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More Women Opting for Preventive Mastectomies

Breast Cancer

On the rise today are a growing number of women diagnosed with breast cancer in a single breast who are choosing to have both breasts removed as a preventive measure.   In fact, among women with a past history of breast cancer, the widespread choice of the procedure—known as a contralateral mastectomy—more than doubled from 5.6 percent in 1995 to 14.1 percent in 2005.

Dr. Stephen B. Edge, of the Roswell Park Cancer Institute in Buffalo, New York, has led a group of researchers who analyzed information from New York State hospital discharge records and the New York State cancer registry to ponder the growth in the number of preventive mastectomies over an 11-year period.  Their combined findings were recently published  in the journal Cancer.

The research showed that contralateral mastectomies were executed on 1.9 percent of women diagnosed with breast cancer in 1995 and 1996, while the number of women freely choosing the procedure jumped to 4.2 percent by 2005. The number of women who voluntarily choose the procedure climbed to an astonishing 683 in 2005 from 295 in 1995. Also, preventive mastectomies known as prophylactic mastectomies had a small increase from 106 in 1995 to 128 in 2005.  These mastectomies took place among women who were at risk for breast cancer due to a well documented family history of the disease, although they had no personal history of the illness its self.

Accounting for almost 9 percent of the 70,000 women who underwent mastectomies between 1995 and 2005,  6,275 women underwent a mastectomy as a precautionary measure.  Of these, 81 percent had a history of breast cancer. The data shows that preventive mastectomies are becoming more and more common.  According to Edge, “Although the total amount of prophylactic mastectomies performed per year was few, it appears that the use of this type of surgery is steadily on the increase.”  He also noted that since no proof exists that removing a healthy breast will improve chances of long-term survival, there is a significant increase in the amount of contralateral mastectomies among women having a history of breast cancer, and that is cause for some concern.

Even from a logical perspective, the best safeguard against the possibility for the recurrence of the cancer is the removal of an unaffected breast.   Edge also pointed out, “Women need to be purposely counseled on the issues of the risks of developing a second cancer, and the largely minute or no impact this may have on their survival.”  Complications such as bleeding, infection and nerve damage are just a few of the risks that are included with the choice of undergoing the preventive mastectomy.

In addition, the larger amount of breast cancer patients benefit from early discovery and effective treatment, and 95 percent of these women are not at a genetically high risk for the disease. So, within a 20 to 30 year period they face only a 10 to 20 percent chance of developing cancer in the unaffected breast.  Edge went on to state that there is clearly a reason for more in depth research into factors that influence definitive choices by women to undergo preventive mastectomy, as the research data offers no potential reasons for the increases.

Due to the lack of use of the diagnosis code for prophylactic surgery for breast cancer, the study report suggested that the amount of prophylactic mastectomies performed in the United States could be far greater than what it is.  Because some insurance plans do not allow coverage for the procedure, the diagnosis code is avoided.  Breast Cancer is the sixth leading cause of death for women in the United States, unfortunately claiming the lives of more than 41,000 women each and every year.

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