Women get aggressive treating breast cancer: More patients opting to get both breasts removed when cancer strikes one
WASHINGTON (AP) – Removing just her cancer, not her whole breast, at first sounded like a good option to Trisha Stotler Meyer. Two years later, a cyst in her healthy breast sparked terrifying new checkups.
“It was at that moment that my breasts became like tonsils,” is how Meyer, 37, puts it. “I don’t need them anymore. They’re gone.”
She’s not alone. More women who have cancer in only one breast are getting both breasts removed, says research that found the trend more than doubled in just six years.
It’s still a rare option: Most breast cancer in this country is treated by lumpectomy, removing just the tumor while saving the breast.
But the new study suggests 4.5 percent of breast cancer surgery in 2003 involved women getting cancerous and healthy breasts simultaneously removed, a 150 percent increase from 1998 — with no sign that the trend was slowing.
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Young women are most likely to choose the aggressive operation, researchers reported Monday in the Journal of Clinical Oncology.
The concern is whether they’re choosing in the heat of the moment — breast cancer surgery often is within two weeks of diagnosis — or with good understanding of the pros and cons.
“Are these realistic decisions or not?” asked Dr. Todd Tuttle, cancer surgery chief at the University of Minnesota, who led the study after more women sought the option in his own hospital.
“I’m afraid that women believe having their opposite breast removed is somehow going to improve their breast cancer survival. In fact, it probably will not affect their survival,” he said.
But removing the remaining healthy breast does greatly lower, although not eliminate, chances of a new cancer developing on the opposite side.
Don’t underestimate the peace of mind that brings, said Meyer, of Vienna, Va.
“Doctors are not up at night crying” in fear of their next mammogram, she said. “I don’t want to have to deal with the stress.”
Meyer was diagnosed with cancer in January 2005, shortly after her son’s birth. She had a lumpectomy, followed by chemotherapy and radiation.
But she didn’t qualify for anti-hormone drugs that protect many women against cancer in the remaining breast. And in March – after finding a lump that turned out to be a cyst – she started considering a return to the operating room. Three weeks ago, she had both breasts removed.
The American Cancer Society estimates 178,480 U.S. women will be diagnosed with breast cancer this year. About 40,460 will die of it.
Tuttle calculated that lumpectomies accounted for almost 60 percent of those surgeries in 2003. The surprise: Single mastectomies remain the No. 2 option but are dropping – while double mastectomies, although uncommon, were on the rise for every stage of cancer. Even women who qualify for anti-hormone drugs to protect the remaining breast were as likely to choose removal as women with harder-to-treat tumors.
Why? Tuttle is planning a new study to tell, and to see if candidates are warned about such risks as infection that increase with the bigger surgery.
Georgetown’s Willey says better reconstructive surgery is partly spurring the trend. Still, she often encourages women to wait to remove the second breast, as lining up reconstruction sometimes dangerously delays treating the cancer.
“When I was younger … I really tried to argue with patients and talk them out of it,” Willey said. Now, if they’ve weighed the options, she doesn’t.
“I can’t recall a single patient who tells me they regret that decision.”
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