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    Breast Removal Slashes Risk of Cancer in High-Risk Women

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    Hartmann says there are other options for these women such as close follow-up and medication. She adds that surgery is not the choice most women make. A study by researchers at Johns Hopkins University in Baltimore found that when 160 women with family histories of breast cancer were asked about prophylactic mastectomy "two-thirds of them said they wanted to discuss it, but only 14 or 10% went on to have the surgery. That's about the rate that we see."

    She says, however, that the surgery remains controversial. "Opponents argue that, as a solution, it is too extreme," Hartmann says. Proponents of the surgery, on the other hand, say, "if it reduces risk, where is the question?" She says that there are many factors that influence a woman's decision to chose the surgery but the strongest is "family. If a woman has a family, has children, she is more anxious to take some action that assures her she will be there for her family."

    Hartmann says that almost all women undergoing the procedure opt to have reconstructive surgery involving breast implants at the same time.

    Although Hartmann says she doesn't know the cost of preventive mastectomy, she says the women are typically hospitalized for five days. She says, too, that insurance companies had originally balked at paying for the procedure, claiming it was an unproven or experimental procedure. With the publication of the earlier study from the Mayo Clinic that found prophylactic mastectomy yielded a 90% reduction in risk for women with strong family histories, insurers are now agreeing to pay for the procedure, she says. "The insurers recognize that it is expensive, but not as expensive as treatment for breast cancer."

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