Some women who’ve been diagnosed with early-stage breast cancer in one breast choose to have that breast and the other healthy breast removed – a double mastectomy. Removing the other healthy breast is called contralateral prophylactic mastectomy.
The healthy breast usually is removed because of an understandable fear that a new, second breast cancer might develop in that breast. More and more women who’ve been diagnosed are opting for contralateral prophylactic mastectomy – in the late 1990s, between 4% and 6% of women who were having mastectomy decided to have the other healthy breast removed. More recently, between 11% and 25% of women having a mastectomy decided to have contralateral prophylactic mastectomy.
A study done by Mayo Clinic researchers suggests that most women who have contralateral prophylactic mastectomy have no regrets and would make the same choice again.
The study was published in the September 2014 issue of the Annals of Surgical Oncology. Read the abstract of “Impact of Reconstruction and Reoperation on Long-Term Patient-Reported Satisfaction After Contralateral Prophylactic Mastectomy.”
It’s important to know that a double mastectomy is a bigger operation than a single mastectomy or a lumpectomy. The recovery is longer and more difficult, and the risk of complications is higher.
It’s also important to know that recent research has found that women diagnosed with early-stage breast cancer in one breast who are treated with lumpectomy followed by radiation therapy have the same survival rates as women who are treated with double mastectomy.
All the women in this study had a family history of breast cancer. The women were surveyed twice: about 10 years after surgery and about 20 years after surgery. The researchers asked the women about their quality of life and their satisfaction with their choice of surgery.
Ten years after surgery:
- 83% of the women said they were satisfied with their decision to have a double mastectomy
- 84% of the women said they would make the same decision about surgery again
- 73% said they would make the same decision about whether to have reconstruction or not
Still, women who had reconstruction and had to have more surgery because of complications were less likely to be satisfied with their choice to have contralateral prophylactic mastectomy. Women who didn’t have reconstruction were more likely to be satisfied with their contralateral prophylactic mastectomy decision and make the same decision again.
Only 269 women completed the survey 20 years after surgery. These women were still satisfied with their decision: 92% said they would choose contralateral prophylactic mastectomy again.
Overall, most of the women – whether or not they had reconstruction – said they felt the same about themselves and their femininity after surgery as they did before and would make the same choices again.
“I think what this study does is adds some literature to the hands of the people counseling patients to say, ‘Whatever decision you make, you’re very likely to be happy with that in the long run, so listen to yourself, and make the decision that’s best for you,’” said Judy Boughey, M.D., Mayo breast surgeon and lead author of the study.
When you’re first diagnosed with breast cancer, fears about the future can affect how you make decisions. This is especially true for women who have an abnormal breast cancer gene or who have watched a mother or sister be diagnosed with breast cancer. You have to make a number of decisions at a very emotional time when it can be hard to absorb and understand all the new information you’re being given.
At Breastancer.org, we support every woman’s right to make treatment decisions based on the characteristics of the cancer she’s been diagnosed with, her medical history, her risk of recurrence or a new breast cancer, and her personal preferences. But it’s very important to make sure you understand all the pros and cons of any treatment or procedure you’re considering, including how the treatment or procedure may affect your reconstruction options and if the treatment is likely to make you live longer.
If you’ve been diagnosed with early-stage breast cancer, ask your doctor about ALL of your treatment and risk reduction options. Contralateral prophylactic mastectomy is only one of these options and is an aggressive step. While it may be the right decision for you, give yourself the time you need to consider the decision carefully. It’s a good idea to talk to your doctor about how the details in your pathology report may affect your future risk. You want to be sure that your decisions are based on your actual risk of recurrence or a new cancer. Make sure you understand the benefits and risks of all your options. Together, you and your doctor can make the choices that are best for you and your unique situation.
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