More Women with Breast Cancer Opt for Removal of Both Breasts

Kathleen Blanchard's picture
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New research from the University of Minnesota shows that more women with breast cancer opt for removal of both breasts rather than take a chance that breast cancer will spread.

Todd Tuttle, M.D., lead researcher of the study found an increase of 188 percent among young women who choose bilateral mastectomy in the earliest stages of breast cancer, between 1998 and 2005. Tuttle also wonders why women are opting to have both breasts removed for early and noninvasive breast cancer, "If there is so little convincing evidence about the benefits".

According to Dr. Tuttle, professor of oncologic surgery with the University of Minnesota Medical School and researcher at the University's Masonic Cancer Center, more women with non-invasive breast cancer, confined to the milk ducts, are choosing to have both breasts removed, even though statistics show no difference in survival rates compared to less invasive forms of breast cancer treatment.

Surgery that preserves the breast, hormone therapy and radiation for breast cancer in its early stage is associated with 98 to 99 percent survival rates. Dr. Tuttle says, “Therefore, removal of the normal contralateral breast will not improve the excellent survival rates for this group of women. Nevertheless, many women, particularly young women, are choosing to have both breasts removed."

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The new study supports previous research from Dr. Tuttle showing that more women with breast cancer prefer removal of both breasts once a diagnosis of breast cancer has been made, despite the excellent prognosis associated with early ductal breast cancer.

Dr. Tuttle suggests further research to clearly define the decision making process for women who choose to have both breasts removed in very early stages of cancer, especially given the potential risks and complications, and lack of solid evidence regarding the need. He suggests that physicians have a strong influence on the increasing rates of women who opt for removal of both breasts for early non-invasive breast cancer, but there is no way to evaluate what women are told. “Patients often think interventions can improve survival, even when explicitly told they do not”, says Tuttle.

Dr. Tuttle writes “Research is important and timely because it may ultimately provide decision making tools for women and their physicians”, based on multiple factors, such as breast size, genetic cancer risks, breast density, and tumor size.

Tuttle says that women who opt for removal of both breasts in early stages of breast cancer may be doing so for cosmetic rather than medical reasons, though he does not negate the value of peace of mind.

http://jco.ascopubs.org/cgi/content/full/26/11/1910

http://jco.ascopubs.org/cgi/content/full/27/9/1347

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