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Sometimes Bilateral Mastectomies Make No Sense

Posted 4/11/2014

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  This is a soap box issue for me, I admit it. It makes me nuts that women are, in growing numbers, opting for unnecessary and medically unhelpful bilateral mastectomies when less surgery would be just as effective and safer. There are always risks with surgery, and there are more risks with bigger surgery. It is generally better to have your breasts than not (and having lived both ways, I can attest to that one), and far too often this painful choice is made by distressed women who do not clearly understand the realities. They, of course, are motivated to a large extent by fear and the determination to do everything possible to stay well. What they often don't appreciate is that taking off one or two breasts usually makes no difference in survival; the big risk is not developing a second breast cancer in the future. The big risk is the one you already have.

  Sometimes there are medical reasons that one or two mastectomies are needed. My own situation was having previously had radiation; a body part cannot be radiated more than once, so a second cancer in the same breast required a mastectomy. Sometimes the size or location of the tumor or multi-focal tumors or positive gene mutations or other specific reasons make this the right surgical decision.

  There is also the celebrity factor as high profile women make this choice. I appreciate that we don't know, and have no reason to know, all the details of their situations, but the part that becomes public too often influences other women to make the same choice.

  This is an excellent essay by my friend, Marc Silver, author of Breast Cancer Husband, about this issue.

Why My Wife Didn't Choose A Double Mastectomy

by MARC SILVERYet another entertainment figure has gone public with her decision to have a double
mastectomy after a breast cancer diagnosis. Samantha Harris is the latest in a series of
entertainers who've decided on that surgery as treatment for the disease.
Harris, a 40-year-old mother of two and former co-host of Dancing with the Stars, said
she chose this procedure after consulting with three specialists. It was a difficult choice,
she reports, but she feels it enabled her "to take control" and that she is "so much
As the husband of a breast cancer survivor, I can relate to what Harris says. A welcome
sense of control and calm follows the agony of wrestling with treatment options.
I have also learned that a double mastectomy is not the best choice for all breast cancer
patients. Nor does it eliminate fear of recurrence.

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  • Patti Hill said:
    4/14/2014 7:36 AM

    This is an issue for me too. People ask me all the time why I didn't have a double mastectomy. When I tell them the statistics they invariably give me "I don't believe you" looks. Many tell me they would take them both off.