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Breast Cancer Health Center

Fear Prompts Some Preventive Mastectomies

Many young women with breast cancer overestimated risk of recurrence in opposite breast
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"We are not telling women what surgery to have," Rosenberg said. "We want to be sure they are making an informed decision."

Women should talk over the pros and cons with their physicians, she suggested. While 80 percent of the women said they spoke with their doctor about the reasons for having contralateral mastectomy, only 51 percent reported that their doctors talked about reasons not to have the surgery.

The findings echo some previous research, according to Sarah Hawley, an associate professor of internal medicine at the University of Michigan Health System, in Ann Arbor. In her study, presented last year at a medical meeting, Hawley found that nearly 70 percent of women choosing the contralateral prophylactic mastectomy actually had a low risk of developing cancer in the healthy breast.

"Their findings are consistent with ours, in that desire to prevent cancer in the non-affected breast is a big reason patients reported for getting [contralateral prophylactic mastectomy]," Hawley said.

Better communication is needed to be sure women know the risks and benefits, and lack of benefit of getting the preventive surgery, Hawley pointed out. Better strategies to help patients manage anxiety and worry would help, too, she added.

Women choose to have contralateral prophylactic mastectomy for a number of reasons, said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital, in New York City. She reviewed the findings.

"Although there may be no survival benefit, many women are concerned that they want to move on with their lives and want to reduce the chance of developing a cancer on the opposite breast in the future," Bernik said. They may be trying, understandably, to avoid another round of treatment in the future.

Women need to decide what is right for them, Bernik stated. "It is clear that with breast cancer surgery, one size does not fit all."

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