New research suggests that using a double mastectomy as a preventive measure may not impact survival rates
Dr. Vasily Giannakeas is a scientist at the Women’s College Hospital Research and Innovation Institute, and Dr. Steven Narod is a senior scientist and director of the Familial Breast Cancer Research Unit at the institute. He is also a professor at the University of Toronto and author ofWomen with breast cancer in one breast often choose to have both breasts removed – in a procedure known as a bilateral mastectomy – just to be on the safe side.
There are many reasons why a woman will make this decision. For some, the more symmetric result of a double mastectomy, followed by the reconstruction of both breasts, is a factor. But for most patients, the decision to remove both breasts is based on the fear of the cancer coming back. They wish to avoid a second diagnosis, a second surgery and possibly more chemotherapy and radiotherapy.
Unfortunately, developing a contralateral breast cancer does raise the patient’s chance of dying from breast cancer. In our study, women with breast cancer on one side had a 20-year survival rate of 84 per cent, compared with 68 per cent for those with cancer in both breasts. For patients with ductal carcinoma in situ , the survival rate fell from 98 per cent to 87 per cent if a cancer was later diagnosed in the opposite breast.
However, we were surprised to find that a bilateral mastectomy does not reduce a patient’s chance of dying from breast cancer. In our study, among 36,028 women who had just a tumour removed, also known as a lumpectomy, there were 3,077 deaths from breast cancer. We took a look at another group of 36,028 closely matched women who chose to have both breasts removed, and found there were 3,062 deaths from breast cancer among them.
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