Double Mastectomy Treatment 'Does Not Increase' Breast Cancer Survival Rates, Study Shows | HuffPost Life

Considering A Double Mastectomy? This May Make You Think DIfferently

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If you're considering a double mastectomy as a preventative measure, or form of treatment, against breast cancer then you'll want to take note of new research which might just make you think differently about the procedure.

Following an increase in the number of breast cancer patients opting for double mastectomies, a new study has found that removing breasts entirely could actually make no difference to survival chances and that other treatment-types would be just as effective.

Research carried out in California found that women who had lumps removed followed by radiotherapy lived as long as those taking the drastic step of discarding both breasts.

Yet there is evidence of increasing numbers of women seeking double mastectomies after having cancer diagnosed in just one breast.

The same team of researchers who analysed data on 189,734 patients found that rates of the procedure soared from 2% in 1998 to 12.3% in 2011 - an annual increase of 14.3%.

Lead scientist Dr Allison Kurian, from Stanford University, said: "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.

"Furthermore, 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."

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Of the women recruited, just over half (55%) had surgery to remove lumps followed by radiation treatment. Almost 40% had one breast removed and 6.2% on average underwent a double mastectomy over the 13-year study period.

Women electing to have complete breast removal were more likely to be white, younger than 50, and from the middle or upper social classes.

Long term survival rates did not differ significantly between women who underwent a double mastectomy and those who received a lumpectomy plus radiotherapy. After 10 years, just under 19% of the patients had died.

Survival rates were slightly worse for women who had one breast removed compared with breast-preserving treatment, possibly for socio-economic or ethnic reasons, said scientists.

The authors, whose research appears in the Journal of the American Medical Association, wrote: "In a time of increasing concern about over-treatment, the risk-benefit ratio of bilateral mastectomy warrants careful consideration and raises the larger question of how physicians and society should respond to a patient's preference for a morbid, costly intervention of dubious effectiveness.

"These results may inform decision-making about the surgical treatment of breast cancer."

They stressed that for some women with a genetic risk of breast cancer, a double mastectomy remained an effective treatment option.

It was also true that removal of both breasts might help alleviate a woman's fear of a second cancer occurring in the remaining breast.

In addition, some of the latest breast-reconstruction techniques achieved better results when both breasts were rebuilt together.

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Co-author Dr Scarlett Gomez, from the Cancer Prevention Institute of California (CPIC), said: "We're hopeful that this study will open a dialogue between a patient and her physician to discuss these kinds of questions. It's an important piece of evidence that can guide their decision-making process."

A number of celebrities have had double mastectomy operations. Hollywood star Angelina Jolie is the latest and most high-profile star to highlight the dilemma facing women at high risk of developing breast cancer.

The star of Tomb Raider, Mr & Mrs Smith and Salt revealed last month that she had undergone a preventative double mastectomy to reduce her risk of developing the disease.

Her mother Marcheline Bertrand died of cancer in 2007 and days after Jolie revealed her surgery, her aunt, Debbie Martin, 61, died of breast cancer.

Jolie, a mother of six and wife of Brad Pitt, said she took the decision to have the procedure because she found she carries the "faulty" gene BRCA1, which sharply increases her risk of developing breast cancer and ovarian cancer.

Writing for the New York Times, she said her doctors had estimated she had an 87% risk of developing breast cancer and a 50% risk of ovarian cancer.

Former X Factor judge Sharon Osbourne revealed in November that she had undergone a double mastectomy.

The 60-year-old beat colon cancer a decade ago but opted for surgery after finding she carried a gene which increased the risk of developing breast cancer.

In an interview at the time with Hello! magazine, she said: "As soon as I found out I had the breast cancer gene, I thought 'The odds are not in my favour'.

"I've had cancer before and I didn't want to live under that cloud. I decided to just take everything off, and had a double mastectomy.''

Story continues below...

11 Little Known Breast Cancer Facts

Breast cancer is actually many different types of cancer(01 of10)

Breast cancer, in its simplest definition, is cancer that starts in the cells of the breast. But what we call "breast cancer" actually includes several different types of cancer, all of which require different treatments and have different prognoses. (credit:Shutterstock)

A lump doesn't always (or even usually) mean cancer(02 of10)

Most breast lumps indicate something other than breast cancer—some possible causes for breast lumps include cysts, fibrosis, or benign tumours. And some women are just prone to lumpy breasts, which is stressful but harmless. That said, if you find a lump, get it checked out — know that the odds are good that it's nothing serious, but see your doctor about it for your own peace of mind. (credit:Susan G. Komen)

Breast cancer isn't always a lump(03 of10)

It's helpful to know that breast cancer can appear in forms other than a lump, which means there are other physical signs you should watch for. Other symptoms that you should get checked out include thickening of the skin in the breast or underarm area; swelling, warmth, redness, or darkening of the breasts; a change in your breast size or shape; dimpling or puckering of the breast skin; an itchy, scaly sore or rash on the nipple; a pulling in of your nipple or another part of your breast; sudden nipple discharge; or pain in one spot of the breast that doesn't go away. (credit:Shutterstock)

Breast cancer risk isn't always determined by family history(04 of10)

A family history of breast cancer (on either your mother or father's side) can be an indication that your personal odds of developing it are higher than average, but they don't guarantee that you will. As well, the majority of women who develop breast cancer have no identifiable risk factors, including family history. And the BRCA1 and BRCA2 gene mutations are hereditary, but only account for five to 10 per cent of all breast cancers. (credit:Shutterstock)

