Rate of double mastectomy has sharply increased in women with early stage breast cancer

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Mammographer at WorkMore breast cancer patients are choosing to have both breasts removed (double mastectomy), even when not medically indicated, a recent study from Vanderbilt University finds. The study, led by Dr. Kristy Kummerow, and Dr. Mary Hooks, examined data from more than 1.2 million adult women treated at centers accredited by the American Cancer Society and the American College of Surgeons Commission on Cancer from 1998 to 2011, using the National Cancer Database. The study was published in JAMA Surgery.

The researchers found that the proportion of patients with early-stage breast cancer who had a mastectomy in the affected breast rose from 34 percent to 38 percent in the study period. Rates of double mastectomy when cancer had been detected in one breast increased from about 2 percent in 1998 to 11 percent in 2011. In women undergoing mastectomy, the rates of breast reconstruction increased from 12 percent in 1998 to 36 percent in 2011. The greatest increases in proportions of women undergoing single or double mastectomy and breast reconstruction surgery were seen in women with node-negative and in situ (cancer that has not spread) disease.

The study did not look into why women were choosing to undergo mastectomies. One possibility is that women are becoming more aware of the improvement in breast reconstruction options over the past two decades, suggests Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital. But another reason is fear some women may want to undergo double mastectomies as they believe it will give them a survival advantage. However, past research has found that bilateral mastectomies are not associated with lower mortality rate compared to unilateral mastectomies. Dr. Ann Partridge, an oncologist at Dana-Farber Cancer Institute, states, I tell women, recognize that you are really treating your anxiety and we have better ways to manage that.