A third of women who opt for breast-conserving cancer surgery say they now have an asymmetry between their breasts that greatly affects their quality of life, a new study says.

Women whose affected breast looked noticeably different after surgery were twice as likely to fear their cancer returning and to have symptoms of depression when compared with women whose breasts still appeared similar, according to the study by researchers at the University of Michigan Comprehensive Cancer Center.

Their findings are published in the July 10 issue of the Journal of Clinical Oncology.

"We found that one of the most important factors of postoperative quality of life and satisfaction was postoperative asymmetry or the aesthetic outcome that women experienced after their surgery," study author Dr. Jennifer Waljee, a resident in general surgery at the U-M Medical School, said in a university news release.

Many women diagnosed with breast cancer can choose between surgery that removes just the tumor and some surrounding tissue or a mastectomy, which removes the entire breast. Reconstructive surgery is possible after each type of operation.

"It's important for women to think about all of those issues at the time that they're making their surgical decision and realize that although breast-conserving surgery may or may not be less disfiguring than mastectomy, they're likely to experience some asymmetry afterwards that may impact their quality of life," Waljee said.

Surgeons usually discuss prior to the operation the types of aesthetic changes mastectomy patients will see after. The researchers believe the same level of counseling is not given those having breast-conserving surgery, leaving them with incorrect expectations of what their breast will look like after the operation.

"It's important for breast surgeons to have an open and honest dialog with their patients so that they understand patients' expectations before surgery and can better address postoperative recovery needs," Waljee said.