The study found that over a 10 year period, rates of Contralateral Prophylactic Mastectomy (CPM), in patients who had previously been diagnosed with breast cancer, tripled, despite no long-term benefits compared with women who kept their healthy breasts.
Researchers analysed data from a group of nearly 500,000 women with a unilateral stage-one to stage-three breast cancer diagnosis.
They noted that while CPM may have a survival benefit for patients that are at high-risk of developing breast cancer, such as those with a genetic mutation, the majority of women undergoing CPM are at low risk for developing breast cancer in the unaffected breast.
The study showed that women who are diagnosed with cancer in one breast are increasingly unlikely to be diagnosed with cancer in the other breast.
“Patients and caregivers should weigh the expected benefits with the potential risks of CPM including prolonged recovery time, increased risk of operative complications, cost, the possible need for repeat surgery, and effects on self-image,” says senior author, Mehra Golshan, MD, Distinguished Chair of Surgical Oncology at Brigham & Women’s Hospital.
Krystal Barter, founder of Pink Hope – Australia’s only community designed to inspire women to be proactive about their breast and ovarian health – says women often opt for a double mastectomy for ‘peace of mind’.
“[I] don’t think that women should remove a healthy breast without consideration,” says Krystal, who underwent a preventative double mastectomy at age 25 after inheriting a gene fault. “It is an emotional decision.”
One in eight Australian women will be diagnosed with breast cancer in their lifetime and Australian Government statistics show that women with faults in their BRCA1 and BRCA2 genes (genes that promote the growth of DNA repairing proteins) have an estimated 30 to 60 per cent risk of developing breast cancer with a 50 per cent chance of passing that gene on to family members.
Extensive research has uncovered that patients at high risk of developing breast cancer through a mutation of the BRCA1 and BRCA2 genes may benefit from prophylactic (preventative) surgery, however, the majority of women at low risk gain little from removing a healthy breast.
Other physiological effects, as well as a desire to appear symmetrical after a mastectomy and after reconstructive surgeries can also have a large impact in the decision to undertake CPM.
Krystal’s mother, grandmother, and great-grandmother were diagnosed with the disease early in life, and genetic testing revealed her family carries the BRCA1 gene fault. “The complexities that women face are so much more than a black and white, on paper diagnosis,” says Krystal.
More recently, Krystal has undergone additional preventative surgeries, having her fallopian tubes and one ovary removed to further reduce her cancer risks.
Krystal shared the same gene fault as Angelina Jolie, who’s very public mastectomy journey has increased the conversation about hereditary cancer risks in many families. In spite of that, Krystal says it can be very easy to get caught up in the ‘Angelina effect’.
She says it’s important for women to rely on advice from their doctor and focus on doing what is best for them.
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