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Too many women electing unnecessary double mastecomies

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Despite so much information about breast cancer risks available, a new study published in JAMA Surgery last month
found that many breast cancer patients are electing to have a double mastectomy even when their individual risks don’t justify such drastic surgery.

Women with the BRCA 1 or 2 genetic mutation and/or those with a very strong family history of breast cancer do have a significantly high risk for developing breast cancer and for them, prophylactic bilateral mastectomy, may be appropriate.

Fewer than 10 percent of women with newly diagnosed breast cancer in one breast are estimated to have one or both of these clinical indications.

However, when lead author Sarah Hawley, PhD, MPH, an associate professor of internal medicine at the University of Michigan, Ann Arbor and her colleagues evaluated the medical records of more than 1400 women with diagnosed breast cancer in one breast, nearly 70 percent of those who had their unaffected breast removed were never at high risk for developing a new cancer.

The authors stated that it is misplaced fear that drives the decision.

In addition to the obvious need for better education of the patient regarding risks, the authors correctly question how surgeons who agree to such an extensive procedure which is not clinically indicated can justify that decision simply to reduce their patient’s fear.

Clearly there is a need for women to feel more empowered when faced with a diagnosis of breast cancer, to take a deep breath when they first hear the terrifying words “you have cancer” and then take some time to understand their individual risks and options. Often that may mean seeking more than one opinion.

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