Study Finds Bilateral Mastectomy Decreases Cancer Risk But Does Not Improve Survival Rates

July 25, 2024 TruthUSA

A new study has revealed findings that may impact decision-making for women undergoing breast cancer surgery.

The research shows that while bilateral mastectomy can reduce the risk of cancer in the opposite breast, it does not improve overall survival rates. This challenges the idea that more aggressive surgery leads to better long-term outcomes for women with unilateral breast cancer.

Study Details

Researchers from the Women’s College Hospital in Toronto examined the long-term effects of different surgeries for women with cancer in one breast. They sought to determine if bilateral mastectomy (removal of both breasts) provides a survival advantage over lumpectomy (removal of the tumor and surrounding area) or unilateral mastectomy (removal of one breast).

Using data from a large cancer registry, the study focused on women diagnosed with early to mid-stage breast cancer in one breast between 2000 and 2019. A total of 661,270 women participated, with an average age of 58.7 years.

The women were categorized into three groups based on their initial surgery: lumpectomy, unilateral mastectomy, and bilateral mastectomy. To ensure comparability, 36,028 women in each group were matched by age, tumor stage, and estrogen receptor status.

Participants were followed for 20 years to track the development of cancer in the opposite breast and breast cancer mortality. The researchers also collected data on treatments like chemotherapy and radiotherapy.

Over the 20-year period, 766 women with lumpectomies, 728 with unilateral mastectomies, and 97 with bilateral mastectomies developed cancer in the opposite breast. Women who underwent bilateral mastectomy had a significantly lower risk of developing cancer in the opposite breast, with only 1 out of 370 affected, compared to approximately 1 out of 15 with lumpectomies and 1 out of 50 with unilateral mastectomies.

“Breast cancer mortality rates were similar in patients who underwent lumpectomy and bilateral mastectomy,” noted study author and cancer epidemiologist Vasily Giannakeas to The Epoch Times.

Trends in Bilateral Mastectomies

Many women diagnosed with breast cancer choose double mastectomies. A 2017 study published in the Annals of Surgery revealed that the number of women opting for this procedure more than tripled from 2002 to 2012, increasing from 3.9 percent to 12.7 percent.

The study, which analyzed data from 496,488 women with unilateral invasive breast cancer, found that despite the surge in double mastectomies during that period, there was no significant improvement in long-term survival compared to less extensive surgeries.

Another 2017 study published in JAMA Surgery indicated that nearly half of women diagnosed with early-stage breast cancer considered a double mastectomy, with about one in six opting for the procedure. The study, involving 2,578 women, showed that while 44 percent contemplated contralateral prophylactic mastectomy, only 38 percent were aware that it does not improve survival for all women.

Recent research, published in the American Journal of Surgery in 2023, explores these trends further. This study revealed that bilateral mastectomy rates rose from 5.6 percent in 2004 to 15.6 percent in 2013 but have since dropped to 11.3 percent in 2020. The decline was consistent across all racial groups, indicating a potential shift in surgical decision-making.

While the initial increase in bilateral mastectomies suggested increasing popularity, the recent decline may reflect a better understanding of the limited survival benefits compared to less extensive surgeries.

Implications for Patients and Health Care Providers

The findings of the study hold significance for patients and healthcare providers. Dr. Sowden emphasized the importance of understanding the pros and cons of different surgical options for women with unilateral breast cancer.

When faced with a breast cancer diagnosis, patients may find it challenging to grasp this complex information while navigating through their emotions. The common belief that more aggressive surgery is more effective in fighting the disease might not necessarily apply to breast cancer.

“Education plays a crucial role in the initial patient visit. It’s like dispelling myths because many patients think that removing the breast is the safest option that will extend their life,” Dr. Sowden explained. “Patients need to comprehend the benefits and limitations of surgery. Opting for a mastectomy may seem like a way to eliminate anxiety, but it’s essential to understand that the recurrence rate is not zero,” she added.

Healthcare providers can use the study findings to facilitate discussions with patients about their treatment choices. By emphasizing personalized care, they can help patients weigh the benefits of reducing cancer risk against the lack of survival advantages, enabling more informed decisions aligned with patients’ values and preferences.

Study author Mr. Giannakeas shared a personal anecdote to illustrate the complexity of surgical decisions. While their study did not delve into the quality of life related to surgery selection, Mr. Giannakeas mentioned that other research indicates that women opting for bilateral mastectomy often experience a sense of relief.

Referencing his own mother, who was diagnosed with breast cancer seven years back, he recounted, “Ultimately, she chose to undergo a bilateral mastectomy due to the fear of potentially facing another diagnosis and treatment in the future.” He believed that this decision offered her peace of mind that breast-conserving surgery could not.

“Every cancer patient brings their unique biases and beliefs, which we must address for both them and their families. The aim is to ensure that each patient feels confident and comfortable with the decision they ultimately make,” Dr. Sowden stated. “It’s a deeply personal decision, and my role is to support them in making the choice that suits them best.”

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