When faced with breast cancer in one breast, increasingly more women are opting to undergo contralateral prophylactic mastectomy (CPM), a surgery to remove the unaffected breast. But a new study in Journal of the National Cancer Institute shows that getting both breasts removed when only one breast has cancer might not lengthen your life.
Using data from the Surveillance, Epidemiology, and End Results registry and large meta-analyses, researchers at University of Minnesota calculated the survival rates for women with newly diagnosed breast cancer in those who opted for CPM and those who did not. The results: CPM increased women's life expectancies by 0.13 to 0.59 years for women with stage I breast cancer and of 0.08 to 0.29 years for women with stage II breast cancer.
That's a max of about seven months. What's more, the 20-year-survival rate of women who had had their opposing, unaffected breast removed was less than one percent higher than those who chose to keep their healthy breast when diagnosed with breast cancer.
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Why so low? For many women with breast cancer in one breast, the chances that cancer will later develop in the other breast are very small—between two to four percent in the five years after treatment, according to a previous study in Annals of Internal Medicine. That study found that most women greatly overestimate this risk and often choose this surgery in hopes of upping their chances of survival.
Here's the exception: According to one study in the Journal of Clinical Oncology, the risk of contralateral breast cancer in women with a BRCA mutation is approximately 40 percent at 10 years. So in these cases, oncologists may recommend women remove both breasts, even if only one is currently affected. In fact, women like Angelina Jolie and Lindsay Avner, the founder of Bright Pink, made the decision to remove both of their healthy breasts when they found out they had this genetic mutation.
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Still, many women without the genetic mutation may choose to undergo CPM, and that's not necessarily a bad option. While every surgery comes with complications, it's a safe and effective way to reduce the risk of breast cancer in the unaffected breast (even if it is a small one). And there are other reasons women may consider this procedure. For some patients, especially those who want to undergo reconstructive surgery, removing both breasts and starting from scratch is a way to help them look more natural. Plus, it can still help assuage women's fears—and that's valuable in and of itself, says study researcher Todd M. Tuttle, M.D.
In the end, though, CPMs are all about balancing risks and rewards—and those pros and cons are different for every single woman. So speak with your doctor about the best course of action for you.
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