Grant: Planning and Dissemination Grant - Institute Community Support

Evidence from research shows that lumpectomy (surgical removal of the cancer only) is appropriate therapy for most women who have early stage breast cancer (ESBC) or ductal carcinoma in situ (DCIS). There is a growing trend for women to choose to have both breasts removed when they are diagnosed with a unilateral breast cancer or DCIS. Many women incorrectly believe removing a healthy breast that does not have cancer (called a contralateral prophylactic mastectomy (CPM)) as well as the breast with cancer will prevent recurrence and metastasis of breast cancer, and increase survival. Furthermore, they are not aware of the surgical complications and long-term risks of CPM including pain, body image and sexuality. As a result, more women are choosing CPM when it is not medically recommended. The purpose of this proposal is to review the research evidence with physicians from across Canada to generate guidance that will help them to discuss the risks and benefits with women. This in turn will help women make decisions that will optimize their health and quality of life. To do this we will assemble an expert panel of physicians of various specialties from across Canada to generate the guidance statement. It will be reviewed by groups that represent the interests of breast cancer patients, then endorsed by national professional organizations that represent physicians, and broadly shared by those organizations with physicians so that they can use the guidance when discussing treatment options with women who have ESBC or DCIS.