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Preventative mastectomy on the rise in the US
Last Updated: 2009-03-04 15:27:02 -0400 (Reuters Health)March 5, 2009
NEW YORK (Reuters Health) - A growing proportion of American women with relatively benign form of cancer in one breast are choosing to have the other breast removed, researchers have found.Ductal carcinoma in situ is a non-invasive form of breast cancer, and is very curable with surgery -- either a lumpectomy or mastectomy.
As lead investigator Dr. Todd M. Tuttle told Reuters Health, "Our findings indicate that women with noninvasive breast cancer are increasingly choosing to undergo double mastectomy. Importantly, removal of the opposite normal breast will not improve the survival rates for these patients, who have an excellent prognosis."
Tuttle and colleagues at the University of Minnesota Medical School, Minneapolis examined data on more than 51,000 women diagnosed with ductal carcinoma in situ in one breast from 1998 to 2005.
The rate of removal of the other, normal breast was 4.1 percent for all surgically treated patients and 13.5 percent for those who had a mastectomy, the team reports in the Journal of Clinical Oncology.
Among all the women treated surgically -- including those who underwent breast-conserving lumpectomy surgery -- the rate of preventative mastectomy of the other breast more than doubled from 2.1 percent in 1998 to 5.2 percent in 2005.
Excluding those who had breast-conserving surgery, the rate almost tripled from 6.4 percent to 18.4 percent.
In an accompanying editorial, Dr. Abram Recht of Harvard Medical School, Boston observes that the effect of this so-called contralateral prophylactic mastectomy is not completely clear.
"Regardless of any survival benefit," he writes, "some patients may feel contralateral prophylactic mastectomy will give them greater peace of mind."
SOURCE: Journal of Clinical Oncology, online February 17, 2009.
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