Female vs Male doctors differ in recommendations?

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Chloesmom
Chloesmom Member Posts: 1,053

Talked to a friend who had second, third, and more opinions before choosing her surgical plan.

She said the male doctors were more focused on a lumpectomy. Perhaps it's a male thing to be comfortable with not messing with appearance. Or maybe they having no idea how childbirth hurts are trying to save us from pain they wouldn't want to handle.

The female docs on the other hand were totally supportive of BMX (which she opted to do to not have to worry about mammos etc and hopefully be done with it).

Has anyone else encountered this?

I really like the BS but keep mulling over his comment about why I want to put myself through the extra pain and recovery of the BMX when he can save part of the breast and do a reduction on the other. Is this just sound advice or perhaps a male bias? The prospect of having to do rads and possibles more surgery in the future if something else crops up is making my head spin


Comments

  • Juliecc
    Juliecc Member Posts: 4,868
    edited December 2014

    Interesting topic. Both my male surgeon and my female plastic surgeon recommended BMX for me so I am not much of a help. Some factors that made me ok with this are that my tumor on the left side was close to my chest wall and radiation could cause lung damage, the surgeon would need to take a large area and the cosmetic oucome would not be great, and I had a history of very dense breasts and multiple biopsies over the years. My breasts were droopy and not great but I do miss my nipples.

  • exbrnxgrl
    exbrnxgrl Member Posts: 12,424
    edited December 2014

    yes, very interesting . I am fairly certain I've never seen a discussion of lump vs. bmx framed this way. I don't think it would be easy to reach any conclusions based on your friends experience and your assumptions about why male docs would go for lumpectomies over mx. Might make an interesting research study, but in the end, I hope that the decision over which surgery to go with is based on the patients best medical interests, not the surgeons gender.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2014

    I had a different experience. My surgeon first suggested strongly to get an excisional biopsy (he seemed to intuit something was wrong when he felt my lump) and then when he went over the pathology, he said he could do a BMX in a week if I wanted it. I did finally choose a BMX but I had it done 18 months after initial dx since I was 1) in shock and couldn't make rational decisions) and 2)wanted to research options. He did do my BMX and I'm happy I went with him.

  • Siren40
    Siren40 Member Posts: 31
    edited December 2014

    I had conversations with two surgeons (female) and my MO (male) and all three pushed the lumpectomy. They gave the same reasoning to me......there have been numerous studies on the long-term benefits of both and the outcomes are the same either way. Why put myself through a much bigger surgery with more drastic results when I could have a quick outpatient surgery with minimal scarring and a quick recovery time if I got no added benefit. However they did say if my genetic test showed anything they would then recommend the mastectomy.

    But regardless of my decision, they did all tell me it was my choice and they would support me either way. I think that's most important- a doctor should give the patient enough information to allow them to make an informed decision they feel is best for them and then support it.

  • glennie19
    glennie19 Member Posts: 6,398
    edited December 2014

    My male BS really pushed me for a lumpectomy.  But I had Paget's and the whole nipple area would have to go,, so it would have been like my breast was sliced in half,, and I figured what is the point of keeping the rest?  And then I would need rads.  If I had the MX,, no rads.  We "discussed" this at length and finally he admitted that his wife (also a doctor) would have made the same decision that I made.  HELLO!  So in my opinion,, I think it could be a male bias,,

    I also got the argument, that I'm so young,,, I was 54 at diagnosis,,, that I would want to keep my breast,,  and then he left excess skin cuz he was sure that I would have recon.  We never discussed recon, cuz I knew I didn't want it and I didn't bring it up.  Dumb move on my part.

    Your friend has to decide what she wants and not let the doctors influence her.  How does she feel about the appearance afterwards?  Is she planning recon? If so,, it would be important to talk to a PS about recon options with lump vs BMX.  

  • Lily55
    Lily55 Member Posts: 3,534
    edited December 2014

    I know this is going to sound odd but maybe it also depends on whether the doctor is a breast man or not........I think that could make a difference.......often male doctors can put their beliefs on to women

  • wrenn
    wrenn Member Posts: 2,707
    edited December 2014

    Basing this stuff on gender of doc to me would be no different than basing it on which one wore a blue shirt. It is such a general statement...like this one. :-) "often male doctors can put their beliefs on to women".

  • DiveCat
    DiveCat Member Posts: 968
    edited December 2014

    I don't think such a small sample size can allow for those kind of conclusions. Especially not when their position can also be dependent on what the approach was at time they went to medical school/did their training, whether they are up to date on current medical recommendations and approaches, their own patients' experiences, and so on.

    Many doctors, whatever their sex, promote breast conserving surgery wherever possible, because yes, for the average breast cancer patient, lx + radiation has similar outcomes to mx, and generally mx (especially with recon) is a much larger surgery and can have greater risk of negative side effects (like post-mx pain, reconstruction complications if going with recon, etc).

    I agree with Siren, the most important thing is to have a doctor ready and willing to provide their patients with the information required to make an informed choice, and to be supportive of that decision.

  • WinningSoFar
    WinningSoFar Member Posts: 951
    edited December 2014

    It's my opinion that surgeons in general like to do less cutting than more cutting if there's a choice. Less cutting means fewer complications and surgeons don't like complications. That makes more sense to me more than a gender bias.

  • Kicks
    Kicks Member Posts: 4,131
    edited December 2014

    I want the most competent care/Dr I can get - period. It doesn't matter to me if they are male or female. My surgeon, chemo Dr and rads Dr were men - they were all fantastic. I have heard that some women do not like my chemo Dr as he is very to the point and not 'gentle'. This is a lot of why I like him - I want to be given info 'straight out' - not 'sugar coated'. That's what I want. I've only had 3 female 'Drs' in my life - my PC PA (of 18 yrs), my Dermatology PA and my Psychiatrist (I'm SAD and ADD - yes, women can be ADD and even old women). They are also very to the point.

    When the boys were young , they had women pediatricians a few times but except for one, I always preferred the men. Hubby's favorite Dr was a woman Flight Surgeon. We are all so different. Bottom line is we need to feel comfortable with who we see and not all AFR right for all others.


  • Chloesmom
    Chloesmom Member Posts: 1,053
    edited December 2014

    Appreciated all the posts. Guess I made people a little side tracked. Didn't mean to infer a bias in terms of all doctors, but mostly wondered if males might have been resistant to wanting to put women through more surgery when less might do in their opinion in terms of the physical trauma I got several "why do you want to do the BMX when lumpectomy will suffice. They were very competent and professional. I am in a medical profession myself and hand picked the guys.

    I think DiveCat nailed what I was trying to think through in saying how they awe looking to have less potential negative side effects.

    Thankfully I have a lot of confidence in my surgeons and they agreed to do what I want and need emotionally .now that the decision is made I just look forward to having it done. I get the date tomorrow

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