New research shows that the number of women who have the aggressive double mastectomy surgery for breast cancer tripled in 10 years. Research also shows that the double mastectomy surgery is not correlated with longer survival, as opposed to other, less invasive surgeries for breast cancer.
There are three types of surgeries women who are diagnosed with breast cancer may undergo as part of their treatment. Breast Conserving Surgery, Breast Conservation Surgery or Segmental Mastectomy — Less radical surgery that removes the cancer and surrounding breast tissue as opposed to the entire breast.
Lumpectomies and partial mastectomies fall under this umbrella. A lumpectomy requires the removal of the breast lump and some of the surrounding tissue. A partial mastectomy is more comprehensive, removing the tumor, surrounding breast tissue and the lining over the chest muscles below the cancer affected area.
Typically radiation therapy follows breast conserving surgery. In the case of early stage breast cancer, breast conserving surgery coupled with radiation therapy has the same survival rate as a mastectomy for breast cancer, according to a 20-year follow up study of a randomized trial comparing lumpectomy, lumpectomy plus irradiation (localized form of radiation treatment), and mastectomy for breast cancer published by the New England Journal of Medicine in 2002.
While complications of breast conserving surgery are uncommon, they may include bleeding, infection, or a reaction to anesthesia. Blood or clear fluid may collect in the wound and require draining. Side affects may include breast pain and feelings of pulling, pinching, tingling or numbness.
A unilateral mastectomy removes the breast affected by cancer. A double mastectomy or Bilateral Mastectomy removes the affected and unaffected breasts.
— TJ MartellFoundation (@tjmartell) March 4, 2016
Some women opt for double mastectomy surgery for breast cancer as a preventative measure, though the new research led by Dr. Mehra Golshan, distinguished chair in surgical oncology at Brigham and Women’s Hospital and Associate Professor, Surgery at Harvard Medical School, suggests there is no link between having a double mastectomy for breast cancer and an improved survival benefit as opposed to those who undergo less invasive breast conserving surgery.
“Despite all the data [over decades] comparing women who underwent breast-conserving surgery and mastectomy and [sic] the survival was exactly the same.”
Researchers examined the rates of the three different types of breast cancer surgeries among nearly 400,000 women who had been diagnosed with breast cancer and had surgery between 2002 and 2012. Data was pulled from a National Cancer Institute database. The data showed that the number of women who had a double mastectomy for breast cancer tripled, from 3.9 percent to 12.7 percent over 10 years. The rate of unilateral mastectomy dropped while the rate of breast conserving surgery remained steady during that period. Double mastectomy for breast cancer carries a higher risk of complications as compared with breast conserving surgery or unilateral mastectomy.
According to CNN, researchers examined the outcomes of over 200,000 women in the same database who had surgery before 2007.
“They estimated that the 10-year survival rates were similar for the three types of surgery: 91.8% for breast-conserving surgery, 83.8% for unilateral mastectomy and 90.3% for bilateral mastectomy.”
According to Golshan, however, there may be a survival benefit to double mastectomy for breast cancer among women who have a genetic risk factor, especially for those with a BRCA mutation.
In 2013, actress Angelina Jolie announced she had undergone a double mastectomy, though she had not been diagnosed with breast cancer. She additionally had her ovaries and fallopian tubes removed in an effort to avoid ovarian cancer. In her New York Times op-ed she advocated for universal access to gene testing for women who may have a family history of breast or ovarian cancer and a possible BRCA gene mutation. She addressed having to grapple with her mother’s nearly decade-long battle with cancer and come to terms with her inherited risk for developing breast (estimated at an 87 percent risk) or ovarian (estimated at a 50 percent risk) cancers.
Today one-in-eight women in the United States (approximately 12 percent) will develop breast cancer in her lifetime. Women at risk for breast cancer or those who have been diagnosed with breast cancer, while they face a difficult decision with regard to surgery, now more than ever have many strong options for treatment.
Golshan’s research was published on Friday in Annals of Surgery, a monthly journal comprised of original articles in the field of surgery.
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