Research reveals prophylactic mastectomy is on the rise

A new study of New York State data finds that the number of women opting for surgery to remove the healthy breast after a cancer diagnosis in one breast is rising, despite a lack of evidence that the surgery can improve survival. The study also finds that despite extensive press coverage of women who choose to have both breasts removed because of a strong family history of cancer, the rate of this surgery is relatively low and has changed little in the last decade. The study appears in CANCER, a peer-reviewed journal of the American Cancer Society.

Prophylactic mastectomy, the removal of a noncancerous breast, is one method for reducing a woman's risk of developing breast cancer; however, there is little information available on the prevalence of prophylactic mastectomies for preventing breast cancer among high-risk women or on the prevalence of the surgery to prevent tumors in the healthy breast among women whose cancer is limited to one breast.

Researchers led by Stephen B. Edge, M.D., FACS, of the Roswell Park Cancer Institute in Buffalo, NY, examined the frequency of prophylactic mastectomies in New York State between 1995 and 2005 using mandated statewide hospital discharge data combined with data from the state cancer registry. They identified 6,275 female New York residents who underwent prophylactic mastectomies. Eighty-one percent of the women had been diagnosed with cancer in one breast, while 19 percent had no personal history of breast cancer.

The researchers found that the number of prophylactic mastectomies increased during the time period, particularly among women with cancer in one breast. Over the 11-year study period, the prevalence of these contralateral mastectomies more than doubled. The prevalence of bilateral prophylactic mastectomies among women with no personal history of breast cancer increased only slightly.

"These data from New York are the only data on a large population of women that examine the use of bilateral prophylactic mastectomy," said Dr. Edge. "These data demonstrate that prophylactic mastectomy is an uncommon procedure that is performed most commonly on women with a personal history of breast cancer. Although the total number of prophylactic mastectomies performed per year was small, it appears that the use of the surgery is increasing." In addition, he noted that women with breast cancer should have careful counseling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.