By Susan E. Matthews
When Angelina Jolie wrote about her decision to get a mastectomy after learning that she was genetically predisposed to have a higher risk for breast cancer, she sparked a media frenzy. In reality, Jolie is just one of a growing number of women who are opting to remove their breasts rather than face the risk of breast cancer.
One particular group of women who are opting to remove healthy breasts is those who have already been diagnosed with cancer in one breast. In just the last decade, the number of women who, once diagnosed with early stage cancer in one breast, have opted to not only remove the cancerous breast but also their healthy breast has more than doubled.
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Unfortunately, new research presented at 2013 Clinical Congress of the American College of Surgeons shows that opting to do so may only increase life expectancy by a maximum of six months, which is nearly inconsequential when noting that most women survive to live another 20 or 30 years, or more.
The reasons for the increase in mastectomies lie in both improvements in the technology for both mastectomy and reconstruction, and in a general increase in awareness and genetic testing, said study author Todd Tuttle, MD, FACS, chief of surgical oncology at the University of Minnesota.
Researchers from the University of Minnesota analyzed data that included information on the treatment and survival rate of more than 100,000 women who had been diagnosed with early breast cancer. They found that for women who were age 40 at the time of diagnosis, if they opted to remove both breasts, one prophylactically, they lived to an average of 78.8 years. For women who choose not to remove the second breast when diagnosed at 40, life expectancy was 78.3 years.
For a 60 year old, getting the double mastectomy resulted in a life expectancy of 78.1 years, while only having surgery on the cancerous breast yielded a life expectancy of 78 years.
"The differences are probably clinically meaningless," Tuttle said.
The reason for the six month difference for women first diagnosed at 40 is that a very small percentage of them will go on to get breast cancer in the other breast and die from it, Tuttle said. But this happens in less than one percent of cases.
However, women often don't perceive it this way. "Women with breast cancer substantially overestimate the likelihood of getting cancer in the other breast, and the benefit of a double mastectomy," Tuttle said.
This could be problematic, because the double mastectomy poses a higher risk of consequences like infection or surgical complications compared to a single mastectomy, said Judy Boughey, MD, a surgeon at the Mayo Clinic in Rochester, Minn. Dr. Boughey pointed to a study that shows that risk of wound complication was nearly double for women choosing a double mastectomy versus that of a single.
Boughey said she was not surprised with the increase the doctors found for double mastectomies, as she had seen this reflected in her clinical work.
"I think many women decide they want to pursue it knowing it's unlikely to improve their survival, but think it's going to improve their anxiety," she said. "The key phrase we hear is 'I just don't want to go through this again -- I want control over my own destiny.'"
She emphasized that these days women are lucky to have many treatment options, and it's important to continue researching what the best options are.
"At the end of the day, it's probably going to be a very personal decision, and it may or may not be influenced by the data, but we need to have the best data," Boughey said.
"Double Mastectomies May Not Increase Life Expectancy, Study Says" originally appeared on Everyday Health.