Most Women Who Choose Double Mastectomy Don't Need To, Study Shows11/28/12
TUESDAY, Nov. 27 (HealthDay 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, said study
author Dr. Sarah Hawley, an associate professor of internal
medicine at the University of Michigan Health System in Ann Arbor.
The procedure is called a contralateral prophylactic mastectomy
However, that worry can be out of proportion to actual risk, she
said. "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," she said.
The risk of a new cancer in the healthy breast is less than 1
percent for most women, Hawley explained, while the risk of cancer
coming back in the same breast or nearby lymph nodes is 8
Hawley's team 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
Hawley is scheduled to present the findings Friday at the
American Society of Clinical Oncology's Quality Care Symposium, in
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," Hawley said. 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, she said. While
there are no specific guidelines for who should undergo CPM, Hawley
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.
"The new study confirms the trend we all know exists," said Dr. Isabelle Bedrosian, an associate professor of surgical oncology at the University of Texas M.D. Anderson Cancer Center, in Houston.
"Taking off the opposite healthy breast has absolutely no bearing on the survival from the current cancer," Bedrosian said. "Breast cancer does not spread from one breast to another," she added.
"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," Bedrosian pointed out.
"If they are doing [CPM] to reduce the chances of breast cancer in the opposite breast, the chances are very low," Bedrosian said. "And for most women, we should be able to quantify what 'low' is."
Research presented at medical meetings should be viewed as
preliminary until published in a peer-reviewed journal.
To learn more about breast cancer recovery, visit the
American Cancer Society.
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