Countless women are getting breast removal surgery today. Many researchers are saying that such precautionary measures are probably being taken much too early for many women.

Why are more and more women getting breast removal surgery so early?

Reuters reports on new research that shows that removal rates for early cancers are increasing across the United States. Numerous women are taking this step out of fear that the cancer will progress or eventually come back (relapse).

The study shows that women electing to get their breasts removed for early cancers instead of getting breast-conserving procedures are at an all time high.

Which choice is the right one?

This group of researchers is not saying that either choice is wrong or right. “But they point to a recent 34 percent rise in the likelihood a woman will opt for total breast removal as a trend that needs further study to make sure women are being well informed about their risks,” according to Reuters.

What has been the evolutionary trail of breast cancer related surgeries?

Originally the complete removal of a breast, known as a mastectomy, was common until the 1980s. But then by the early 1980s research at that time produced the lumpectomy, which is the removal of just the tumor in the breast. It is said to provide an outcome equivalent to a mastectomy. This is said to be particularly true for early cancers.

How was the study conducted?

Researchers utilized data on 1.2 million women who had surgery for early-stage breast cancer between 1998 to 2011. These numbers came from the National Cancer Data Base, which captures about 70 percent of newly diagnosed cancers in the United States.

What were the results?

Reuters reports, “The percentage of women who were eligible for lumpectomy but chose mastectomy increased from about 34 percent in 1998 to about 38 percent in 2011. The odds of women choosing mastectomy rose by about 34 percent between 2003 and 2011. Rates of breast reconstruction increased from 12 percent in 1998 to 36 percent in 2011. Rates of removal of both breasts when only one was found to have cancer rose from 2 percent in 1998 to about 11 percent in 2011.”

When do women most commonly get a mastectomy?

Researchers found that the rise in mastectomy rates is largely attributable to cases where a woman has both breasts taken out after cancer is found in one breast and cases of mastectomy with breast reconstruction. Women in the U.S. have one small benefit, which is that the U.S. requires insurers to pay for reconstruction after a mastectomy.

The researchers looked into whether tests over the BRCA gene are attributable to why the number of mastectomies being conducted has gone up. But surprisingly, they found that these gene tests are not one of the catalysts driving the increase in mastectomies. “Earlier this year, a study also published in JAMA Surgery found 94 percent of women who chose lumpectomy between 1998 and 2008 had not died of breast cancer after 10 years, compared to 90 percent of women who chose mastectomy,” according to Reuters.

Researchers found that it is largely attributable to doctor recommendations, patient concerns, use of breast MRIs and desire by the patient for breast symmetry. Women who do not have genetic risk factors also tend to overestimate the risk of cancer developing in their second breast.

Dr. Bleicher from Fox Chase Cancer Center in Philadelphia told Reuters, “At least in my personal experience, there is this predisposition out of fear and talking to friends that bigger treatment is better.”

Some doctors also believe that many physicians over-recommend the surgery possibly due to the financial gains that stand to be obtained. A mastectomy is a longer and more expensive operation than a lumpectomy.

Dr. Kummerow, from Vanderbilt University School of Medicine, led the study.

She issued a statement saying, “We don’t know what’s going to be happening in the future, but it’s important for patients, providers and policymakers to know that this is our current trajectory. It’s hard to say what’s going to happen. If the trajectories are going to continue or if it’s going to flatten out.”

 

Gerry Oginski
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NY Medical Malpractice & Personal Injury Trial Lawyer
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