There may be little to no survival benefit for most women with breast cancer to have their healthy breast removed as well, new research indicates.
Many women with cancer in one breast have been electing to have the second breast removed (prophylactic mastectomy) out of precaution, but this new study finds that over 20 years, the survival benefit between women who’ve had a the second breast removed and those who kept their healthy breast was less than 1 percent, HealthDay reported.
“We found fairly convincing evidence that there really is no meaningful long-term survival benefit for the vast majority of women with breast cancer by having their opposite breast removed,” study researcher Dr. Todd Tuttle told HealthDay. Tuttle, the chief of surgical oncology at the University of Minnesota School of Medicine, said the research shows that most patients have very minimal increases in life expectancy (1-7 months) by choosing to have the second breast removed.
Younger women with stage I, estrogen receptor-negative breast cancer saw the biggest increase in survival rate from having the second breast removed, but even that was minimal. The survival difference between those who had the surgery and those who didn’t was still less than 1 percent over 20 years, the study found.
The study, published in JNCI: Journal of the National Cancer Institute, did not include women who had BRCA-1 and BRCA-2 breast cancer. According to HealthDay, these genes greatly increase a woman’s risk of breast and ovarian cancer. Because of this increased risk, women are often offered preventive surgeries to remove the breasts and the ovaries.
For the study, researchers analyzed more than 100,000 women with stage I or stage II breast cancer to track survival over 20 years. Tuttle’s team then used a model to simulate survival results in women who had prophylactic mastectomy and those who did not, HealthDay reported.
Other factors, such as surgical complications or quality of life were not taken into account. Previous studies have suggested that women’s motives for having the second breast remove revolve around fear of the cancer spreading. One study of women age 40 and under with breast cancer who chose preventive mastectomy found that 94 percent of the women said they wanted to increase survival, yet only 18 percent thought the procedure would actually do that, HealthDay reported.
Tuttle said women who have the procedure for a peace of mind are giving themselves a false sense of security. He said that while women who have had breast cancer in one breast are at increased risk of developing cancer in the opposite breast, the probability of developing cancer in the second breast is about 4 or 5 percent over the next 10 years, HealthDay reported.
Sources and More Information
- Prophylactic Mastectomy does Little to Improve Breast Cancer Survival Rate, SideEffectsLawSuitsNews, archives, July 18th, 2014.
- Removing Healthy Breast of Little Benefit to Breast Cancer Patients: Study, HealthDay, breast-cancer-news-94, Jul 16, 2014.
- Marginal Survival Benefit After Contralateral Prophylactic Mastectomy, Medscape Medical News Oncology, viewarticle/828411, July 16, 2014.
- The harms and benefits of modern screening mammography, BMJ 2014; 348:g3824, 17 June 2014.
- Survival Outcomes After Contralateral Prophylactic Mastectomy: A Decision Analysis, Oxford JournalsMedicine & Health JNCI J Natl Cancer Inst Volume 106, Issue 810.1093/jnci/dju160 – Full PDF – May 12, 2014.
- Assessing Mammography’s Benefits and Harms, Oxford JournalsMedicine & Health JNCI J Natl Cancer Inst Volume 106, Issue 410.1093/jnci/dju103, March 31, 2014.
- Perceptions of contralateral breast cancer: an overestimation of risk, NCBI, Dr. Todd Tuttle, PMID: 21947590, 2011 Oct;18.