70 Percent of Double Mastectomies May Be Unnecessary

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It’s scary to think about, but if you had breast cancer, would you choose to have both of your breasts removed? Unfortunately, many women diagnosed with breast cancer face this very decision. After all, you’d think that if you have breast cancer in one breast, the risk of it occurring in your other breast is very high. Reality check: For most women, that’s simply not the case. And a new study published in the journal JAMA Surgery finds that as many as 70 percent of women who choose to have contralateral prophylactic mastectomy (CPM)—removal of the unaffected breast—don’t actually need the surgery. [Tweet this stat!]

Unless a woman tests positive for the BRCA1 and BRCA2 gene mutations, has a strong family history of breast or ovarian cancer, or is diagnosed with certain types of breast cancer, her risk of developing the disease in her other breast is no higher than the general population’s risk of breast cancer—about 1 in 8, says study author Sarah Hawley, Ph.D., M.P.H., of the University of Michigan. In her study of more than 1,400 breast cancer patients, she found that about 8 percent received CPM. “With breast cancer, if it comes back it comes back locally in the area where the cancer was originally found or it comes back systemically,” Hawley says. “It’s not more likely to come back in the other breast.”

So why are so many women who don’t need CPM still having the surgery? “For many women it’s about peace of mind,” Hawley says. “Even if they’re told it’s not really going to help, they think that having it done will help them manage that worry. For some women, especially those with younger children and families, the worry is too much to bear.”

Hawley’s hope is that the medical system offers more resources such as counseling and other resources to help women manage the anxiety and feel better about having a unilateral mastectomy or conservation surgery if that’s what they choose to do.

Ultimately, you have to decide with your doctor and your loved ones what’s right for you. If you’re facing this difficult choice (huge hugs to you), be sure you’re working with a surgeon you feel comfortable with and who gives you options.

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