MedicalResearch.com Interview with:
Katharine Yao, MD
Director, Breast Surgical Program
NorthShore University HealthSystem
Medical Research: What is the background for this study? What are the main findings?
Dr. Yao: A survey of breast surgeons was conducted to determine their knowledge level with contralateral breast cancer and how contralateral prophylactic mastectomy (CPM) affects survival. Of five knowledge questions, only 60% scored with high knowledge (4 or 5 questions correct) scores. Surgeons mostly scored low on contralateral cancer risks. Most surgeons correctly stated that contralateral prophylactic mastectomy does not provide a survival benefit. Nonetheless, our knowledge questions did not address other important issues about CPM such as operative complications, or contralateral breast cancer risks for other high risk subgroups. Higher knowledge was associated with fellowship training and duration of practice.
Medical Research: What should clinicians and patients take away from your report?
Dr. Yao: Several reports have shown that patients lack knowledge about different aspects of contralateral prophylactic mastectomy but our report shows that some physicians may also lack some knowledge.
This lack of knowledge may be due to lack of adequate studies in the literature to answer the key questions or perhaps a true knowledge deficit. We plan to launch future surveys of physicians that will further delve into these areas of knowledge deficits.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Yao: Future decision aids or teaching materials that can address these knowledge deficits will not only assist patients in their surgical decision making but will also assist physicians in counseling patients on surgical decisions. We are currently working on an online decision aid to be used by surgeons during their consultation with patients that will increase patient’s knowledge about contralateral breast cancer risks, how contralateral prophylactic mastectomy affects local and distant recurrence and operative risks with different surgical procedures. We hope to eventually launch a national randomized trial that will test the decision aid against “usual care” with the primary endpoint of more informed decision making for contralateral prophylactic mastectomy .
Professor Benjamin Thompson PhD (2015). Not All Surgeons Fully Aware of Contralateral Prophylactic Mastectomy Risks and Benefits