More women under 40 choosing double mastectomy to prevent recurrence of cancer

Researchers have known for some time that a small but growing number of women with breast cancer are choosing a double mastectomy, even when they have other less radical options.

A study published earlier this year by Dr. Todd Tuttle at the university found that while the vast majority of women with the early cancer, known as ductal carcinoma in situ (DCIS), choose to have only the cancerous tissue removed, a growing number are opting for double mastectomies. Between 1998 and 2005 the number who chose the more aggressive option rose from 2.1 percent to 5.2 percent, a 148 percent increase, he found.

While a double mastectomy greatly reduces the risk of cancer occurring in the other, healthy breast, it does not improve breast cancer survival rates, research has shown.

In this new study, Tuttle looked at the records of 571 Minnesota breast cancer patients at six of the Fairview Health Services Hospitals, including the University Medical Center. The group included women between 18 and 80 years who had breast cancer surgery for invasive breast cancer or DCIS in 2006 and 2007.

About half had surgery to conserve the cancerous breast, a third had a mastectomy to remove the breast. A total of 92 had a double mastectomy, he found.

Those who chose the double mastectomy were more likely to be young, and have larger tumors. Though there were only three surgeons out of 23 who were women, their rates of doing double mastectomy surgeries were 46 percent compared with 23 percent for male surgeons.

Tuttle said in the study that since there were so few women surgeons in the study, the findings were not conclusive. It could be, he said, that patients who want aggressive treatment may be more likely to choose female surgeons.

"Several other research studies have established that the surgeon is a critical factor contributing to the decision of surgical treatment for breast cancer," he said. "However, it was not clear in our study whether female surgeons recommend (double mastectomy) more often than their male counterparts, or if patients diagnosed with breast cancer may be more receptive and comfortable talking about (it) with a female surgeon," he said.
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