Some women who are diagnosed with breast cancer are able to choose between different types of surgery to remove their tumors. Because these surgical options are equally effective, the decision often comes down to the woman’s preference about factors such as recovery time, potential complications, and effect on appearance. But a new study shows that some women also take another factor into consideration: cost. The cost of care is particularly important for women with lower incomes, the study found. However, the researchers found that very few women reported discussing costs with their medical team, despite their desire to do so. “Doctors discuss many variables with women facing preference-sensitive breast cancer treatment decisions, yet the potential for financial harm is not routinely discussed,” said lead investigator Rachel Greenup, M.D., a surgeon at Duke Cancer Institute. Many studies have established that financial toxicities—difficulties that result from the burden of medical costs—are a real problem for people with cancer. “Now it is time to identify opportunities for interventions that protect patients receiving costly care,” Dr. Greenup added. For some women in the study, the cost of care was higher than they expected, and a few reported that the unexpected financial burden interfered with subsequent medical care. Findings from the NIH-funded study were published online July 29 in the Journal of Oncology Practice. “Providing patients with information about the cost of their care allows them to make informed treatment decisions, and also to proactively pursue strategies that might decrease their level of financial hardship,” said Janet de Moor, Ph.D., M.P.H., deputy associate director of NCI’s Healthcare Delivery Research Program.