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    More Women Choose to Remove Noncancerous Breasts

    Study: Prophylactic Mastectomy Increasing as Acceptance of Procedure Grows

    Prophylactic Mastectomy: No Improvement in Survival Rate

    Despite dramatically lowering chances of future breast cancers from developing, prophylactic breast removal has not been shown to cut down a woman’s chances of dying from breast cancer – a distinction that study author Stephen B. Edge, MD, FACS makes to caution patients against choosing the surgery without careful consideration.

    “Unfortunately, the cold hard fact is that the threat to their life comes from the cancer that they already have,” says Edge, who heads the department of breast surgery at Roswell Park Cancer Institute in Buffalo. He remarks that he is heartened to find it still relatively uncommon for women with no past breast cancers to undergo double mastectomies, in light of recent media coverage of celebrities who choose the dramatic procedure.

    Women who are considering removing a healthy breast should weigh the pros and cons with the help of counseling in a breast cancer program that includes specialists in genetics, advises Edge. “People usually make good decisions when they’re well-informed,” he says.

    Both Simmons and Edge agree that the best candidate for prophylactic removal of both breasts is a BRCA-positive woman who also has a strong family history of the disease, meaning she has several first- and second-degree relatives who were diagnosed at a young age.

    The current study, published in the Sept. 28 online edition of the journal Cancer, used cancer data collected from New York state health records. The results showed that women who underwent double mastectomy to protect against further cancer development were more likely to be younger, white, and carry private health insurance than other breast cancer patients.

    Edge attributes the overall drop in mastectomy rates seen over the past two decades in the study to the high success rate of surgical lump removal -- a less invasive, relatively conservative approach compared to extracting the entire breast. He says that lumpectomy yields a survival rate similar to mastectomy.

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