Most Women Who Choose Double Mastectomy Don't Need To, Study Shows | WPN World People News

Almost 70 percent of women with breast cancer who choose to have both breasts removed as a precaution actually have a low risk of developing cancer in the healthy breast, a new study finds.

Worry about recurrence -- which is understandable -- typically drives the decision to have the opposite breast removed. The procedure is called a contralateral prophylactic mastectomy (CPM).

However, that worry can be out of proportion to actual risk. Our point is that worry about recurrence probably should not drive choice for CPM since this procedure will not reduce the risk of cancer recurrence; it is only going to reduce the risk of developing a new primary in the non-affected breast.

The risk of a new cancer in the healthy breast is less than 1 percent for most women, while the risk of cancer coming back in the same breast or nearby lymph nodes is 8 percent.

Researcher surveyed nearly 1,500 women who had been treated for breast cancer and had not had a recurrence after four years. Of those, 35 percent had considered CPM and 7 percent had the surgery to remove both breasts. When they looked only at the women who had a mastectomy to treat their cancer, nearly one in five chose to have both breasts removed.

Yet, 70 percent of the women who underwent CPM actually had a very low risk of developing breast cancer in the healthy breast.

The CPM procedure has been increasingly requested by women with breast cancer in recent years. The downsides of CPM are the same as those for any surgical procedure. Among them are risks associated with surgery, extended recovery time and any psychosocial drawback to having both breasts removed.

Overall, the rate of women who underwent CPM was low, at 7 percent. But among those who had a mastectomy in the breast with cancer, 19 percent opted to have the other breast removed.

For some women, of course, the CPM is warranted. While there are no specific guidelines for who should undergo CPM, expert said the Society for Surgical Oncology recommends it be considered in certain women, such as those with a BRCA1, BRCA2 or other gene mutations known to raise breast cancer risk, along with those who have a family history.

Taking off the opposite healthy breast has absolutely no bearing on the survival from the current cancer. Breast cancer does not spread from one breast to another.

What this study shows is we [doctors] still need to do a better job of informing. We are not doing a good job of informing these women. Fear is real. The best way to counter fear is with information.

If they are doing [CPM] to reduce the chances of breast cancer in the opposite breast, the chances are very low. And for most women, we should be able to quantify what 'low' is.

Source: HealthDay News