Doctor-Patient Talks Affect Use of Breast Reconstruction Surgery

(HealthDay News) -- A lack of patient-doctor discussion may contribute to socioeconomic, age and race-related disparities in the use of breast reconstruction after mastectomy, says a study by researchers at Brigham and Women's Hospital and the Dana-Farber Cancer Institute in Boston.

The study also found that breast reconstruction was more likely to occur after a surgeon discussed options with a patient, which suggests the need to increase and improve these conversations, the researchers said.

They analyzed data on 626 patients who underwent mastectomy for breast cancer. Of those patients, 253 (40.4 percent) received breast reconstruction, and 249 (39.8 percent) had a documented discussion about the option with a doctor.

About 70 percent of those who had a discussion about breast reconstruction had the procedure. But the researchers found that increasing age and lower levels of education were associated with lower rates of a documented discussion. Hispanic patients, those born outside of the United States, and those whose primary language wasn't English were less likely to undergo reconstruction after discussing it with a doctor.

The study was published in the April issue of the Journal of the American College of Surgeons.

The decision to have breast reconstruction is a complex one that's influenced by access to care, patient preference and a doctor's interaction with the patient, the researchers noted.

"Patient preferences should be respected, but an informative discussion of reconstruction is required to help patients understand and weigh the risks and benefits of this procedure," Dr. Caprice C. Greenberg, Instructor of Surgery in the Center for Surgery and Public Health at Brigham and the Center for Outcomes and Policy Research at Dana Farber, said in a prepared statement. "We learned that physicians need to improve communications with all women undergoing a mastectomy, regardless of age, race or socioeconomic status."

She and her colleagues said doctors should systematically address the issue of breast reconstruction with all patients undergoing mastectomy. Doctor-patient discussions could include interpreters and educational materials to ensure an informative discussion regardless of a patient's primary language, ethnicity or education level.

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Minimizing Sagging Breasts

Provided by: DrDonnica.com

Q: I have fairly large breasts. I wear a size 38D bra but since I nursed my two children I've noticed that my breasts are really beginning to sag. I admit that my chest has always been the one thing that makes me feel sexy, and I am becoming very concerned about it especially because my grandmother's breasts hang nearly down to her knees! Is this hereditary, and is there anything I can do, like exercises, vitamins, special bras, to prevent it?

A: Unfortunately, gravity is not always our friend! As most women age, we notice that various body parts start to sag, even if we watch our weight and continue to exercise. While exercise cannot change the actual sagginess of your breast tissue itself, building up your pectoral muscles with a weight-training program can significantly improve the appearance of your bust.
Losing any extra weight you may be carrying since the birth of your children will also benefit your bust. Finding a bra that provides a lot of support can also help. I recommend that you consult an experienced bra saleswoman who should measure your bust (a free service) and recommend the best fitted bra for you.
There are no vitamin supplements that can help. While I strongly recommend that you--and your partner--appreciate the sexiness of your body without resorting to reconstructive surgery, a breast lift is a fairly common surgical procedure that women in your situation can consider.