by the physician.

Among 107 women, Dr. Cyran's group calculated 93% concordance between the procedure type recommended by the physician and the procedure undergone. They point out that physicians recommended mastectomy to 45% of women who had no apparent clinical contraindication to breast-conserving surgery.

The most common reason cited by patients for choosing a mastectomy was fear of recurrence. "To increase the use of lumpectomy," the investigators note, "fear of recurrence may need to be addressed with improved education and counseling."

Arch Surg 2001;136:185-191.

Thanks to Reuters Health

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