Fear prompts cancer patients to remove healthy breasts

More and more young women with breast cancer are choosing to remove their healthy breast to avoid recurrence and improve survival -- despite evidence that this doesn't help, according to a study published in the Annals of Internal Medicine.

Lead author Shoshana Rosenberg, ScD, from Dana-Farber Cancer Institute, and colleagues surveyed 123 women ages 40 or younger without known bilateral breast cancer who had undergone bilateral mastectomy. The survey included questions about the women's health history, reason for choosing the surgery, and knowledge and perceptions about breast cancer.

Ninety-seven of the women had stage I or stage II breast cancer and 60% of tumors were estrogen-receptor-positive. Ninety-eight percent of the women surveyed said they decided to remove their healthy breast to decrease their risk for contralateral breast cancer (Ann Intern Med, September 17, 2013, Vol. 159:6).

Although 94% of the women surveyed said they chose bilateral mastectomy to increase survival, only 18% reported thinking that the surgery improved survival rates. Almost all of the women surveyed overestimated the actual risk of contralateral breast cancer, Rosenberg's team found. And while the women identified physicians as the most important source of information about breast cancer, only one-third of them cited a desire to follow a physician's recommendations as an extremely or very important factor in their decision.

"Many women have misperceptions about breast cancer risk," Rosenberg and colleagues wrote. "We believe that this points to a need for better risk communication strategies in an effort to ensure that treatment decision-making is truly evidence-based while remaining patient-centered."

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