Skip to main content

Most Women Needlessly Opt for Double Mastectomy

TOP - Daily

Worries over cancer recurrence lead women to choose double mastectomy

The question of potential overtreatment among women with breast cancer has been raised due to recent studies showing an increase in these patients choosing the more aggressive contralateral prophylactic mastectomy.

Despite a very low risk of facing cancer in the healthy breast, about 70% of women have both breasts removed following a breast cancer diagnosis, according to a new study from the University of Michigan Comprehensive Cancer Center.

Researchers found that 90% of women who had surgery to remove both breasts reported being very worried about the cancer recurring. “Women appear to be using worry over cancer recurrence to choose contralateral prophylactic mastectomy. This does not make sense, because having a non-affected breast removed will not reduce the risk of recurrence in the affected breast,” says Sarah Hawley, PhD, associate professor of internal medicine at the U-M Medical School.

The study involved 1446 women who had been treated for breast cancer and who had not had a recurrence. Hawley and colleagues found that 7% of the women had contralateral prophylactic mastectomy. Among the women who had a mastectomy, nearly 1 in 5 had a double mastectomy.

Researchers also considered clinical indications for double mastectomy, including the patients’ family history of breast and ovarian cancer and the results of any genetic testing.

Women with a family history of 2 or more immediate family members (mother, sister, daughter) with breast or ovarian cancer or with a positive genetic test for mutations in the BRCA1 or BRCA2 genes may be advised to consider having both breasts removed, because they are at high risk of a new cancer developing in the other breast. However, the development of a second cancer in the healthy breast is unlikely among women without these indications.

“For women who do not have a strong family history or a genetic finding, we would argue it’s probably not appropriate to get the unaffected breast removed,” says Hawley.

The study results suggest that one of the biggest aspects driving the decision to have double mastectomy is concern about recurrence. Hawley says it’s important to educate women that a contralateral mastectomy will not reduce the risk of recurrence.

Source: University of Michigan Health System.