How breast cancer treatment decisions are made by women in North Dakota

BACKGROUND: Although equally effective, women in rural midwestern states ch oose modified radical mastectomy (MRM) over breast conservation surgery for early stage breast cancer. This study assessed treatment decisions by the women of North Dakota. METHODS: Surveys were sent to women treated for early stage breast cancer f rom 1990 through 1992. Separate surveys were sent out to surgeons in the st ate. The questions assessed physician and patient perceptions of treatment and the decision making process. RESULTS: A majority of surgeons believed that the long-term and disease-fre e survival was equal and that the preference for choosing MRM was due mostl y to inconvenience of radiotherapy. The women reported that the surgeon was the most influential in the treatment decision and that concerns over radi ation, duration of treatment, and travel restrictions all were factors in t he decision. CONCLUSIONS: Education of surgeons and patients plus the early involvement of the radiation oncologist in discussing options is essential in the treat ment of early stage breast cancer. Am J Surg. 1998;176:515-519. (C) 1998 by Excerpta Medica, Inc.