There are several options for treatment when you are diagnosed with breast cancer. For some women — even those in the earliest stages of the disease — it may seem like the best option for survival is to get a double mastectomy. In a double mastectomy, all of the breast tissue in both breasts is removed. Why take the risk of cancer returning to the breast by only getting a lumpectomy or a single mastectomy?
However, a study of women in California has found that a double mastectomy doesn’t decrease the risk of death. Breast cancer can still return to the breast area or other areas of the body.
This isn’t the first study to find that bilateral mastectomies don’t reduce risk of death. One previous study found that preventative double mastectomies for patients with the BRCA2 mutation, as well patients who had DCIS or breast cancer that hadn’t spread to the lymph nodes, did not improve survival rates. However, women with BRCA1 gene mutations who underwent preventative double mastectomies did reduce the risk of death.
This study was published in the journal Cancer, a publication by the American Cancer Society.
Researchers used data from the Surveillance, Epidemiology, and End Results (SEER) program. They looked at women in California who had been diagnosed with breast cancer that was stage 0 to stage III from 1998 to 2015. These women had been treated with a bilateral mastectomy rather than either breast-conserving therapy like a lumpectomy and radiation or a unilateral mastectomy.
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They looked at a total of 245,418 patients. Of those patients, 7784 of them (or 3.2%) developed second contralateral breast cancer (CBC) — which means they developed breast cancer in the opposite breast of their first diagnosis.
The researchers compared the risk of getting secondary breast cancer and the risk of death from breast cancer between women who had a bilateral mastectomy, women who had a single mastectomy of the affected breast, and women who had breast-conserving therapy including surgery and radiotherapy.
Researchers found that bilateral mastectomies do reduce the risk of breast cancer recurring. However, the risk of death from breast cancer for women with double mastectomies was equivalent to women who underwent breast-conserving therapy with radiation.
“Bilateral mastectomy may reduce second breast cancer risk by 34 to 43 cases per 10,000 person‐years compared with other surgical procedures, but is not associated with a lower risk of death,” wrote the authors in their conclusion. “Second breast cancers are rare, and their reduction should be weighed against the harms associated with BLM.”Whizzco