An 8-year study involving half a million American women with breast cancer, found that surgically removing diseased and healthy breasts did not increase an individual's chance of survival.
The results seem to confirm earlier suspicions that undergoing a double mastectomy, an aggressive procedure that causes emotional and physical pain, does not significantly protect against cancer recurrence.
However, a double mastectomy may be helpful for women with a strong family history of breast or ovarian cancer, and those with a personal history of radiation.
Some breast cancer patients may be undergoing mastectomies unnecessarily
The research was led by Dr. Mehra Golshan, Director of Breast Surgical Services at Dana Farber/Brigham and Women's Cancer Center in Boston, Mass. Scientists followed more than 500,000 U.S. breast cancer patients for more than eight and a half years to observe whether or not their cancer returned, reports the Daily Mail.
When a woman decides to remove a healthy breast, it is called a contralateral (opposite breast) prophylactic (preventive) mastectomy (CPM). CPM surgeries involve the removal of both breasts, including the one that contains cancer, as well as the healthy one, according to Susan G. Komen, a breast cancer awareness group.
Based on their findings, researchers concluded that while the number of double mastectomies has more than tripled in recent times, the invasive surgeries did not improve a patient's survival rate. CPM surgeries increased from just under 4 percent in 2002 to nearly 13 percent in 2012.
"Our analysis highlights the sustained sharp rise in popularity of CPM while contributing to the mounting evidence that this more extensive surgery offers no significant survival benefits to women with a first diagnosis of breast cancer," said Golshan.
The findings are major, especially considering how traumatizing it can be for a woman to have one or both of her breasts removed.
A survey of nearly 1,000 women who underwent a bilateral or CPM surgery revealed that 70 percent of them had concerns relating to reconstruction, including, "the longevity; look and feel of implants, pain, numbness, scarring, and reconstruction options."
Others said that they wished they had seen photographs to better prepare them for the final result.
Weighing benefits against the risk
"Patient and caregivers should weigh the expected benefits with the potential risks of CPM, including prolonged recovery times, increased risks of operative complications, costs, the possible need for repeat surgery and effects on self-image," Golshan said.
As ecancer.org explains, women who do not carry specific genetic mutations for breast and ovarian cancer often opt for CPM surgeries, going against current guidelines. This is primarily done out of fear.
"[T]he risk of a second primary breast tumour in the breast unaffected at the time of first diagnosis is low compared to that of distant metastases ... A small percentage of patients with specific genetic aberrations such as mutations in the breast cancer susceptibility genes BRCA1 and BRCA2 are known to be at much increased risk of a second primary tumor."
But few patients who receive CPM surgeries fall into these high-risk categories. A decision ecancer.org says is "motivated by a fear of recurrence that is entirely understandable but that is disproportionate to the actual risk.
"Most of these women could be treated very well with lumpectomy, an operation that conserves healthy breast tissue, has a shorter recovery time and fewer long term adverse effects.
"Surgeons are increasingly uncomfortable with the idea of performing extensive operations that they consider unnecessary, but are under pressure to acquiesce to patients' requests for these."