Would Plastic Surgeons Choose Breast Conservation Therapy?

Area of Science:

• Oncology
• Plastic Surgery
• Medical Decision Making

Background:

• Breast conservation therapy (BCT), involving partial mastectomy and radiation, is standard for early breast cancer.
• Radiation therapy carries risks and can influence future breast reconstruction.
• Understanding surgeon preferences is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate plastic surgeons' preferences for breast cancer treatment scenarios.
• To identify key factors influencing treatment decisions among plastic surgeons.

Main Methods:

• A survey was distributed to members of the American Society of Plastic Surgeons.
• Participants reviewed three hypothetical breast cancer diagnosis scenarios.
• Treatment preferences and rationale were recorded.

Main Results:

• Mastectomy with implant-based reconstruction was preferred over BCT for ductal carcinoma in situ and invasive ductal carcinoma (node-negative and node-positive).
• Key reasons included avoiding radiation therapy risks, cancer recurrence concerns, and anxiety about future surveillance.
• Preferences varied slightly based on cancer stage, with bilateral mastectomy favored for node-positive disease.

Conclusions:

• Plastic surgeons generally avoid breast conservation therapy for early-stage breast cancer.
• Radiation therapy risks significantly influence treatment decisions, alongside recurrence and surveillance anxiety.
• Acknowledging these surgeon biases can improve patient consultations for breast reconstruction.