Facing breast cancer and mastectomy, a stark choice

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In the 1970s, women’s health advocates were highly suspicious of performing a mastectomy in breast cancer cases, fearing doctors were too quick to remove the breasts, and disfiguring results. Today the pendulum has swung the other way and a new generation of women favor a more aggressive approach to ward off cancer before it can strike. Even though they have healthy breasts… 

Prophylactic mastectomy or removal of one or both breasts without a cancer diagnosis is on the rise. Experts agree that a double mastectomy is a reasonable option for women who have a strong genetic risk and have tested positive for a breast cancer gene (BRCA1, BRCA2). But the risk that a woman with breast cancer will develop cancer in the other breast is about 5% over 10 years (even though a University of Minnesota study show that women estimate that risk to be over 30%, motivating drastic decisions, especially with younger women).

Per researchers, about 15% (up from less than 3% in the late 1990s) of women with breast cancer (30,000 a year) opt for contralateral mastectomy (removing a healthy breast alongside one with cancer) without having received genetic testing or counseling for the majority, just out of fear of the risk of recurrence. Also on the rise, mastectomies based on genetic risk only (no database track these women though).

These recent trends could be explained by various factors:

  • The persuasive power of continuous breast cancer awareness campaigns, that create fear of the disease and encourage proactivity
  • The improvements in reconstructive breast surgery (nipples can even be preserved in some instances)
  • The comfort felt from an increasing number of celebrities dealing with the disease and going public with their mastectomy decision

This is a critical, life-changing health decision to make, one that involves surgery and recovery, and as such, should not be made lightly. Besides getting genetic counseling, the best prepared patients have the possibility to join support groups and research all their options. Yet, most of the women who had a double mastectomy  (or in this case Contralateral Prophylactic Mastectomy, or CPM) were not at high risk for a cancer recurrence, and as suggested by a University of Michigan study, most of these women never sought genetic testing or counseling prior to making their decision.

This may come from the fact that people view a breast, even if very emotionally, as a body part one can live without, which gives them the impression to have a choice. And this power of having a choice becomes the only way to put fear of the disease behind them. And that they can get all the cancer completely out of their body.

Credit photo: Stuart Bradford


* Up for some thought-sharing on this topic?  
. In what circumstances would you consider such major, drastic surgery: genetic risk, prior cancer on one or both breasts?
. Would you “just” trust your team of doctors or get additional medical opinions and do your own research before deciding on a mastectomy?
. Do you consider a healthy diet and home environment as additional powerful variables in preventing breast cancer and other serious health diseases?
. Do you tailor your diet so that food becomes a powerful preventative ally in preserving your long term health? If so, how?
Let us know… 

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