Giving up a physical part of one’s body is never an easy decision to make. This is especially true for women who suffer from breast cancer and get a mastectomy, or the removal of a breast. Still, a recent trend has been on the rise as women get double mastectomies, but according to a new study, as many as 70 percent of women who have a mastectomy do not need one, prompting researchers to worry about over-treatment and an increased chance of premature ovarian failure.
“People want absolute certainty,” breast surgeon Monica Morrow at the Memorial Sloan-Kettering Cancer Center said. “Unfortunately, even having a double mastectomy doesn’t provide certainty that breast cancer will not recur. So it’s a false sense of security.”
Morrow is a co-author of a paper that will be presented at the American Society of Clinical Oncology’s Quality Care Symposium in San Diego.
Another co-author, Sarah Hawley, of the University of Michigan, said double mastectomy “does not make sense” for about three-quarters of the women who are choosing the operation “because having a non-affected breast removed will not reduce the risk of recurrence in the affected breast.”
The study examined 1,446 women that had been treated for breast cancer using traditional approaches, such as chemotherapy and DHEA fertility treatments and none had the cancer come back. Researchers found that, of the women who had a mastectomy, 20 percent had both breasts removed. That came out to a total of 7 percent of the women who had a double mastectomy performed.
Many women who have double mastectomies do so because they worry about the breast cancer recurring in the other breast. In fact, while 90 percent of women diagnosed with breast cancer worried about the possibility of cancer in the healthy breast, researchers say that cancer in one breast does not affect the chances of cancer in the other.
The more radical operation makes medical sense, Hawley says, for fewer than 10 percent of women with early breast cancer. Those include the 1.5 percent who have a genetic mutation called BRCA-1 or BRCA-2 and another 8 percent who have a strong family history, which means two or more immediate relatives who’ve had breast or ovarian cancer.
Regardless, researchers concluded women who do not fall into either of those situations, a double mastectomy as a preventative measure is likely overkill. The procedure also comes with a host of complications and leads to a more difficult recovery. Some women will also need to undergo radiation or chemotherapy, which will further delay their treatment and can result in a poor ovarian reserve.
“One of the biggest fears when you get a cancer diagnosis is, if I go through this treatment, can I be done, can I go on and live my life and not have to worry about it coming back?” Hawley says.
“I have seen young women who leave the office having signed up for lumpectomy,” Morrow says, “and they call back the next day and say, ‘Well, I was on the Internet or I was talking to my friends and they said I’m a young mother, don’t I want to do everything I can to be there for my child? I think I want a double mastectomy.’ “