FRIDAY, April 29 (HealthDay News) -- Despite concerns regarding
appearance, few breast cancer survivors who opted for a double
mastectomy as a precautionary measure regretted their decision
decades later, a new study finds.
Researchers at the Mayo Clinic in Rochester, Minn., questioned
hundreds of women who sacrificed a healthy breast in the hope of
avoiding another cancer. Twenty years after their surgery, 97
percent said they would make the same decision again.
"The real question is, how did they feel in the long run?" said researcher Dr. Judy C. Boughey, breast surgeon and associate professor of surgery. "I want my patients to do what they will be happy with in 10 or 20 years."
Previous research found that women who had undergone
prophylactic double mastectomy were satisfied with their decision
soon after the surgery. This new research shows that those who were
"comfortable with that decision still are many years after," said
The findings were to be presented Friday at the annual meeting
of the American Society of Breast Surgeons in Washington, D.C.
Research presented at meetings is considered preliminary until it
is published in a peer-reviewed journal.
With today's improved breast reconstruction techniques, women
are likely "to be even happier with the results" than they were in
decades past, noted Dr. Stephanie Bernik, chief of surgical
oncology at Lenox Hill Hospital in New York City, who is familiar
with the findings.
Breast cancer affects about one in eight U.S. women, according
to the National Cancer Institute. Nearly 90 percent will survive
five years or more, according to the agency.
Surgical treatments include lumpectomy (excision of the tumor
and surrounding tissue), mastectomy (removal of the diseased
breast) or double mastectomy (removal of both breasts). A
prophylactic double mastectomy does not guarantee that the cancer
will not recur.
Adjunct treatment may include radiation, chemotherapy or hormone
therapy, said Boughey.
For the study, women who had a cancerous breast and a healthy
breast removed between 1960 and 1993 were asked 10 years later if
they were satisfied with their choice. They were also asked if they
would make the same decision again.
After another 10 years, the majority were surveyed once more.
Complete results were available for 269 women.
In the initial survey, 86 percent said they were satisfied with
their decision and 95 percent said they would repeat the procedure
if they had to again. In the 20-year follow-up, 90 percent
expressed satisfaction with their decision and 97 percent said they
would repeat it.
However, about 30 percent in both time periods said they had
suffered from negative body image, and nearly a quarter said their
sense of femininity and sexual relationships were affected. Those
effects did not increase with time, the results showed.
Experts say the prospects for women who undergo mastectomy today
are much improved from 20 years ago. "We have procedures now that
they didn't even have when the women in this study had their
surgeries," Bernik said.
For instance, breast reconstruction now often accompanies the
cancer surgery. The important thing is for women to come to terms
with the decision, said Bernik.
"We don't push it [double mastectomy]," she said. Often, a young woman will have children, nurse them, and then decide to have the second breast removed, she noted.
According to Bernik, about 10 percent of breast cancers are
caused by genetic mutations, and women who have family members
already diagnosed with breast cancer are at higher risk if the
cancer is genetically influenced.
Other risk factors for breast cancer are age or long exposure to
estrogen, which occurs when menstruation begins at an early age and
continues past 50, said Boughey. Women who give birth to a first
child later in life are also at higher risk, she noted. Men can
also develop breast cancer, but it is uncommon.
Breast cancer patients are doing better these days than even
five or 10 years ago, said Boughey.
To learn more about preventive mastectomy, visit the
U.S. National Cancer Institute.