Linda Spillers/AP
Trisha Stotler Meyer plays with her
three-year-old son Max in 2007. Stotler
Meyer recently had both breasts
removed following a 2005 diagnosis
of cancer in one breast.

More Breast Cancer Patients Choose Radical Prevention Procedure

April 10, 2009 12:56 PM
by Cara McDonough
An increasing number of women with early-stage breast cancer or a genetic predisposition to the disease are having both breasts removed, despite medical advice to the contrary.

Women Choosing Double Mastectomies

A new study published in the Journal of Clinical Oncology finds that the number of U.S. women choosing to have both breasts removed when faced with the earliest form of breast cancer has increased dramatically in recent years.

The rate of women choosing contralateral prophylactic mastectomy—having both breasts surgically removed, even if only one breast is affected—rose 188 percent from 1998 to 2005.

The study followed women who have ductal carcinoma in situ, or DCIS, which is the most common type of noninvasive breast cancer. Although having a lumpectomy to remove the affected tissue is still more common than a double mastectomy, the new numbers are surprising.
Women with cancer in one breast are not the only ones taking what might seem radical preventative measures. Women with no cancer at all are doing the same.

Karen Aulner, 36, is watching her sister battle the disease; she also tested positive for a gene mutation that puts her at high risk for breast cancer. As a result, Aulner chose a preventative double mastectomy, although she does not have a cancer diagnosis.

Her sister was “the healthiest person I ever knew,” Aulner said to The Washington Post. “If I could not have that happen to me? Heck, yeah."

Opinion & Analysis: A healthy preventative measure, or too invasive?

The increase in women choosing bilateral mastectomy is related to the availability of tests for the BRCA1 and BRCA2 genes, which can assess a woman’s risk for breast cancer. The genetic tests also measure ovarian cancer risk.

According to the Post, many women, including actress Christina Applegate, who had a double mastectomy last summer, “describe it as the lifting of a great burden, because they no longer have to face the stress of mammograms or feel panicky if they find a small lump during a self-exam.” Applegate’s decision inspired a wave of articles and discussions about the topic.

But medical experts don’t necessarily recommend the procedure. Dr. Todd Tuttle, a University of Minnesota cancer surgeon who led the recent study, said in 2007 that there is little data that having a contralateral prophylactic mastectomy improves overall survival rates.

"We need to determine why this is occurring and use this information to help counsel women about the potential for less invasive options,” he said.

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Related Topic: Other recent breast cancer studies

There have been many studies investigating the possible causes of breast cancer, and how to reduce the high rates of the disease.

In November, a study in Japan suggested that lack of sleep may be linked to a higher breast cancer risk. The study showed that a lack of melatonin may disrupt release of estrogen, which is considered a possible factor in the development of breast cancer cells.

Another study, released in December, strengthened the ink between hormone replacement therapy and a higher risk of breast cancer and heart attacks in women. The new study suggested that taking estrogen and progestin for a couple of years could raise the risk of developing breast cancer. During the same period, women who took fewer hormones had a decrease in breast cancer rates.

Reference: Breast cancer


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