Surgeonsfrequently fail to discuss breast reconstruction options with women who have undergone surgery for breast cancer, a new U.S. study suggests.

Breast reconstruction is usually presented as an option to women who have undergone major breast conserving surgeryor a mastectomy, the complete removal of the breast. Women with early-stage breast cancer do not usually require reconstruction surgery.

The surgery involves replacing removed or lost breast tissue and the creation of a new breast form through an implant or movement of tissue from another part of the body to the chest area.A second minor procedure is done later to reconstructthe nipple.

Researchers at the University of Michigan Medical Centre examined the experiences of 1,178 women age 79 and younger who had been operated on for stagesI toIII breast cancer between December 2001 and January 2003.

They discovered that only 33 per cent of the women had been counseled by a surgeon about breast reconstruction surgery. Younger, more educated patients were more likely to have the breast reconstruction discussionthan older or less educated patients, the study found.

The average age of patients who were counseled about breast reconstruction was 56, versus 61 for those who were not counseled. While 41.9 per cent of women with at least some college education were advised about reconstruction options only 30 per cent of those with high school or less were given the information.

The study also revealed that women who did have a conversation about breast reconstruction were more likely to consider a mastectomy as it meant they could "preserve" their breast. It also made them more amenable to breast surgery of any kind.

"This research suggests that patients should be informed of all options in order to be educated consumers of health care and ensure maximal breast cancer treatment decision quality," reads the study.

"Our results suggest a need for comprehensive breast cancer treatment decision aids, including information on initial surgery and other treatment options such as reconstruction," the study said.

The findings are to be published in the Feb. 1, 2008, issue of Cancer, a journal of the American Cancer Society.