In women who have cancer in one breast, removing both breasts is not necessarily helpful. The American Society of Breast Surgeons, in fact, issued a statement last year in a bid to discourage women diagnosed with one-sided breast cancer but without genetic risk for the disease from getting double or contralateral mastectomy.
Researchers, however, have found an increase in contralateral mastectomy among women whose early stage cancer only affects one breast. It also appears that the trend varies across states.
Rate Of Double Mastectomy Varies Across States In The United States
In a study covering the period between 2004 and 2012, researchers looked at more than 1.2 million women with early stage cancer in one breast and found that 15 percent of patients between 20 and 44 years old got preventive mastectomy in the District of Columbia, which is far lower compared with about 49 percent in South Dakota.
"In this cohort study of more than 1.2 million women who received a diagnosis of invasive unilateral early-stage breast cancer treated with surgery, the proportion of contralateral prophylactic mastectomies varied substantially by state," the researchers wrote in their study.
"The proportion among women 20 to 44 years of age during the period from 2010 to 2012 ranged from 15.7% in Hawaii to 42.8% to 48.5% in 5 contiguous Midwestern states."
General Trend Rises Across The Country
The general trend, however, rises as the proportion of women with early stage cancer in one breast between ages 20 and 44 who opted for the contralateral mastectomy increased from 11 percent to about 33 percent across the country. Over this same period, the proportion in similar patients who were at least 45 years old who had double mastectomy also increased from about 4 percent to about 10 percent.
Why Women Opt For Contralateral Mastectomy
Study researcher Ahmedin Jemal, of the American Cancer Society in Atlanta, said that their research, which was published in JAMA Surgery on March 29, cannot explain why so many women now opt for contralateral mastectomies.
"One factor that could contribute to the increase is this desire for symmetry," Jemal said. "Another factor is probably the Angelina Jolie effect. She was diagnosed with the BRCA-1 cancer gene that mutation that causes breast cancer, and she had a double mastectomy, so that was covered widely in the media."
Double Mastectomy Rate Higher In The United States Than In Other Countries
The researcher also said that the rate in the United States is higher compared with that in other countries. Compared with 13.5 percent of women in the United States with cancer in one breast who opted to have the other breast removed, the rate is only between 2 and 3 percent in the UK.
Jemal and colleagues did not also have information on how many women in the study had increased risk for breast cancer due to genetics or because they had already been treated with radiation therapy to the chest.
Jemal said that doctors need to have detailed discussion with women about treatment options, but some women who are not at increased risk still opt to have the cancer-free breast removed regardless of learning about the risks and benefits.
