Double Mastectomy Not Recommended for Most Breast Cancer Patients

The number of women undergoing double mastectomy has increased significantly in the past decade.  A new study shows that some 70 percent of women, who opt for breast removal, need not undergo the surgery at all.

Breast cancer is the second-most common type of cancer diagnosed in the U.S. Each year, some 232,000 women develop breast cancer.

Previous research has shown that the number of women undergoing double mastectomy has increased by 150 percent between 1998 and 2003.

The current study, conducted by researchers at the University of Michigan Comprehensive Cancer Center and colleagues, raises an important question. Is breast cancer being overtreated?

Several studies have already shown that women with breast cancer diagnosis are undergoing an aggressive type of procedure called contralateral prophylactic mastectomy.

"Women appear to be using worry/fear 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, Ph.D., associate professor of internal medicine at the U-M Medical School.

The data for the present research came from 1,446 women who had been treated for breast cancer and who didn't experience a recurrence of the cancer. Researchers found that at least seven percent of the study group had undergone surgery to remove both the breasts.

The team then looked at the cancer history of the participants. Women, who have a close relative diagnosed with breast cancer or have BRCA1 or BRCA2 gene mutation, have higher breast cancer relapsing risk. These women need to talk to their doctors about breast removal surgeries. However, not all women in the early stage of cancer need the operation.

Researchers found that 70 percent of the women, who had both breasts removed, had low risk of cancer recurrence.

"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," said Hawley in a news release.

The study was funded by the National Cancer Institute and will be presented at the American Society of Clinical Oncology's Quality Care Symposium.

Angelina Jolie wrote in a New York Times op-ed May 2013 that she had both her breasts removed to reduce her risk of developing breast cancer. She said that she had a rare gene that increased her chances of developing the cancer and advised women to undergo genetic screening to see if they, too, are carriers of the gene. However, health authorities have warmed people to not blindly follow the trend. U.S. Preventive Services Task Force [USPSTF], published a statement in the Annals of Internal Medicine, saying that the surgery must be conducted only after extensive discussion with the patient.