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Double mastectomy choice challenged by researchers

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Nearly three-quarters of women who have both breasts removed after a cancer diagnosis may be wrong to take the drastic step, a study has suggested.

Researchers who studied 1,447 women treated for breast cancer found that 8% of them had undergone a double mastectomy.

But 70% of these women did not meet the medically approved criteria for losing both breasts – a family history of breast or ovarian cancer, or BRCA 1 or BRCA 2 gene mutations.

“Having a non-affected breast removed will not reduce the risk of recurrence in the affected breast”

Sarah Hawley

They had a very low risk of developing cancer in the healthy breast, the US scientists said.

Study leader Dr Sarah Hawley, from the University of Michigan, said: “Women appear to be using worry over cancer recurrence to choose contralateral prophylactic mastectomy.

“This does not make sense, because having a non-affected breast removed will not reduce the risk of recurrence in the affected breast,” she said.

“For women who do not have a strong family history or a genetic finding, we would argue it’s probably not appropriate to get the unaffected breast removed.”

The research, published in the journal JAMA Surgery, also found that 18% of the women studied had considered a double mastectomy.


Sarah Hawley

Women with a risky family history and BRCA mutations make up around 10% of all those diagnosed with breast cancer.

They are considered to be at high risk of a new cancer developing in the unaffected breast.

Without these indications, women who develop a tumour in one breast are very unlikely to acquire a second cancer in the other.

Many of the women in the study who elected to have a double mastectomy were candidates for breast-conserving surgery to remove lumps, the researchers said.

Overall, about three-quarters of the patients reported being very worried about their cancer. Those who chose to have both breasts removed were significantly more likely to be concerned.

A double mastectomy is a major operation that can be associated with complications and difficult recovery, the authors pointed out.

Most of the participants who had the procedure underwent breast reconstruction as well.

The study found that women with higher education levels and who had been given a magnetic resonance imaging (MRI) scan before surgery were more likely to choose a double mastectomy.

The new research coincides with former Dancing With The Stars host Samantha Harris making public her decision to have a double mastectomy following a diagnosis of breast cancer.

She was praised by Baroness Delyth Morgan, chief executive of the Breast Cancer Campaign, who said: “Samantha’s openness in sharing her experience serves as a stark reminder of the impact of a breast cancer diagnosis.

Baroness Delyth Morgan

Baroness Delyth Morgan

“Being breast aware can be crucial to early diagnosis, increasing chances of survival. It is important women report any unusual changes to their GP and consider attending routine breast screening when invited.”

Ms Harris discovered a lump in her right breast during a routine self-examination.

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Readers' comments (1)

  • I had breast cancer with a mastectomy and tram flap reconstruction in one breast. I was told I had a 93% chance of not having a recurrence. 19 years later I was diagnosed with a completely different type of cancer in the other breast and ended up with a mastectomy. This past year has been difficult and trying with needing chemotherapy, surgery and then radiation however, I can not say that I am sorry that I did not have a double mastectomy when I had the first cancer. I lived 19 years with my own breast on the unaffected side. It was not recommended at that time and I know that having a double mastectomy is not as easy as it sounds. Surgery is surgery and has its own recovery and possible complications. It should not be taken lightly and I don't think it should be recommended to everyone.

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