BRCA1 or BRCA2 don't always mean cancer is in your future(05 of10)

The news that Angelina Jolie had had a preventative double mastectomy after testing positive for the BRCA1 gene mutation made many women wonder if they had the same mutation--and what it would mean for them if they did. If you do have the BRCA1 or BRCA2 gene mutation, your lifetime risk of developing breast cancer or ovarian cancer is significantly elevated, and women with the mutations who do get cancer tend to develop it at younger ages; one estimate states that 55 to 65 per cent of the women with the BRCA1 mutation and 45 per cent of those with the BRCA2 mutation will develop breast cancer by age 70, versus 12 per cent in the general population. But it does not mean that cancer is definitely in your future, and every person has to make her own individual decision, based on a variety of factors, about how to best mitigate her risk of disease. (credit:Shutterstock)

Not all women have a one-in-eight risk for breast cancer(06 of10)

This often-cited statistic is somewhat misleading. Breast cancer risk varies based on a variety of factors, including age, weight, and ethnic background. Risk increases as you get older (http://www.cdc.gov/cancer/breast/statistics/age.htm): most breast-cancer cases are in women in their 50s and 60s. Also, some ethnic groups appear to be more susceptible to breast cancer; the National Cancer Institute in the U.S. says that white, non-Hispanic women have the highest overall risk of developing breast cancer, while women of Korean descent have the lowest risk, but African-American women have a higher death rate. Finally, being overweight or obese may also up your risk; there is evidence that being obese or overweight after menopause can up your breast-cancer risk, possibly because fat tissue is a source of estrogen. (credit:Shutterstock)

There are ways to lower your risk(07 of10)

You can't prevent breast cancer, per se, but there are ways to lower your personal risk. If you are overweight or obese, you could try to lose weight in a healthful way; if you are already in a healthy weight range, try to stay there. Exercise regularly, as as little as 75 to 150 minutes of walking a week has been shown to have a lowering effect on risk. Limit your alcohol consumption — research found that women who have two or more alcoholic drinks each day have an elevated risk of breast cancer. And avoid hormone therapy during menopause, as a combo of estrogen and progestin has been shown to raise breast-cancer risk. (credit:Shutterstock)

Mammograms aren't foolproof(08 of10)

Mammograms are a powerful way to detect breast cancer early on, but they aren't 100 per cent. Mammograms are most effective in women aged 50 and over; they detect about 83 per cent of women who have breast cancer in that age group. For younger women, the sensitivity is 78 per cent. However, that does mean some cancers are missed and that there are false-positive results as well, which could require a biopsy to confirm. Talk to your doctor about when you should start getting mammograms regularly, or if you have symptoms that suggest that you should get one. (credit:Shutterstock)

Fertility treatments don't raise your breast-cancer risk(09 of10)

Some wondered if Giuliana Rancic's fertility treatments were behind her diagnosis of breast cancer in her late 30s, but experts interviewed by WebMD said that there is no strong evidence connecting the disease with the use of fertility drugs. It's true that hormonal treatments can raise the risk for post-menopausal women, but women undergoing fertility treatments are almost never in that age range, and also take the medications for a much shorter period of time. (credit:Getty Images)

Most women survive breast cancer(10 of10)

Cancer is scary, but in most cases, women who are diagnosed with breast cancer survive and lead healthy lives. According to the Breast Cancer Society of Canada, the five-year survival rate is 80 per cent for men and 88 per cent for women. That's up from 79 per cent for women in 1986. (credit:Shutterstock)

Former Liberty X singer Michelle Heaton was another who took the decision to have drastic surgery.

She had a double mastectomy late last year after she was diagnosed with a mutated BRCA2 gene, which meant she had an 80% chance of developing breast cancer and a 30% chance of ovarian cancer.

Anastacia has undergone a double mastectomy after being diagnosed with breast cancer for the second time, the US singer has announced.

The I'm Outta Love star, 45, announced the second diagnosis in February, cancelling her planned European tour.

Now she has updated fans on her recovery as part of Breast Cancer Awareness Month.

She said in a statement: "In light of Breast Cancer Awareness Month l wanted to take the opportunity to support a cause particularly close to my heart.

"l was diagnosed with breast cancer for the second time earlier this year and am currently in the final stages of recovery after undergoing a double mastectomy."

She added: "It has been an intense journey but l am feeling great and ready to start the next chapter.

"Breast Cancer Awareness Month gives all who are facing this disease a chance to gain strength and support from each other.

"Early detection has saved my life twice. I will continue to battle and lend my voice in anyway I can."

Anastacia, who said she underwent a double mastectomy with Latissimus Dorsi flap surgical procedure, was first diagnosed with the disease in 2003.

Eluned Hughes, head of public health at the charity Breakthrough Breast Cancer, said: "Double mastectomies are not routinely offered to women with breast cancer in the UK unless they have a family history of the disease or a high risk of recurrence, as outside of these groups there is no evidence to suggest that this would be of benefit.

"Having a double mastectomy is a difficult decision - there may be many reasons why women from California are opting for this procedure, so it's important that every woman has all the information about the risks and benefits of the surgery for them.

"Our dedicated team of scientists are working to make personalised medicine the standard for breast cancer treatment. By gaining a full understanding of every type of breast cancer, what causes them to begin and by mapping how they grow and spread, we will be able to match up each and every patient with a precise treatment plan based on the most effective ways of beating their particular breast cancer - with the fewest side effects possible."

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