Cancer patients choosing double mastectomy more

A growing number of women diagnosed with cancer in one breast are opting to have both breasts removed to reduce the odds of the cancer coming back and gain some peace of mind.

A study by a University of Minnesota researcher found that over a six-year period the number of women choosing that aggressive approach increased by 150 percent — even though statistically the risk of developing cancer in the second breast is less than 1 percent. It's far more common that cancer will spread to other parts of their body, experts said.

"What I hear frequently is, 'I just want to be done with it,' " said Dr. Todd Tuttle, a breast- cancer surgeon at the University of Minnesota and one of the authors of the study published Monday in the Journal of Clinical Oncology.

Present guidelines for treatment of a localized breast cancer call only for removal of the tumor and not for a mastectomy.

Researchers surmised that some women believe the health-care system did not detect their tumor early enough and that continued screening would not be effective, while others might have been traumatized by chemotherapy. Improvements in reconstructive surgery also have made a double mastectomy a more acceptable alternative.

"If they are making this decision based on fear, and thinking that it will increase their survival, then that would concern me," said Dr. Julie Gralow of the University of Washington, a spokeswoman for the American Society of Clinical Oncology.

"But if they understand that it won't necessarily improve their survival, and that emotionally it is the best thing for them, then we would have to support it," said Gralow, who was not involved in the study.

An estimated 178,480 women will be diagnosed with breast cancer this year, according to the American Cancer Society, and about 40,460 will die of it. The study is the first national look at how many women choose to remove both a diseased and a healthy breast.

Tuttle used a government cancer registry that covers 16 regions, a representative sample of the U.S. population, to track more than 150,000 breast-cancer surgeries between 1998 and 2003.

He calculated that lumpectomies accounted for almost 60 percent of those surgeries in 2003. Lumpectomies have gradually increased because they were proved just as effective as breast removal for early cancer in 1991.

The surprise: Single mastectomies remain the No. 2 option but are dropping — while double mastectomies, although uncommon, were on the rise for every stage of cancer.

Overall, the rate of double mastectomies rose from 1.8 percent in 1998 to 4.5 percent in 2003, the latest period for which data is available. Among women having a mastectomy, the proportion having the second breast removed as a prophylactic rose from 4.2 percent in 1998 to 11 percent in 2003.

This story was compiled from The Associated Press, Los Angeles Times and (Minneapolis) Star Tribune reports.