Women Undergoing Double Mastectomies Following Breast Cancer Diagnosis Increased

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The number of women who undergo double mastectomies after detectionof a tumor in one breast increased by 150% from 1998 to 2003, accordingto a study published on Monday in the Journal of Clinical Oncology, the Los Angeles Times reports.

For the study, researchers led by Todd Tuttle of the University of Minnesota Medical Schooland colleagues collected data on 152,755 patients who had cancer in onebreast from a federal registry that included information from 16regions, which accounted for about 26% of the U.S. population. Thestudy found that the rate of participants who underwent doublemastectomies increased from 1.8% in 1998 to 4.5% in 2003. About 57.8%of participants underwent lumpectomies during the five-year period, andabout 38.9% underwent unilateral mastectomies, according to the study(Maugh, Los Angeles Times, 10/23).

The study alsofound that 6.7% of participants younger than age 40 underwent doublemastectomies, compared with 1.3% of women older than age 70 (Marcotty, Minneapolis Star Tribune,10/22). In addition, the study found that participants who underwentunilateral mastectomies were more likely to undergo double mastectomiesthan those who underwent lumpectomies and that participants with Stage1 cancer were more likely to undergo double mastectomies than thosewith more advanced cancer.

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"What we'reactually seeing is more and more women at the two extremes: eitherhaving minimal surgery, a lumpectomy, or having a bilateralmastectomy," Tuttle said, adding, "Fewer women are having just onebreast removed" (Caryn Rabin, New York Times,10/23). Tuttle also said, "I'm afraid that women believe having theiropposite breast removed is somehow going to improve their breast cancersurvival. In fact, it probably will not affect their survival" (AP/Hartford Courant, 10/23).

Inaddition, Tuttle said, "The comment patients make is, 'I just want tobe done with it,'" adding, "They never want to have another mammogramagain; they never want to have another biopsy again" (New York Times,10/23). He said, "Being diagnosed with breast cancer has to be one ofthe most stressful events in a woman's life, and they don't want torepeat that again" (Minneapolis Star Tribune, 10/22).However, Tuttle raised concerns about the "women who are on the fenceand make a very quick decision before really considering the otheroptions or the fact that it is an irreversible procedure" (Olson, St. Paul Pioneer Press, 10/23).

Julie Gralow, chair of the communications committee of the American Society of Clinical Oncology,said, "My first reaction to this study, because it came as a bit of asurprise, was, 'Oh, are we doing our job explaining that point topatients?'" She added, "We want to support women in doing what feelsright to them," but "our job is to make sure they have all the accurateinformation" (New York Times, 10/23). Benjamin Paz of the City of Hope Comprehensive Cancer Center called the results of the study "alarming because the goal of medicine is to help people live well with their organs" (Los Angeles Times, 10/23).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyWomen's Health Policy Report, search the archives, and sign up for emaildelivery at kaisernetwork.org/email. The Kaiser Daily Women'sHealth Policy Report is published for kaisernetwork.org, a free service of TheHenry J. Kaiser Family Foundation.

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