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Are double mastectomies unnecessary?

Published on | Kylie Chin

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A new study published in JAMA Surgery found that preventative double mastectomies might not be as beneficial as the public is led to believe. The paper, from researchers at the University of Michigan Comprehensive Cancer Center, found that of the 70 percent of women who are diagnosed with breast cancer and undergo a contralateral prophylactic mastectomy (removal of both the cancerous and normal breast) most usually don’t need to remove both breasts because their chance of developing the disease again is quite low.

However, it should be noted that if you test positive for the BRCA 1 and BRCA 2 gene mutation or have a family history of breast or ovarian cancer then doctors will typically recommend undergoing contralateral prophylactic mastectomy because you are at a significantly higher risk for ovarian and breast cancer. Angelina Jolie had both breasts removed after learning she indeed did carry the gene mutation—a fact that is often lost in the media. And so, a belief rushes through the public that if you’re diagnosed with breast cancer, then a double mastectomy is the best option—which is simply not the case.

The study details

The study examined 1,447 women who had been treated for breast cancer without a recurrence. About 75 percent of patients expressed worry that their breast cancer would return. Just under 10 percent of the women underwent a contralateral prophylactic mastectomy, while 18 percent considered the option.

“They want to choose the surgical procedure that they think gives them the lowest possibility of recurrence and the greatest chance of surviving their breast cancer,” Dr. Tari King told CBS News. “But…when we tell them that removing their normal breast won’t make them live longer and there is no survival benefit, there’s a disconnect.”

According to King, who didn’t write the study but works with the co-author, 10 years after the initial cancer diagnosis, only 3 percent of breast cancer patients will actually have a cancer develop in their healthy breast.

Between 1998 and 2008, the frequency of contralateral prophylactic mastectomies is increasing—from 29 to 207 per 1,000 mastectomies—according to a study published in the journal Plastic Reconstructive Surgery. Fear of recurrence drives the decision making, so it’s important to educate women better about the risks and benefits of contralateral prophylactic mastectomy.

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