Who really needs a double mastectomy?

Controversial new research out of Stanford reveals that having both breasts removed doesn’t actually increase your chances of survival if you have early-stage breast cancer.

We often assume the most aggressive treatment will result in the best patient outcome, but this is not always the case.

In a large study examining almost 190,000 Californian women, double mastectomies did not have a survival benefit when compared with a lumpectomy (removing the cancerous lump) plus radiation therapy.

The women included in the study were diagnosed with early-stage breast cancer in one breast between 1998 and 2011.

“We can now say that the average breast cancer patient who has bilateral mastectomy will have no better survival than the average patient who has lumpectomy plus radiation,” said Stanford’s Allison Kurian.

Kurian, an assistant professor of medicine, health research and policy, also highlighted the differences between the surgical options for breast cancer. “A mastectomy is a major procedure that can require significant recovery time and may entail breast reconstruction, whereas a lumpectomy is much less invasive with a shorter recovery period.”

The notion that most women who have double mastectomies don’t actually need them isn’t a new one. In fact, Kurian’s research is the second study this year to challenge the necessity of the procedure.

So, why are more women having double mastectomies?

Around the world, an increasing amount of women who are diagnosed with early-stage breast cancer are opting for double mastectomies.

Researchers believe that fear and emotion may be a driving factor for many of these patients. In an editorial accompanying the study, Dr. Lisa Newman, from the University of Michigan, Ann Arbor, wrote that the “dense fog of complex emotions that accompanies a new cancer diagnosis” can impair the ability to properly process the risks of the various treatment options available for breast cancer patients.

Additionally, some women believe having the most aggressive surgical procedure will be the best way to reduce the possibility of being diagnosed with cancer or prevent recurrence.

The media may also play a role in promoting awareness of the procedure — particularly with one of today’s most high-profile celebrities, Angelina Jolie, having had both breasts removed in May 2013.

Jolie tested positive for the BRCA gene, but wasn’t actually diagnosed with cancer.

Closer to home, a current story line in the popular television show, Winners & Losers, is also exploring this theme, with main character, Jenny Gross, preparing for a preventive double mastectomy after genetic testing showed she was at a high risk of developing breast cancer.

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Who should consider a double mastectomy?

Perhaps one of the more positive findings to come out of this research is a clearer understanding of what the better treatment approach is for women who are newly diagnosed with breast cancer.

The researchers said their results may be able to inform future decision-making about breast cancer surgery.

However, it’s important to remember that this research was only completed on women who had early-stage breast cancer in one breast — not on women who had more advanced forms of cancer.

Anyone considering a double mastectomy should be encouraged to take the time to consider the benefits and risks of all the available treatment options, and to discuss their individual health status and concerns with specialist physicians and oncologists.

To find out more about breast cancer and available treatment options, visit the Breast Cancer Network Australia.

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