Double Mastectomy and Inherited Breast Cancer
Study found procedure might cut risk of death in half for those with certain genetic mutations
"It's a very personal decision," said Michels, who wrote an editorial on the study. "I think we cannot just say, 'Here are the statistics: It's a no-brainer.' I think it's not a no-brainer."
For one thing, Michels said, the study was small. It was also an observational study -- not the preferred double-blind, placebo-controlled study. There may have been important differences between the study groups that researchers weren't able to account for, and those differences may have played a bigger role in survival than their choice of surgery.
"If we have more and larger studies, they will probably confirm these results, but it's a little premature to say this," Michels said. "It's good evidence, but it's not superb evidence."
For those who aren't ready to part with both breasts, experts say there are other options.
"We get a lot of women who are diagnosed, and they're young and they get sent to us for fast-turnaround BRCA testing so they can make treatment decisions," said Dr. Mary Daly, chairwoman of cancer genetics at Fox Chase Cancer Center in Philadelphia. "At a time of so much emotion and chaos, I'm not sure they always make the best decision."
"This article sort of shows you that if you're not quite ready to make that decision at the time of the initial diagnosis, you can still go back and remove the other breast later and it probably will still be effective," Daly said.
Only 44 women in the study had both breasts removed at the same time. Another 137 women chose to have their unaffected breast removed at a later date. On average, women removed their second breast about two years after their diagnosis.
Beyond removal of the breasts, Daly said there are other treatments that can help women with BRCA mutations. Those include removal of the ovaries, which also decreases the chances of breast cancer; preventive medications such as tamoxifen; and intensive monitoring with yearly mammograms and MRIs.