More women choose contralateral prophylactic mastectomy

researchThe number of women with cancer in one breast who opt to have the other breast preventively removed — known as a contralateral prophylactic mastectomy — more than doubled from 1995 through 2005 in New York state, according to a study published in the journal Cancer, the Los Angeles Times reports.

There is no evidence that having a preventive mastectomy improves survival, according to lead author Stephen Edge, a professor of surgery and oncology at Roswell Park Cancer Institute. Edge said, “We are not making a value judgment that this is good or bad.” He added, “But it’s an important trend. The concern is that we have women doing this out of a gut reaction” without sufficient counseling about risk.

According to the study, nearly 5,000 New York women opted for the contralateral procedure during the review period. The study showed that rates of the procedure were steady among women who had never had cancer but had a higher risk of developing the disease. According to the Times, healthy women might choose to have both breasts removed if they have a strong family history of breast cancer or if they test positive for the BRCA-1 or BRCA-2 gene mutations, which increase the risk for the disease.

Todd Tuttle, chief of the Surgical Oncology Division at the University of Minnesota and author of a similar 2007 study, said it is unclear why contralateral prophylactic mastectomies have increased. He noted that there now is a better understanding about genetic risks and an increased availability of gene testing, as well as significant improvements in mastectomy and breast reconstruction techniques.

Tuttle said there is a concurrent trend of women choosing mastectomy over the less-invasive option of a lumpectomy, in which only the tumor is removed. He said, “Throughout surgery, there is such a huge push to do procedures that have less scarring, the shortest surgery, the shortest recovery,” adding, “That is true for everything except breast cancer” (Roan, Los Angeles Times, 9/29).

© 2009 The Advisory Board Company.