Is removing a healthy breast a guarantee for beating cancer?
hey suggest that the most effective precautionary option for getting cancer in a healthy breast is a contralateral mastectomy
What you need to know:
- Some cancer patients may opt to remove the healthy breast to prevent the occurrence of contralateral breast cancer.
- This type of breast cancer occurs when the healthy breast is also affected.
In 2013, American actress and filmmaker Angelina Jolie wrote an opinion piece, detailing her choice to undergo a double mastectomy to reduce her risk of breast cancer. She did not do it because she had been diagnosed with cancer, but because she has a cancer gene - BRCA1, which predisposes her to the disease. Studies have shown that this procedure reduces the risk of getting a diagnosis of breast cancer.
It is different, however for patients who already have a breast cancer diagnosis. Some cancer patients may opt to remove the healthy breast to prevent the occurrence of contralateral breast cancer. This type of breast cancer occurs when the healthy breast is also affected. A new study published in the scientific journal JAMA Oncology shows that removing a healthy breast may not guarantee survival from breast cancer. While it may reduce the risk of getting another diagnosis, the preemptive surgery, in their words, ‘did not appear to reduce the risk of death’.
This study however excludes people who have the BRCA1 and BRCA2 genes which generally makes them at risk of getting a cancer diagnosis. The scientists analysed data of more than 650, 000 breast cancer patients who had cancer on one side of their breast. “It is possible that many women who chose bilateral mastectomy overestimate their risk of developing a contralateral breast cancer and may overestimate the benefit in terms of reducing breast cancer deaths,” says the study.
Their data show that 69 in every 1,000 women with breast cancer are likely to develop contralateral cancer within 20 years of diagnosis. After experiencing contralateral breast cancer, the mortality rate increased four-fold from the time of contralateral cancer until the end of follow-up among the study cohort,” shows the study. A separate editorial published in the same journal says that many patients who have cancer on one side of the breast worry that the second breast is susceptible to getting cancer that is why they decide to do away with it, anyway.
They suggest that the most effective precautionary option for getting cancer in a healthy breast is a contralateral mastectomy. “One possible explanation for why contralateral breast cancer is associated with a worse prognosis is that early-stage breast cancer is primarily a systemic disease. It involves circulating and disseminating tumour cells that can enter dormancy after initial treatment. These dormant cells, if reactivated, could lead to contralateral breast cancer, as the contralateral breast serves as a secondary site following the primary breast of origin,” explains Dr Kefah Mokbel in an editorial comment. He is a breast cancer surgeon who was not part of the study.
This however is not the first study that raises doubt on the impact of double mastectomy. Another study analysed data between 1998 and 2011 on patients who had undergone that procedure and found that there was no major impact after removing the second ‘healthy’ breast.
