Preventive Mastectomy Does Not Improve Five-Year Survival In Most Breast Cancer Patients, Study Finds

Main Category: Breast Cancer
Article Date: 02 Mar 2010 - 1:00 PDT

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A preventive mastectomy of a healthy breast does not increase survival rates in most women with cancer in the other breast, although the procedure might prolong survival in a specific subset of patients, according to a new study from researchers at MD Anderson Cancer Center, Time reports. Although previous research has shown that double mastectomy lowers the risk of breast cancer recurrence, the new study is the first to conclude that the procedure is unnecessary for many women, according to Time.

Isabelle Bedrosian, the study's lead author and an assistant professor in MD Anderson's surgical oncology department, said, "We have not had real data to guide us." She added, "We can't sit down with a woman and say, 'If you do this, this is your expected benefit.' And when we don't have those data, then biases become the big drivers of decision making." According to Bedrosian, many physicians and women err toward surgery to be cautious, which has fueled a trend toward unnecessary procedures. Time reports that the rate of double mastectomies rose by 150% from 1998 to 2003.

The study involved 107,000 women undergoing mastectomy for breast cancer. Only patients younger than age 50 with early-stage cancer and estrogen-receptor negative tumor experienced an improvement in their chance of five-year survival -- a group that represents less than 10% of breast cancer patients. The study found that women in this group had a 4.8% increased chance of surviving five years, compared with women who did not have a preventive mastectomy. Bedrosian said, "We hope this study helps women make better decisions," adding that the results "provide some reassurance that perhaps a (preventive) mastectomy is not necessary, perhaps overly aggressive and perhaps a bit too much."

Some experts said the findings were too preliminary to apply to clinical practice. George Sledge, president-elect of the American Society of Clinical Oncology and a professor of medicine at Indiana University, said that factors other than mastectomy could have affected women's survival rates in the study. Women who choose a double mastectomy "may be overall healthier in that they see their physician more frequently, and their physician may be more aggressive in treating their cancer in terms of what chemotherapy they use," he said (Park, Time, 2/25).

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