More Women with Breast Cancer Opt for Removal of Both Breasts

New research from the University of Minnesota shows that more women with breast cancer opt for removal of both breasts rather than take a chance that breast cancer will spread.

Todd Tuttle, M.D., lead researcher of the study found an increase of 188 percent among young women who choose bilateral mastectomy in the earliest stages of breast cancer, between 1998 and 2005. Tuttle also wonders why women are opting to have both breasts removed for early and noninvasive breast cancer, "If there is so little convincing evidence about the benefits".

According to Dr. Tuttle, professor of oncologic surgery with the University of Minnesota Medical School and researcher at the University's Masonic Cancer Center, more women with non-invasive breast cancer, confined to the milk ducts, are choosing to have both breasts removed, even though statistics show no difference in survival rates compared to less invasive forms of breast cancer treatment.

Surgery that preserves the breast, hormone therapy and radiation for breast cancer in its early stage is associated with 98 to 99 percent survival rates. Dr. Tuttle says, “Therefore, removal of the normal contralateral breast will not improve the excellent survival rates for this group of women. Nevertheless, many women, particularly young women, are choosing to have both breasts removed."

The new study supports previous research from Dr. Tuttle showing that more women with breast cancer prefer removal of both breasts once a diagnosis of breast cancer has been made, despite the excellent prognosis associated with early ductal breast cancer.

Dr. Tuttle suggests further research to clearly define the decision making process for women who choose to have both breasts removed in very early stages of cancer, especially given the potential risks and complications, and lack of solid evidence regarding the need. He suggests that physicians have a strong influence on the increasing rates of women who opt for removal of both breasts for early non-invasive breast cancer, but there is no way to evaluate what women are told. “Patients often think interventions can improve survival, even when explicitly told they do not”, says Tuttle.

Dr. Tuttle writes “Research is important and timely because it may ultimately provide decision making tools for women and their physicians”, based on multiple factors, such as breast size, genetic cancer risks, breast density, and tumor size.

Tuttle says that women who opt for removal of both breasts in early stages of breast cancer may be doing so for cosmetic rather than medical reasons, though he does not negate the value of peace of mind.

More Breast Cancer Patients Opting For Double Mastectomies

David Goodhue - AHN Reporter

Minneapolis, MN (AHN) - The number of women in the United States opting to have double mastectomies following certain breast cancer diagnoses increased almost 200 percent between the late 1990s and 2005, according to researchers at the University of Minnesota.

Dr. Todd Tuttle, the lead researcher in the study, and a cancer surgeon, said many of these surgeries are often unneeded because survival rates in women treated for ductal carcinoma in situ - or early-stage breast cancer -- is very high.

The 10-year survival rate for women with DCIS is 98 to 99 percent," Tuttle said in a statement. "Therefore, removal of the normal contralateral breast will not improve the excellent survival rates of this group of women. Nevertheless, many women, particularly young women, are choosing to have both breasts removed."

DCIS cancer is described by Tuttle as the earliest form of breast cancer, when it is confined within a duct area of the breast. It is very treatable with "breast-conserving" surgery, radiation or hormone treatment, Tuttle said.

Tuttle told the Minneapolis Star-Tribune that many women choosing double mastectomies do so for cosmetic reasons. But he said reconstructive surgery can be riskier and require more recovery time than having a lumpectomy, which can usu

Breast cancer leaflet to be rewritten

Monday, 23 February 2009

A NHS leaflet informing patients about breast cancer screening is to be dropped and rewritten following complaints from experts.

Experts have said that the leaflet – sent out with invitations for women to attend screenings – is inadequate, misleading about the risks involved, and could mean women are being subjected to unnecessary surgery, chemotherapy and radiotherapy.

Professor Mike Richards has announced that the leaflet Breast Screening: The Facts will be completely rewritten and published later this year.

“A formal review is in progress and will be tested against the best available evidence,” he said.

“Our cancer screening programmes in this country are internationally recognised as being world-class and 1,400 lives are saved every year through breast screening. I want to reassure women that breast screening is safe and can lead to cancer being diagnosed and treated much earlier.”

The decision followed a letter published inThe Times newspaper last week signed by 23 doctors, surgeons, academics and health specialists, who claimed that "there are harms associated with early detection of breast cancer by screening that are not widely acknowledged".

“For example, there is evidence to show that up to half of all cancers and their precursor lesions that are found by screening, if left to their own devices, might not do any harm to the woman during her natural lifespan,” said the letter.

“Yet, if found at screening, they potentially label the woman as a cancer patient: she may then be subjected to the unnecessary traumas of surgery, radiotherapy and perhaps chemotherapy, as well as suffer the potential for serious social and psychological problems.”

The letter quoted research published last month in the BMJ, which said that 10 healthy women out of every 2,000 who were screened would be treated for cancer.

People signing the letter included Professor Michael Baum, Emeritus Professor of Surgery at University College London and Dr Paul Pharoah, Cancer Research UK Senior Clinical Research Fellow, University of Cambridge.

The experts called for the NHS to rewrite the information so they were properly informed and able to make an informed decision.

The letter also said: “None of the invitations for screening come close to telling the truth” and it said the leaflet was not being honest about the risks.

Consequently, the women “are being manipulated, albeit unintentionally, into attending”.