Do Unfounded Fears Lead to Unneeded Mastectomies?

Medically reviewed in July 2022

Consider this: You’ve just been diagnosed with breast cancer. You’re scared, and all you want is to get the tumor out of your body. Then you’re faced with a choice. Should you have your healthy breast removed to keep the cancer from returning?

The procedure we’re talking about is called contralateral prophylactic mastectomy, and a growing number of women (about 25%) treated for early-stage breast cancer are opting to do it. But are they doing so unnecessarily? 

According to a survey of 123 young women with breast cancer, an overwhelming majority (98%) said they chose the preventive breast surgery (which removes the entire healthy breast) to reduce their risk of breast cancer recurrence. Additionally, 94% said they did it to improve their chances of survival. The research was published in the September 17, 2013 issue of Annals of Internal Medicine. But there’s evidence that, for most women, the surgery has no effect on survival.

The Real Risk of Breast Cancer Recurrence
Women may choose preventive surgery because they overestimate their cancer risk. While the risk of a recurrence is high in women who carry the BRCA1 or BRCA2 gene mutation, in women who don’t have the mutation, a tumor in one breast doesn’t mean an increased chance of cancer in the other. Without the operation, their risk over the next 5 years is only 2% to 4%.

Pros and Cons of Preventive Breast Cancer Surgery
A double mastectomy is a big operation, and as with any surgery, there can be complications. Though rare, they include such things as bleeding or infection. Because preventive mastectomy is irreversible, the surgery can have psychological effects on a woman due to changes in her body image. The biggest benefit may be (relative) peace of mind, though there’s still no guarantee that the procedure will protect an individual woman from breast cancer.

We know that being diagnosed with breast cancer is an anxiety-provoking time period, but there are a lot of facts to consider. If you’re faced with the decision, make sure to work with your doctor to fully understand your risks and benefits before you jump to any conclusions.

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