October 23, 2007 in Nation/World

More cancer patients having both breasts removed

Josephine Marcotty (Minneapolis) Star Tribune
 

At a glance

The number of women choosing to have both breasts removed when they had cancer on one side increased from 1.8 percent in 1998 to 4.5 percent in 2003.

The risk of developing cancer in the second breast is less than 1 percent.

MINNEAPOLIS – A growing number of women diagnosed with cancer in one breast are opting to have both breasts removed to reduce the odds of the cancer coming back and gain some peace of mind.

A study by a University of Minnesota researcher found that over a six-year period the number of women choosing that aggressive approach increased by 150 percent – even though statistically the risk of developing cancer in the second breast is less than 1 percent. It’s far more common that cancer will spread to other parts of their body, experts said.

“What I hear frequently is, ‘I just want to be done with it,’ ” said Dr. Todd Tuttle, a breast cancer surgeon at the University of Minnesota and one of the authors of the study published Monday in the Journal of Clinical Oncology.

“Being diagnosed with breast cancer has to be one of the most stressful events in a woman’s life, and they don’t want to repeat that again.”

The research is significant because it comes at a time when cancer surgeons are trying to do less surgery, not more. That shift is driven by advances in drug treatments that can prevent new cancers, imaging technology that can detect tumors early, and a better understanding of the risks and disfigurement of surgery.

The researchers found that between 1998 and 2003 the number of women who opted for a double mastectomy, though quite small, increased at a rapid rate. They used a database that provides information on a fourth of the cancer patients in the United States.

During the six years about 153,000 women were diagnosed with breast cancer on one side and treated with surgery. The majority had either a lumpectomy, in which part of the breast is removed, or had the affected breast removed.

But the number choosing to have both breasts removed when they had cancer on one side increased from 1.8 percent in 1998 to 4.5 percent in 2003. Tuttle thinks that the rate has continued to climb.

Women younger than 40 were much more likely to choose a double mastectomy than those in their 70s; an average of 6.7 percent compared with 1.3 percent, the study showed. Tuttle said younger women were more likely to choose the more aggressive approach because they still had long lives in front of them.

Dr. Lynn Hartmann, a breast cancer researcher at the Mayo Clinic, said that for younger women a double mastectomy might be appropriate. Many who have cancer at a young age are at high risk for carrying the breast cancer gene. About 5 percent to 10 percent of women who get breast cancer do carry the gene, she said. For them, the risk of recurrence in the other breast is quite high, she said.


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