In California, the percentage of women diagnosed with early-stage breast cancer who undergo double mastectomies has significantly increased between the years of 1998 and 2011, even though the procedure has not been linked with a lower risk of death compared to breast-conserving surgery and radiation.
Randomized trials have suggested similar survival rates for patients with early-stage breast cancer who are treated with breast-conserving surgery and radiation or with mastectomy, The JAMA Network Journals reported.
Success rates for single and bilateral mastectomies only appears to have superior benefits in certain subgroups.
"Because bilateral mastectomy is an elective procedure for unilateral breast cancer [in one breast] and may have detrimental effects in terms of complications and associated costs as well as body image and sexual function, a better understanding of its use and outcomes is crucial to improving cancer care," background information on the articles stated.
The researchers used data from the used data from the California Cancer Registry to compare the rates of death after bilateral mastectomy, unilateral mastectomy, and breast-conserving procedures accompanied by radiation. The study included 189,734 patients; the researchers found among these patients the rates of bilateral mastectomy increased from 2.0 percent in 1998 to 12.3 percent in 2011. This signifies and annual increase of 14.3 percent. Use of unilateral mastectomy declined in all age groups.
Bilateral mastectomy was most often used by non-Hispanic white women who had private health insurance or those who were treated at a National Cancer Institute-designated cancer center.
"In a time of increasing concern about overtreatment, the risk-benefit ratio of bilateral mastectomy warrants careful consideration and raises the larger question of how physicians and society should respond to a patient's preference for a morbid, costly intervention of dubious effectiveness," the authors wrote. "These results may inform decision-making about the surgical treatment of breast cancer."
The findings were published in the Sept. 3 issue of Jama.
