Study Says 7 Out of 10 Double Mastectomies Are Unnecessary: Not True

COMMENTARY | The Detroit Free Press reports on a study by the University of Michigan Comprehensive Cancer Center, which concludes that 7 out of 10 bilateral (double) mastectomies would never have seen a cancer recurrence. This study is flawed and so are the conclusions.

The Study

The study by the University of Michigan took 107 women -- 30 percent of them were at high risk or had BRCA mutations -- and came to the conclusion that the remaining 70 percent of bilateral mastectomies in this group were unnecessary. It went further to say that lumpectomy was a better option for these women.

So as far as the University of Michigan is concerned, if you are not in a high-risk group then a bilateral mastectomy is not necessary. What the study does not address is the high rate of additional surgeries after a lumpectomy, personal decisions to reduce recurrence risk, and preferences for reconstruction.

The Study Fails

The study did not address the fact that all breast cancers cannot be removed by lumpectomy, even if the patient is low risk for recurrence. Low risk is a relative term. I had one breast removed by mastectomy and my oncologist told me that I have a 20 percent chance of a cancer recurrence in that breast.

This study does not take into account the high rate of re-incisions for lumpectomies. Many times, clear margins are not obtained and the patient must undergo additional surgeries to remove more breast material. This means multiple incision sites, risks of infection, and lots of scarring.

Lumpectomies are followed by radiation treatment -- a highly toxic and tissue-damaging procedure. Many women, myself included, do not want to undergo radiation. So we opt for mastectomy to protect our skin, heart, and lungs from radiation damage.

There is more to a surgical decision than reducing the risk of recurrence. In my case, a lumpectomy was an option, but I would have lost more than 25 percent of my breast. My high-grade tumors were aggressive. It would have been likely that I would be back for more surgery. The best medical decision for me was a mastectomy.

Having the best reconstruction options available may mean losing both breasts short term. Again, the study does nothing to address quality of life or patient mental well-being. I asked my plastic surgeon which would give me the best cosmetic results, a lumpectomy or a mastectomy. He replied, "a mastectomy." So a mastectomy it was. End of discussion.

Before data is applied to all women with breast cancer, it must examine a large enough sample that includes all possible reasons for having a bilateral mastectomy. Sorry University of Michigan, your meager data on 107 women does not pertain to the majority of women with breast cancer. Your conclusions get an epic fail from me -- a breast cancer survivor.

Lynda Altman was diagnosed with breast cancer in November 2011. She writes a series for Yahoo! Shine called "My battle with breast cancer."

Source: http://news.yahoo.com/study-says-7-10-double-mastectomies-unnecessary-not-232600329.html

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