Surgeons have major influence on breast cancer treatment

September 14, 2017

Surgeons have major influence on breast cancer treatment

Michigan Medicine

A woman's choice of surgeon plays a significant role in whether she's likely to receive an increasingly popular aggressive breast cancer surgery.

The procedure, called contralateral prophylactic mastectomy or CPM, involves removing both breasts even when cancer is found only in one. It is seen to be strongly driven by patients' preferences.

A new study, published in JAMA Surgery, finds that surgeons had the strongest influence on the likelihood of a woman having CPM.

Surgeons have huge influence on treatment, and with that comes ultimate responsibility to get it right with patients, even with a procedure that seems to be driven largely by patient preference," says senior study author  and IHPI member, Steven J. Katz, M.D., MPH, professor of medicine and of health management and policy at U-M.

For most women with early stage breast cancer in one breast, removing the unaffected breast does not improve survival. Many experts question whether CPM in these women is overtreatment.

"More extensive treatment than is needed equals more harm and more side effects. There's a sea change going on among cancer doctors who increasingly recognize potential overtreatment and strive to reduce it," says study author Monica Morrow, M.D., chief of the breast surgery service at Memorial Sloan Kettering Cancer Center.

"If a patient does not feel 100 percent confident with what their doctor is discussing and recommending, they should seek a second opinion," Katz adds.