Even after going through the treatment process, many women do not understand the risks and benefits, said lead author Sarah Hawley, Ph.D.

The study looked at 1,132 women from Detroit and Los Angeles who had undergone surgical treatment for ductal carcinoma in situ (DCIS) or invasive but not metastatic breast cancer. The women reported their race and ethnicity, knowledge of survival and recurrence, and cancer topics they discussed with their surgeons, who the study also surveyed.

The results appear in the latest online issue of the journal Health Services Research.

Only 51 percent of women knew that a mastectomy and a lumpectomy plus radiation had the same five-year survival rate. Forty-eight percent of women reported not knowing whether cancer recurrence rates were the same for mastectomy as they were for a lumpectomy with radiation.

“Overall, women were not generally well informed about the risks and benefits of the treatment that they received,” said Hawley, a research assistant professor in the University of Michigan Health System and research investigator at the Ann Arbor VA Healthcare System.

The survey also revealed that African-American and Hispanic women were less likely to know about breast cancer survival and recurrence, as were older women and those with less education.

Women who said that their surgeons discussed both treatment options did know more about survival and recurrence rates, but minority women still lagged in survival and recurrence knowledge, Hawley said.

Treatment location did not improve knowledge of cancer survival and recurrence.

“The authors’ finding of racial and ethnic differences in knowledge of survival and recurrence according to surgical treatment are concerning because of their implications about possible suboptimal communication between surgeons and their ethnic minority patients,” said Leah Karliner, M.D., an assistant professor of medicine at the University of California San Francisco who was not affiliated with the study.

However, Karliner said that the findings are only associations and that readers cannot draw cause-and-effect conclusions about the results. “Women’s knowledge after they have already received their surgical treatment may not accurately reflect their knowledge at the time they decided on that treatment,” she said.

For those undergoing treatment, “I would advise women that is not only okay to ask questions, but that doctors expect it. They should always ask all of their questions before deciding on a treatment option and make sure they understand the reasons behind their doctors’ recommendations for or against a particular treatment,” Karliner said.

The study received funding from the National Cancer Institute, part of the National Institutes of Health.

Health Services Research is the official journal of the AcademyHealth and is published by Blackwell Publishing on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422-2646 or  This e-mail address is being protected from spambots. You need JavaScript enabled to view it . HSR is available online at http://www.blackwell-synergy.com/loi/hesr.

Hawley ST, et al. Racial/ethnic disparities in knowledge about risks and benefits of breast cancer treatment: Does it matter where you go? Health Services Research online, 2008.