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The number of women choosing to surgically remove a healthy breast after receiving a cancer diagnosis in their other breast is on the rise, despite a lack of evidence that the surgery can improve survival. Additionally, women who elect to remove both healthy breasts because of a family history—but no personal history of breast cancer— has increased slightly.
The new study, appearing in Cancer, a peer-reviewed journal of the American Cancer Society, examined the frequency of prophylactic mastectomies in New York State between 1995 and 2005 from mandated statewide hospital discharge data combined with data from the state cancer registry.
The new study also finds that despite extensive press coverage of women who choose to have both breasts removed because of a strong family history of cancer, the rate of this surgery is relatively low and has changed little in the last decade.
One of the most publicized double mastectomies was actress Christina Applegate, who opted to have the surgery in 2008 following a breast cancer diagnosis in one breast. The daughter of a breast cancer survivor, Applegate, then 36, had also tested positive for the BRCA1 gene.
In an interview that aired on Tuesday, August 19, 2008, on ABC’s Good Morning America the Married with Children co-star talked about her decision with news anchor Robin Roberts, also a breast cancer survivor.
“My decision, after looking at all the treatment plans that were possibilities for me, the only one that seemed the most logical was to have a bilateral mastectomy. I didn't want to go back to the doctors every four months for testing. I just wanted to kind of be rid of this whole thing for me. This was the choice that I made, and it was a tough one,” Applegate said.
Prophylactic mastectomy, the removal of a noncancerous breast, is one method for reducing a woman's risk of developing breast cancer; however, there is little information available on the prevalence of prophylactic mastectomies for preventing breast cancer among high-risk women or on the prevalence of the surgery to prevent tumors in the healthy breast among women whose cancer is limited to one breast.
The study’s lead researcher Stephen B. Edge, M.D. FACS, of the Roswell Park Cancer Institute in Buffalo, NY, identified 6,275 female New York residents who underwent the elective surgery; Eighty-one percent of the women had been diagnosed with cancer in one breast only, while 19 percent had a family breast cancer history, but no personal history of the disease. Over the 11-year study—the only large study of its kind to date—saw the prevalence of contralateral mastectomies more than double while bilateral prophylactic mastectomies increased slightly.
Dr. Edge said prophylactic mastectomy is an uncommon procedure that is being performed most commonly on women with a personal history of breast cancer.
“Although the total number of prophylactic mastectomies performed per year was small, it appears that surgery is increasing,” he said in a press statement. In addition, he noted that women with breast cancer should have careful counseling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.
Azsunshinegirl, aka Lynette Summerill, is an award-winning journalist who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.
Source Article: "Surveillance of prophylactic mastectomy: Trends in Use from 1995-2005." Colleen C. McLaughlin, Patricia P. Lillquist, and Stephen B. Edge. Cancer; Published Online: September 28, 2009 (DOI: 10.1002/cncr.24623); Print Issue Date: December 1, 2009.
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