Research Shows Removing Healthy Breast Does Not Improve Breast Cancer Survival, NYT Columnist Writes

March 10, 2010 — Recent studies show that more women with cancer in one breast are opting for removal of both breasts, even though removal of the healthy breast does little to improve survival rates, New York Times columnist Tara Parker-Pope writes. In 2006, roughly 6% of women who underwent surgery for breast cancer chose to remove both the cancerous and healthy breasts, a procedure known as contralateral prophylactic mastectomy, Pope says. According to a University of Minnesota study presented last week at the annual meeting of the Society of Surgical Oncology, 10% of women in their 40s who underwent breast cancer surgery chose to have both breasts removed. A 2009 study in the Journal of Clinical Oncology found that among women who had surgery for ductal carcinoma in situ -- one of "the earliest, most curable forms of cancer" -- the rate of double mastectomy increased from 2.1% in 1998 to 5.2% in 2005, Parker-Pope writes.

According to Parker-Pope, although removing two healthy breasts can reduce the risk of breast cancer in women with a genetic predisposition to the disease, "for most women given a diagnosis of breast cancer, cutting off a healthy breast does not improve the odds of survival." For example, a new study in the Journal of the National Cancer Institute examining data on 108,000 women who underwent mastectomy -- including 9,000 women who opted to remove both a healthy and a cancerous breast -- found that a survival benefit only occurred in a small group of women who were younger than age 50 and diagnosed with early-stage estrogen-receptor-negative tumors that were unresponsive to treatment with risk-lowering drugs. Isabelle Bedrosian, a surgical oncologist at M.D. Anderson Cancer Center and a study researcher, said, "Part of the reason women are frightened is we haven't given them good information," adding, "Part of my hope with this study is to tell most breast cancer patients that it's O.K. not to do this."

Parker-Pope writes that many "women who have opted for the procedure say it's not about the statistics" but about a desire to never relive the stress of undergoing a mammogram or breast biopsy. Some patients also say they have chosen to remove both breasts so their breasts are symmetrical after their operations, she adds (Parker-Pope, "Well," New York Times, 3/8).