Times are changing and more women with breast cancer are choosing to have a mastectomy over less invasive or more breast-sparing surgeries, a new government report shows.
According to data released Monday by the Agency for Healthcare Research and Quality (AHRQ), breast cancer rates remained constant, yet the number of those undergoing mastectomy climbed 36 percent from 2005 to 2013 – including a more than triple the rates of double mastectomies.
The analysis (PDF) also reflects an increase in “drive-by” or outpatient mastectomies, with surgeries in ambulatory settings reaching 45 percent in 2013.
“This brief highlights changing patterns of care for breast cancer and the need for further evidence about the effects of choices women are making on their health, well-being and safety,” says AHRQ Director Rick Kronick.
The overall rates of mastectomies rose from 66 per 100,000 in 2005 to 90 per 100,000 in 2013, which tripled from 9 per 100,000 to 30 per 100,000. One-third of all the breast procedures in 2013 were double mastectomies.
Furthermore, double mastectomies increased in women who did not even have cancer, although the total number remains relatively low.
Those who are genetically predisposed to the condition might be choosing to have both breasts removed as a preventive measure even though there is no cancer diagnosis yet – the so-called Angelina Jolie effect, where the Hollywood actor underwent the operation in 2013 due to a BRCA1 gene mutation.
The analysis also noted that women who had a double mastectomy in 2013 were about a decade younger than women with a single mastectomy, with ages 51 and 61 as the respective average ages.
Doctors’ advice, fear of cancer remission, and a desire for symmetrical breasts emerge as some potential reasons more women prefer mastectomy over less invasive treatments. Their choices, too, may be influenced by breast cancer history in the family or BRCA1 and BRCA2 gene mutations.
Dr. Robert Shenk of Cleveland’s University Hospitals Case Medical Center confirmed seeing a growing number of patients taking an extreme move after a breast cancer diagnosis. He is concerned that they choose invasive procedures to feel “safe” even if only a lumpectomy, which has a high efficacy rate, is the initial suggested option.
“They overestimate the risk it can come back,” he shares.
Photo: Phalinn Ooi | Flickr
