Many women with breast cancer are given the opportunity to choose between total removal of a breast (mastectomy) and breast-conserving surgery (lumpectomy) followed by radiation. Most women who have one site of cancer in their breast, and a tumor under four centimeters often undergo a lumpectomy followed by radiation -- a procedure that is likely to be as effective as mastectomy.

However, a report in the journal Health Services Research a study showed that only half of the women diagnosed with early-stage breast cancer are aware of the risks and benefits of a mastectomy versus a breast conserving lumpectomy plus radiation, even after they have had one of the procedures. And if the woman is black or Hispanic, the odds are even less that she has adequate information.

The study involved 1,132 women from Detroit and Los Angeles, who underwent surgery for ductal carcinoma in situ or invasive - but not metastatic - breast cancer. The women were asked to give their race and ethnicity, knowledge of survival and recurrence and cancer topics they had discussed with their physicians, who were also surveyed.

Findings revealed that only 51 percent of the women know that patients who had a mastectomy or lumpectomy plus radiation had the same five-year survival rate. Forty-eight percent reported not knowing whether cancer recurrence rates were the same for mastectomy as they were for a lumpectomy with radiation.

According to the study leader, Sarah Hawley, a research assistant professor at the University of Michigan Health System and research investigator at the Ann Arbor VA Healthcare System, women were not generally well informed about the risks and benefits of the treatment they received. She said that women who reported their surgeons did discuss both treatment options did know more about survival and recurrence rates, but minority women still had less awareness about survival and recurrence.

Dr. Leah Karliner, an assistant professor of medicine at the University of California, San Francisco, who was not affiliated with the study said that the findings of racial and ethnic differences in knowledge of survival and recurrence according to surgical treatment were reason for concern because of the implications about possible suboptimal communication. Karliner went on to say that the findings are only associations and readers can't draw cause-and-effect conclusions about the results. For more information, go to www.cancer.gov/cancertopics/types/breast.

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