To remove or not to remove a healthy breast

To remove or not to remove a healthy breast. That is a very difficult decision many women have to face when diagnosed with breast cancer.

Why remove a healthy breast?

The procedure is called prophylactic mastectomy, which is the removal of a noncancerous breast. This is considered to be an aggressive preventive measure in order to reduce the risk of developing cancer, and can also involve removal of the ovaries (oophorectomy).

What are the reasons for removal?

Women diagnosed with cancer in one breast can opt for removal of the non-cancerous breast as well.

Women with a strong family history of breast cancer.

Women who tested positive for mutations in the breast cancer genes BRCA1 and BRCA2.

How prevalent is prophylactic mastectomy?

Historically, the number of women opting for prophylactic mastectomy is low. However, a recent report by researchers from the New York State indicates that the number is increasing. The report looked at female New York residents from 1995 to 2005. 6,275 women underwent prophylactic mastectomy. 81% of these women have been diagnosed with cancer in one breast but not the other. The rest had no personal history of breast cancer. During the study period of more than a decade, the rate of prophylactic mastectomy doubled. The increase is mostly due to women who had cancer and opted for removal of healthy one.

According to study leader Dr. Stephen Edge of the Roswell Park Cancer Institute

“These data from New York are the only data on a large population of women that examine the use of bilateral prophylactic mastectomy. These data demonstrate that prophylactic mastectomy is an uncommon procedure that is performed most commonly on women with a personal history of breast cancer. Although the total number of prophylactic mastectomies performed per year was small, it appears that the use of the surgery is increasing.’ In addition …women with breast cancer should have careful counseling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.”

Is prophylactic mastectomy necessary?

Current state of evidence does not support the belief that removal of a non-cancerous breast would lower the risk or prevent the development of cancer, even among those in high-risk groups.

According to Dr. Marissa Weiss at Breastcancer.org:

“Simply having a proven gene abnormality does not necessarily mean that a woman will develop breast cancer, or that her cancer will be any worse than cancer that does not stem from an inherited genetic flaw.”

The take home message is that women should think twice and weigh the risks and benefits of having a noncancerous breast removed.