A popular treatment for breast cancer, a double mastectomy, might not increase breast cancer survivability, but it’s not all bad news.
Double mastectomies involve surgically removing both breasts to prevent cancer from returning and spreading. A new study published Thursday in JAMA Oncology found that the procedure helps prevent the development of breast cancer but might not increase patients’ survival rate.
After analyzing data from over 661,000 women diagnosed with cancer in one breast between 2000 and 2019, researchers observed that women who underwent a lumpectomy or a mastectomy had only a 7% chance of developing contralateral breast cancer or cancer in the other breast. However, researchers also found that removing the other breast via a double mastectomy did not increase survivability.
The cases ranged from non-invasive stage zero breast cancer to stage 3 invasive breast cancers. Over the study’s 20-year period, researchers observed that deaths from breast cancer were around the same in all groups: 8.5% for women who had lumpectomies (removing breast cancer while leaving most of the breast intact), 9% for women who had mastectomies (removing a breast), and 8.5% for women who had double mastectomies.
More findings indicated that over 80% of women did not die from breast cancer after 20 years of follow-up, regardless of which surgery they underwent. However, the paper also showed that women who later developed breast cancer in the other breast had a four-fold higher risk of death.
“That seems like a paradox,” said lead author Dr. Steven Narod, a breast cancer researcher and physician at Women’s College Hospital in Toronto. “If you get a contralateral breast cancer, your risk of dying goes up. But preventing it doesn’t improve your survival.”
Narod and other experts do not think the findings should be used to impact patients’ decisions regarding the procedure. He thinks the findings raise “key” scientific questions about breast cancers that develop in the opposite breast and how breast cancer spreads and kills.
Next to skin cancer, breast cancer is the most common form of cancer to develop in women in the United States. According to the American Cancer Society, it accounts for about 30% (or 1 in 3) of all new female cancers each year. The organization estimates that this year alone, roughly 310,720 new cases of invasive breast cancer will be diagnosed in women, around 56,500 new cases of ductal carcinoma in situ (DCIS) will be diagnosed, and nearly 42,250 women will die from breast cancer.
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While Black women in the U.S. have a 4% lower incidence rate of breast cancer than white women, they have a 40% higher breast cancer death rate than their white counterparts.
Early detection, awareness of family history and preventive lifestyle choices are among the clearest paths to prevention and survivability. A person has a 99% chance of surviving if breast cancer is detected early. Physicians like Dr. Tracy-Ann Moo, a breast surgical oncologist at the Memorial Sloan Kettering Cancer Center in New York, also encourage individuals to develop “breast self-awareness” to be aware of when there are any noticeable changes to their breasts.
“Instead of having this regimented [self-breast exam] of your breast once a month — this position, that position — it’s really just being more aware of your breasts and how your breasts feel,” Moo told theGrio.
