The Journal of Clinical Oncology reports a 150 percent increase between 1998 and 2003 in American women opting to have both breasts removed when cancer has been found in only one breast - a procedure called contralateral prophylactic mastectomy (CPM). But the researchers behind the study caution that this aggressive strategy may be unnecessary since most patients will never develop cancer in the second breast. "Although breast cancer is now often diagnosed at earlier stages, we're seeing more women having contralateral prophylactic mastectomy, even though there are very little data showing that this irreversible procedure improves overall survival," explained study author Todd M. Tuttle, of the University of Minnesota. "We need to determine why this is occurring and use this information to help counsel women about the potential for less invasive options."
Tuttle proposed several potential reasons for the increase in the rate of CPM. There is more public awareness of the genetics of breast cancer and more frequent testing for mutations in BRCA genes, which increase contralateral breast cancer risk (although this study did not examine patients' BRCA status). Moreover, less invasive mastectomy approaches and improved breast reconstruction techniques may persuade more women to have both breasts removed at the same time.
He also warned that women often make the decision to have CPM quickly and at a vulnerable time. Instead, women may benefit from treating just the known breast cancer first and thinking about other options later, after their treatment is completed.
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Source: Journal of Clinical Oncology
