Wednesday, February 1, 2017

Decision for Prophylactic Double Mastectomy After Breast Cancer Diagnosis May Not Be Necessary

It is the rising trend to today that once a woman is diagnosed with breast cancer in one of her breasts, she will have a prophylactic removal of the unaffected breast for fear of recurrence of cancer in that breast.

Maybe this practice can be reduced by counseling and educating woman on the actual risk of recurrence. Many cancer survivors erroneously believe that the risk is 5-10% higher of also getting cancer in the unaffected breast at the time of diagnosis than it actually is. There is actually no evidence that the removal of the unaffected breast will positively affect the chances of survival for woman who have a risk for cancer recurrence.

A breast surgeon in Bristol, England, noticed this trend in his patients and wondered why. He also wanted to know if there was a period of time where the woman could regain her balance after the fright of the diagnosis and a chance to get counseling as to the actual facts, that she might change her mind about the removal of her perfectly good breast.

They did. In this physicians practice there were 23 of 27 women that changed their mind about having a bilateral mastectomy when only one breast was affected. These 23 women had a mastectomy of the affected breast and radiation and/or chemotherapy. They also received counseling and support for a year. And of course it is the woman’s choice so after one year if any woman still wanted the unaffected breast removed this was done for her.

It is obvious that when the diagnosis first occurs it is a time of stress and fear. This is certainly no time to make this emotional decision. All these women were counseled that no survival benefit was ever suggested by this drastic of a surgery. They had yearly mammography as a method for monitoring recurrence.

It is interesting as to the reasons these woman gave as to why they wanted their non cancerous breast also removed at the time the cancerous breast was operated. In twelve of the woman there was a family history of breast cancer. A few of the woman (four) had a family member or friend that didn’t fare well after a single mastectomy. One woman simply wanted to avoid radiation. And three wanted it due to their young age for fear of the cancer coming back.

It is never a good idea to make a hasty decision. It is always recommended to have a second opinion and to research the diagnosis and know all you can BEFORE you make any decisions.



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