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More Women Opting for Prophylactic Mastectomy


A rising number of women who have breast cancer in one breast are opting for prophylactic mastectomy, which is the removal of a healthy breast. The online journal Cancer reports that the number of women who asked their surgeon to remove their healthy breast at the same time the cancerous one was removed doubled between 1995 and 2005. This increase occurred despite a decline by about one-third in the total number of mastectomies performed during the same time period.

This was the first time a study was done to identify how many women in the United States are choosing prophylactic mastectomy. The researchers used cancer data from the New York state health records. A total of 6,275 women had prophylactic mastectomy during the decade studied, and 81 percent of them had cancer in only one breast. The remaining women may have had high risk factors for breast cancer, such as a strong family history of presence of BRCA1 or BRCA2, but this information was not available.

This study did not identify the reasons for the increase in prophylactic mastectomies. Rache Simmons, MD, FACS, of New York-Presbyterian Hospital/Weill Cornell Medical Center, was reported on WebMD to say that the greater availability of genetic testing is likely part of the reason. Women who inherit one of the breast cancer genes are more likely to choose prophylactic mastectomy.

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According to the National Cancer Institute, the lifetime risk of developing breast cancer is about 12 percent among all women compared with about 60 percent of women who have inherited the gene mutations BRCA1 or BRCA2. That is, women with BRCA1 or BRCA2 are about five times more likely to develop breast cancer than a women who does not have the mutations.

Other reasons why prophylactic mastectomies may be on the rise are the safety of the procedure, improved reconstructive surgery techniques, and a greater acceptance of the procedure by women. Some women were inspired by Emmy-award winning actress Christina Applegate’s decision to undergo prophylactic mastectomy at age 37 when her one cancerous breast was removed in 2008. Applegate had the BRCA1 gene.

Prophylactic mastectomy can significantly reduce the chances of developing breast cancer in the future, but studies have not shown that it reduces a woman’s chances of dying from breast cancer. The American Cancer Society recommends that women who have been diagnosed with breast cancer ask their physicians many questions so they understand all their options concerning treatment, complications from surgery, and genetic testing. A session with a genetic counselor may also be advised.

American Cancer Society
Cancer, online, September 28, 2009
National Cancer Institute
WebMD, September 28, 2009