When patients have important decisions to make, such as whether to have a mastectomy or lumpectomy, what advice do you give them?

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SherylNessRNOCN (Nurse (Verified) ) - 05 / 24 / 2012

I think that this is a difficult situation for most patients. If their treating oncologist or surgeon is presenting them with the choice, it means that the research shows that for their stage of breast cancer (usually early stage cancer), either option is possible as a potential effective treatment. A good approach is to take the time needed to think carefully through the two options and understand the potential risks and benefits. Talk through the procedures with the surgeon to understand the recovery and post-operative period. They may want to speak to other breast cancer patients who have experienced these procedures as well, just to get an idea of what helped them decide and how they dealt with the surgery and post-operative period. I also explore with them their personal and family history of cancer. I would encourage the patient to think about their primary concerns. I would also ask about their spouse or partner’s feelings…have they discussed the options together? What are their physical and sexual concerns? Breasts can be an important part of a woman’s identity. Do they understand reconstruction options if they choose mastectomy. Is recurrence of their cancer a concern? Also, is radiation also a part of the equation? In exploring the options, it is important for the patient to understand fully what they are deciding. Resources, reading materials, images and decision guides can be helpful as they are weighing their options. Mayo Clinic has an excellent book – Mayo Clinic Guide to Women’s Cancers, currently available, and soon to be revised and reprinted in October of 2012 as the Mayo Clinic Breast Cancer Book. Mayoclinic.com website has excellent resources and images that describe both procedures as well as the reconstruction process.
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