A large number of women opt to remove their healthy breast in a double mastectomy to avoid cancer, a new report says.
The number of women who have double mastectomy for breast cancer has tripled in 10 years, even though this aggressive surgery has not been associated with a survival benefit.
There are three types of breast cancer surgery: breast-conserving surgery (partial mastectomy or lumpectomy), unilateral mastectomy (the removal of the entire affected breast) and bilateral or double mastectomy (the removal of both breasts).
Most women diagnosed with breast cancer undergo surgery to remove cancerous tissues. In some cases, however, women opt to have breast cancer surgery even if they have not been diagnosed yet. This was what happened with Angelina Jolie, who decided to undergo double mastectomy in 2013 as a preventive measure against breast cancer. Jolie may have influenced many other women to do the same.
Contralateral prophylactic mastectomy (CPM) is a double mastectomy in which the healthy breast is removed along with the cancerous one. Though CPM may have a survival benefit, especially for those who are genetically predisposed to developing breast cancer, most of the women undergoing it are unlikely to be diagnosed with cancer on the other breast.
In the study published in the journal Annals of Surgery, researchers studied the rates of the three types of breast surgery among about 400,000 women in a National Cancer Institute database. These women were diagnosed with breast cancer and underwent surgery from 2002 to 2012.
The researchers found that the number of women who underwent double mastectomy increased from 3.9 percent in 2002 to 12.7 percent in 2012. On the other hand, the rate of unilateral mastectomy decreased from 35.8 percent to 28.9 percent.
"Despite all the data [over decades] comparing women who underwent breast-conserving surgery and mastectomy and the survival was exactly the same, the rate of bilateral mastectomy is actually picking up and not slowing down," said Dr. Mehra Golshan, lead author of the study.
In a separate study published in the Journal of Clinical Oncology, researchers from the Duke Cancer Institute found that even though little evidence shows that CPM could reduce deaths among women with cancer in only one breast, the number of women opting to undergo the procedure has increased.
The researchers found that quality of life is not notably better for women who underwent CPM.
"This study supports what has concerned many of us - that women are not benefiting as greatly from CPM as they expect they will. Unless a woman has a gene mutation that places her at significantly increased risk of a new cancer in the other breast, CPM doesn't prolong life and our study shows that it doesn't make for a notably better quality of life," said Dr. Shelley Hwang, chief of breast surgery at the Duke Cancer Institute.
