Factors influencing choice between mastectomy and lumpectomy for women in the Carolinas

Background and Objectives: The Carolinas have been documented to have a low rate of breast-conserving surgery. The purpose of this study was to determ ine factors that influence women's choice between mastectomy and lumpectomy . Methods: An anonymous questionnaire was designed for the study and was mail ed to women on the mailing lists of cancer organizations in North and South Carolina. Women who had initially been treated in 1995-1998 were included. Results: The rate of breast-conserving surgery (BCS) was 18% and actually d eclined from a high of 23% in 1995. The highest rate of BCS was in private hospitals rather than academic health science centers. Fifty-four of the 21 2 respondents believed they were given a choice between mastectomy and BSC and, of these, only 15% (n = 80) chose BSC, Women in the two treatment grou ps differed in education and income. Sources of treatment-related informati on included cancer organizations, popular media, friends, family, and the I nternet. The most important factor to both groups was perceived probability of cure. Avoidance of radiation treatments was a factor among the mastecto my group. Conclusions: The low rate of BCS for the region was confirmed. Many women a re still unconvinced that BSC offers as great a likelihood of cure as maste ctomy. J. Surg. Oncol. 2001:76:6-12. (C) 2001 Wiley-Liss, Inc.