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More Women Having Healthy Breasts Removed From Fear of Cancer

A new study published in Cancer, the journal of the American Cancer Society, says that more women are having healthy breasts preemptively removed to prevent a recurrence of breast cancer.

The study, which studied 6,275 women from New York state, showed that the number of women who chose to have a healthy breast removed after a cancerous one doubled between 1995 and 2005.  Almost 5,000 women had the procedure, called a contralateral prophylactic mastectomy, in that time.  Dr. Stephen B. Edge, the lead author on the study, said that "We are not making a value judgement that it is good or bad.... The concern is that we have women doing this out of a gut reaction. No one is really counseling women in detail about their risk. They have a 10% to 15% chance of developing cancer in the other breast in 20 years. Most likely that cancer would be detected at a very early age. So does it warrant having the breast removed?"

A small number of women (about 100 per year in New York state) have double mastectomies before they even receive positive diagnoses because their family histories have a high prevalence of breast cancer. That number stayed stable over the eleven years of the study.

Dr. Shawna Willey, director of the Betty Lou Ourisman Breast Health Center, empasized that there's no evidence for the benefits of pre-emptive mastectomies, and that the decision is most likely driven by fear. "For a woman, it's often a knee-jerk emotional reaction when they're told they have breast cancer, especially if they're told they need to have a mastectomy.... They're facing a lot of treatment, and they're thinking they just don't want to have to deal with this in the future."

More reading: National Cancer Institute page on preventive mastectomy.

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The first I heard of this was back in the 80s when I worked for an insurance company. One of the plans covered what they referred to as "prophylactic mastectomy". If there was a history of breast cancer in the family, the plan approved and paid for this surgery. However, this was not such a horrific thing as may be imagined when seeing photos of women after complete mastectomy. In these prophylactic cases, only the tissues beneath the skin and nipple are removed and replaced with an implant. So, it became popular for those who wanted implants but could not afford them. For them, it was seen as fortunate that someone in the family actually had breast cancer! I would hope there would be no coverage for this procedure if we ever get single payer insurance in the US.

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