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Study finds women with breast cancer are choosing unneeded surgery

Growing numbers of women in the United States are choosing to have both breasts removed when cancer is detected in one breast, but in many cases, a double mastectomy is unnecessary, according to researchers at the University of Minnesota Cancer Center.

A team led by Todd Tuttle, M.D., chief of surgical oncology in the Medical School’s Department of Surgery, found that the use of double mastectomies—or contralateral prophylactic mastectomy (CPM) surgery when cancer has been diagnosed in only one breast more than doubled between 1998 and 2003. Of 152,755 women diagnosed with stage I, II, or III breast cancer in this six-year period, 59,460 women had a single mastectomy and 4,969 women who could have had a single mastectomy instead chose to have a double mastectomy. The researchers also noted that the use of CPM surgery increased from 4.2 percent in 1998 to 11 percent in 2003.

Tuttle, a member of the University’s Cancer Center, says that while CPM surgery reduces the risk of cancer in the other breast, the surgery is also more aggressive and irreversible. “Most patients will not experience any survival benefit,” he adds, as the risk of cancer spreading to other parts of the body is greater than the risk of it spreading to the other breast.

Certain women, including those who have been diagnosed with cancer and have the BRCA1 or BRCA2 genetic mutation, have a greater risk of developing cancer in the second breast if cancer is diagnosed in the other.

The study, published online October 22, 2007, in the Journal of Clinical Oncology, is the first to determine the use of CPM surgery on a national level.


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