Study Suggests Double Mastectomy Often Done Unnecessarily


JAMA Surgery recently published the results of a study showing that most women who have a double mastectomy after a breast cancer diagnosis do so despite a very low risk of developing cancer in the healthy breast. Memorial Sloan Kettering’s Monica Morrow, Chief of the Breast Service, was one of the co-authors of the study.

Researchers looked at 1,447 women treated for breast cancer who had not had a recurrence and found that nearly 70 percent of those who received a double mastectomy did not have a medically valid reason to undergo the procedure, such as a family history of breast or ovarian cancer or a genetic test indicating increased risk for these diseases.

They note that for many of these women, worry about cancer recurrence appears to have driven the decision to have a double mastectomy, even though there is no evidence that the procedure can reduce risk.

Memorial Sloan Kettering breast surgeon Tari King talked to CBS Online about the study and the growing popularity of double mastectomy surgeries, a procedure called contralateral prophylactic mastectomy (CPM).

As Dr. King said in our recent article addressing anxiety and the public conversation’s role in the rise in CPM procedures, “There can sometimes be a disconnect between the information that women are receiving from friends and family and the information they receive from their physicians. The strongest point we can make to empower women to consider less-extensive surgery is that there is no survival advantage to CPM, and that removing a healthy breast is not better treatment.”

Watch the CBS Online video and learn more about how anxiety may be fueling more-extensive surgeries in breast cancer patients here.


Commenting is disabled for this blog post.

Dr. Morrow did my lumpectomy in July 2010, I was triple negative stage 2a. She reassured me that a lumpectomy would be a good route to go but the choice was mine. She also removed 4 lymph nodes with a small cancer starting in one. Many women I have spoken too had more than necessary nodes removed. She is a fantastic surgeon & did a beautiful job. My surgery is not obvious. There is not enough praise I can give her or my oncologist in Commack Dr. Fasano & the entire staff.

My sister had a bilateral mastectomy in April at Sloan. She had invasive carcinoma in the right breast and only needed a mastectomy on the right, and mammogram and ultrasound on the left appeared fine, but she wanted it off. Postoperative pathology showed DCIS in the left breast. She is so glad she opted for bilateral. I think unless you live it, you don't understand the psychological stress of the worrying. While the physicians are the scientists and on paper it appears unnecessary for bilateral, the reality is it provides peace of mind. And that is invaluable.

MaryEllen, I have seen the same thing occur within a member of our family. To one, it may seem unnecessary, to others, it may seem very necessary, for enhancement of their quality of life, to reduce uncertainty, etc.

Often the thought an individual may have, is that once they have gone through cancer, they don't know if they have the strength to do it again...the attitude is "Just get rid of them."

They physician is looking through it with the eyes of what is best for the medical community, the patients are looking through the eyes of what they desire and of what is best for themselves.

My double mastectomy was the best thing I ever went through. Now, I can sleep at night.

I believe that this article is about stage 1 non invasive lymph node cancer. Of course there is a good % that it wouldn't return with no family history.
Many times I have heard that if they couldn't get all the margins out, then you opt for bilateral mastectomy. I just got good news at Sloan Wed., what they thought may have turned into cancer, did not! Praise the Lord! ;)

I agree with the statement that "Study Suggests Double Mastectomy Often Done Unnecessarily". I also did my lumpectomy in April 2008 at the age of 38. I was triple negative stage 2a. The choice was mine and because there is no evidence that the procedure can reduce risk. I had a lot of lymph nodes removed, today I am experiencing lymphedema (stage 2) in my left arm. I am glad I made this decision, as I still have both my breast, 6 years in remission. Only the lymphedema that still reminds me that I had cancer at one stage in my life, not a mastectomy

I had the left Breast removed 30 years ago at Sloan Kittering Hospital. Lump in Breast Tissue . Had Mastecomy and it has never returned. KNodes were tested and showed nothing. I am one of the lucky ones. Xrays every year since and it is clear . I am 87 now and thank my lucky stars that I went to Dr. DePolo ( who is no longer at the
hospital) He advised me correctly, and then sent me home free and clean of any cancer. Thank God for the Drs at Sloan and their good judgement.

While I have not met with Dr. Morrow yet, my concerns regarding the double mastectomy vs. single are many. I know that I still need to complete the genetic testing and it's possible that I have a low-risk for family history of breast cancer. Therefore, I probably do not carry the BRAC 1 gene mutation.
However, I wonder if the research suggests that a Stage IIIa triple negative cancer patient should consider a double mastectomy in consultation with her doctor? Does anyone have any thoughts or similar experience?