Friday, September 10, 2010 (Last Updated: 09/13/2010)
FRIDAY, Sept. 10 (HealthDay News) -- For breast cancer patients, between-surgeon variation is wider for patients' receipt of breast reconstruction than for receipt of mastectomy, according to research published online Sept. 8 in Medical Care.
Steven J. Katz, M.D., of the University of Michigan Health System in Ann Arbor, and colleagues analyzed data from linked surveys of 1,780 breast cancer patients diagnosed in Detroit and Los Angeles and 291 surgeons who treated them.
The researchers found that individual surgeons only accounted for 4 percent of total variation in the receipt of mastectomy, but a substantially larger amount of variation -- 16 percent -- in reconstruction. In terms of reconstruction, one particular factor -- the surgeon's tendency to discuss the patient's treatment plans with a plastic surgeon before surgery -- accounted for 31 percent of between-surgeon variation.
"The wide between-surgeon variation in receipt of breast reconstruction after mastectomy suggests that patients should be more cautious about how these decisions are made in clinical practice. In particular, the very strong effect of exposure to plastic surgeons prior to decisions about local therapy suggests that one possible result of multidisciplinary models of decision-making may be a much greater likelihood of receiving breast reconstruction after mastectomy," the authors write.
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