Recent research has shown that despite more having more treatment options, women with cancer in one breast are increasingly choosing to remove both breasts —even though experts in the field say the procedure is not necessarily accompanied by better outcomes.
Now, a new study published Wednesday in JAMA Surgeryfinds that the increase is being driven in part by their surgeons.
Doctors generally discourage contralateral prophylactic mastectomy—also known as CPM, or the removal of a healthy breast when the other has cancer—for women at an average risk for additional breast cancer. They do recommend it for women at a higher risk, like those with a BRCA gene, which greatly increases the risk of getting the disease. Even so, the rate at which women with cancer in one breast choose to remove both has increased nearly six fold from 1998 to 2011, largely among younger women with early-stage unilateral breast cancer and without genetic risk factors—in other words, women who are candidates for less aggressive treatment.
Survival for these women isn’t higher than it is for women choosing less aggressive options like lumpectomy. Also called breast-conserving surgery, only a portion of the affected breast is removed. A March 2016 study of 4,000 women who had breast cancer surgery also found that removing both breasts did not markedly improve a woman’s quality of life in terms of breast satisfaction and their physical, psychosocial and sexual wellbeing.