In the past decade, the proportion of Breast Cancer patients who opt to have a healthy breast removed to prevent future cancers more than tripled over 10 years. However, according to a new study, the procedure did not improve their survival rate. The findings were published online in the Annals of Surgery on March 8.
The study group comprised 496,488 women who were registered in the Surveillance, Epidemiology, and End Results (SEER) study who had been diagnosed with unilateral (one-sided) invasive breast cancer from 1998 through 2012. The women’s breast cancers were staged I to III breast cancer. The researchers compared characteristics and trends over time between women who underwent breast-conserving surgery, unilateral mastectomy, and bilateral mastectomy. They then subjected the data to statistical analysis to examine breast cancer-specific survival and overall survival in women diagnosed from 1998 through 2007, who underwent breast-conserving surgery with radiation (breast-conserving therapy), unilateral mastectomy, or bilateral mastectomy. The data were further analyzed based on age and hormone replacement therapy (HRT) status.
The investigators found that, of 496,488 women diagnosed with unilateral invasive breast cancer, 59.6% underwent breast-conserving surgery, 33.4% underwent unilateral mastectomy, and 7.0% underwent bilateral mastectomy. Overall, the proportion of women undergoing bilateral mastectomy increased from 3.9% in 2002 to 12.7% in 2012. Reconstructive surgery was performed in 48.3% of bilateral mastectomy patients compared to only 16.0% of unilateral mastectomy patients; the rates of reconstruction with bilateral mastectomy rose from 35.3% in 2002 to 55.4% in 2012. When compared with breast-conserving therapy, the researchers found no significant improvement in breast cancer-specific survival or overall survival for women undergoing bilateral mastectomy, regardless of HRT status or age.
The authors concluded that the use of bilateral mastectomy more than tripled during the study period despite evidence suggesting no survival benefit over breast conservation. They recommended that further studies regarding how to optimally counsel women about surgical options should be conducted.
