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Bilateral Mastectomies often Unnecessary

Posted 7/1/2014

Posted in

  Yes, this is a soapbox issue for me. And, yes, I will always fully support the decision that a woman makes about surgery. My experience has been that women make the right choices for themselves; every woman whom I have ever known has been satisfied ("happy" would be a stretch, because none of us are really happy about any of the options) with what she chose. Whether that reflects good self-understanding or being adaptive or both, I don't know. But it is true time and time again.

  My big worry about the increasing number of women who opt for bilateral mastectomies when the medical advice has been that the second mastectomy is not necessary is this: too often women mistake the larger surgery as a way to protect their future health, to reduce the risk of recurrence and death from breast cancer. In a very large scheme, that could be true as removing both breasts reduces the possibility of developing another breast cancer by more than 95%. But removing a healthy breast does nothing about the recurrence risk for the known cancer.

  I also hear women talk about their wish to avoid annual mammograms and, maybe, MRIs and all the accompanying anxiety. I surely understand that. And I surely appreciate the intense anxiety that accompanies a ew diagnosis of breast cancer and our wish to do anything and everything to increase our odds of staying alive. Most of the time (generally except for women who carry one of the gene mutations, BRCA1 or BRCA2) removing the second breast won't make any difference in this endeavor. And it will make a very big difference in terms of one's body.

  Here is a good article from BreastCancer.Org; I give you the start and a link to read more:

Many Women Who Have Double Mastectomy Have
Low Risk of Developing Cancer in Other Breast

Some women who’ve been diagnosed with early-stage breast cancer in one breast choose to have that breast and the other healthy breast removed – a double mastectomy. Removing the other healthy breast is called contralateral prophylactic mastectomy.
The healthy breast usually is removed because of an understandable fear that a new, second breast cancer might develop in that breast. More and more women who’ve been diagnosed are opting for contralateral prophylactic mastectomy – in the late 1990s, between 4% and 6% of women who were having mastectomy decided to have the other healthy breast removed. More recently, between 11% and 25% of women having a mastectomy decided to have contralateral prophylactic mastectomy.
A study suggests that most women who have contralateral prophylactic mastectomy have a very low risk of cancer 
developing in the other healthy breast.

The research was published online on May 21, 2014 by JAMA Surgery. Read the abstract of “Social and Clinical Determinants of Contralateral Prophylactic Mastectomy.”


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