Breast conservation versus mastectomy: patient preferences in a community practice in Kentucky.

Recent studies have indicated a relatively low rate of breast-sparing surgery for carcinoma in the Southeastern United States. From 1987 through 1991, 289 patients from Eastern and Central Kentucky with breast carcinoma were treated by the authors. Despite being fully informed of treatment options of breast cancer, 82% of patients with stage II disease or less and no medical contraindications to breast conservation preferred mastectomy. Overall, 10% of patients underwent breast-sparing surgery, although this figure had risen to 20% by 1991. The most frequent reasons for preference of mastectomy were fear and inconvenience of radiotherapy and a perception that survival would be diminished if mastectomy was not done.