Sept. 19, 2000 -- Breast-reduction surgery can reduce a woman's risk of breast cancer, especially if she is over 50, according to a study published in the journal Plastic and Reconstructive Surgery. But experts interviewed by WebMD say that this alone is not a reason for most women at high risk for breast cancer to have the surgery.
"If a woman is seriously considering the reduction of tissue in her breast because she is very concerned about the likelihood of developing breast cancer, she should know that partial removal -- as opposed to completely removing the entire breast -- results in a meaningful reduction in risk," says John D. Boice Jr., ScD, the study's author.
But he adds that his study results do not necessarily apply to everyone and that each woman should discuss the risks and benefits of such surgery with her physician.
For the study, Boice, who is scientific director at the International Epidemiology Institute in Rockville, Md., and colleagues studied health records of nearly 32,000 Swedish women, with a median age of 33, who had undergone breast-reduction surgery. The women's cases were followed up for an average of eight years.
Based on statistical estimates, the researchers expected to find 224 cases of breast cancer in this group, but instead they found 161 -- 28% less than expected. The gap was even bigger for women who were over 50 when they had the breast-reduction surgery: The researchers found 43% fewer cases of breast cancer than expected in this group.
That result is not entirely surprising, says Arthur Michel, MD, director of the breast center at Highland Park Hospital in Highland Park, Ill. "This may just be due to the fact that you reduce the risk by [simply] removing the tissue," he says. "I think that's nice to know." Michel was not involved in the study.
Stephen Edge, MD, chief of breast surgery at the Roswell Park Cancer Institute in Buffalo, N.Y., says breast-reduction surgery should not be considered as a way of reducing breast cancer risk. "If someone has a very high breast cancer risk and you're going to do surgery on her, that surgery [should be] removal of all breast tissue," says Edge, who reviewed the study for WebMD.
On the other hand, the news that breast-reduction surgery may reduce the risk of breast cancer should be comforting to women who are already considering the surgery for other reasons, such as pain from breasts that are too large. But the issue of breast cancer risk "should not factor heavily into the decision of whether to have the surgery," Edge says.
Michel agrees that breast reduction should not be seen by itself as a method for reducing a woman's risk of getting breast cancer. "Here's a procedure that's a big operation and going to reduce the risk by 28%," he says. "But if you take a 50-year-old woman and put her on tamoxifen, you can reduce her risk of breast cancer by 50%. And that's a lot less invasive and less expensive, even though tamoxifen is an expensive drug."
The reason older women saw a greater reduction in their cancer risk after the surgery may have something to do with the study's relatively short follow-up period, the researchers note. "Because the rates of breast cancer remain low until the later years of life, a protective effect of breast tissue removal may take longer to become evident in younger women."
All in all, "this study is reassuring," Boice tells WebMD. "It means that removing meaningful proportions of the breast does in fact lower your risk of breast cancer appreciably."