UCLA Breast Cancer Surgeon Sorts Out the Facts: Is that Double Mastectomy Really Necessary?

Image

When Angeline Vuong, 27, was diagnosed with cancer in one breast earlier this year, her first reaction was "A DOUBLE MASTECTOMY. NOW. " Turns out, she's far from alone: a recent JAMA study of 190,000 breast cancer cases in California between 1998 and 2011 found a six-fold increase in the percentage of women with early-stage cancer in one breast who were choosing double mastectomies.

But are they necessary? And do they reduce your risk of a second cancer?

The answers to these and other questions regarding double mastectomies may surprise you: if you have breast cancer in one breast, removing your other breast will not increase your chances of survival. It won't help you live longer, and it doesn't decrease a woman's chance of metastatic disease, when the cancer spreads from the breast to the lymph nodes, lungs or bones.

Dr. Deanna Attai, UCLA Health breast surgeon and Angeline's doctor, says every patient is different, and that ultimately the choice to get a double mastectomy is complex and up to patients, their families and their doctors. But most women don't know the facts about double mastectomy risks - and they should be aware of them before making a decision.

"For women who take Tamoxifen or other estrogen blockers, the risk of developing a whole new cancer in the other breast may be as low as five to ten percent, which means that if you have that breast removed, you're doing an aggressive surgery that 90 to 95 percent chance you don't need," says Dr. Attai. "That's worth considering."

After discussing surgery, risks, side effects and treatment options with Dr. Attai, Angeline ultimately decided to have only one breast removed, saying that she wanted to keep her healthy breast as long as possible so that she would be able to look down and see that feminine part of her still there as well as have the option of breast feeding in the future. She sums up her decision by saying "You can always have another mastectomy, but you can't have your breast back."