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Considering Contralateral Prophylactic Mastectomy?

Posted Mar 26 2010 8:10am
Contralateral prophylactic mastectomy is a procedure where a breast cancer patient has the opposite, unaffected breast removed in hopes of reducing their risk of developing cancer in that breast.  This procedure is becoming more and more common among breast cancer patients.  Various studies have reported increases in the use of this procedure since the 1990's.  One study reported that only 6.5% of patients chose this option in 1999, but that increased to 16% in 2007.  Another study reported that 30% of breast cancer patients in one hospital opted for contralateral prophylactive mastectomy in 2006-2007.  This increase is happening despite the fact that the benefits in regards to preventing recurrence or increasing survival are uncertain.  An excellent editorial published in October 2009 discusses these trends in more detail.

A new study presented at the 7th European Breast Cancer Conference a couple of days ago examined why patients typically request contralateral prophylactic mastectomy.  In this study, the breast cancer researcher questioned 27 patients in 2008 and 2009 about their choice for contralateral prophylactic mastectomy.  After these interviews, the women were offered a "cooling off" period of 12 months (while receiving their standard breast cancer treatments) to give their choice further consideration.  The breast cancer researcher reported that
  • All of the patients believed that they would not survive beyond 5 years.
  • All of the patients also overestimated their risk of breast cancer developing in their opposite, unaffected breast.
  • This overestimation was at a rate of 5 - 10 times more than their actual calculated risk.
  • After the 12-month "cooling off" period, all of the women felt less anxious about their chances of developing future breast cancer and 23 of the 27 patients chose not to have the contralateral prophylactic mastectomy.
This study lends some insight into the rising use of this breast cancer treatment option.  A diagnosis of breast cancer is a scary and very stressful situation.  This study suggests that the stress involved might lead to an increased perception of being at high risk for developing cancer in the opposite breast.  The women in this study requested this procedure for a variety of reasons including being young, having lobuluar cancer, low risk family history, and previous bad experience in family members or friends.  Some of these reasons are commonly seen.  Women choosing contralateral prophylactic mastectomy have been reported to generally be: young (< 40 years), more educated, have larger tumor size, more likely to have a family history, and have lobular histology.  The results of this new study show the importance of providing breast cancer patients with adequate counseling regarding their actual risk of recurrence and treatment options and be offered an opportunity to fully consider their options and choices.  If you want to read the full study abstract, you can search the meeting abstracts for it using the author's name (Sahu).

Breast cancer awareness and education are vital parts of our fight against breast cancer.  Without adequate breast cancer awareness, it is even more difficult to make necessary decisions.  My book, Fight Now: Eat & Live Proactively Against Breast Cancer ( www.fightBCnow.com ) is a great way to increase your breast cancer awareness of ways to reduce your personal risk of breast cancer.
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