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Ask the expert

Todd Tuttle, M.D.

Why are more women getting double mastectomies to treat breast cancer when it only affects one breast?

First of all, is it really true that more breast cancer patients are opting for double mastectomies?

Yes, multiple studies have shown that to be the case. We don’t really know why. Some women may choose a double mastectomy followed by reconstruction surgery to ensure symmetry. But I think a lot of women do it because they believe it will improve their chances for long-term survival—and that concerns me.

A double mastectomy won’t improve cancer survival rates?

Research has not shown a survival benefit with the second mastectomy. Most women’s understanding of their cancer risk in the other breast is grossly exaggerated. For a woman with cancer in one breast, the 10-year risk of getting a cancer in the other breast is only about 4 to 5 percent. The greater risk is in having the cancer spread to the lungs, liver, or bones.

Angelina Jolie recently told the world about her double mastectomy, and she didn’t have cancer. Does that make sense?

I actually like the Angelina Jolie story and hope it gets out even more, because she did it the right way. One of her doctors discovered a red flag in her family history— her mother had ovarian cancer at a young age. So Jolie underwent genetic counseling and testing and was found to carry the BRCA gene that is associated with a very high incidence of breast and ovarian cancer. Her decision to undergo prophylactic mastectomy was very reasonable. Women should talk with their doctors and get as much information as possible before making that decision.

Todd Tuttle, M.D., is a member of the Masonic Cancer Center and a surgical oncologist at the University of Minnesota Medical Center, Fairview.

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