Should You Have a Preventative Mastectomy to Help Protect Yourself Against Breast Cancer?
When faced with the possibility of breast cancer, some women opt to have a mastectomy to prevent further cancer. Angelina Jolie made news in 2013 when she chose to have a double mastectomy, not because she had breast cancer, but because she had a mutated gene that greatly increased her risk of developing breast cancer. Other women, with the same gene, also opt to have their breasts removed in an effort to prevent cancer from occurring. But those with the BRCA1 or BRCA2 gene aren’t the only ones opting for mastectomy. When breast cancer has developed in one breast, some women choose to have both breasts removed, even though no cancer is present in the second breast.
Non-Estrogen Induced Breast Cancer
Some experts are questioning whether this is necessary and whether mastectomies save lives. A recent study, published in the July 2014 issue of the Journal of the National Cancer Institute found that there isn’t statistically much of a difference in life expectancy between those who keep their second breast and those who choose to have it removed. The study did not look at women with the BRCA1 or BRCA2 gene, it centered around those with estrogen receptor-negative breast cancer.
Researchers looked at the survival rate of more than 100,000 women over a 20 year span of time. The women had either Stage I or Stage II breast cancer. The 20 year survival rate of those who chose to have preventive mastectomies of their second breast were compared to those who did not opt for this procedure. According to the scientists, there was less than 1 percent difference in 20 year survival rates between the two groups. This statistic is so small that some experts believe that having the second breast removed is unnecessary and gives women a false sense of security.
When You Have an Increased Risk of Breast Cancer
This is different than preventive mastectomy when you have the BRCA1 or BRCA2 gene. In these cases, especially if a close family member has been diagnosed with breast cancer, you might opt to discuss this option with your doctor. Having these genes greatly increases your chance of developing breast cancer, for example, Angelina Jolie explained that her doctors placed her risk of developing breast cancer at 87 percent and her risk of developing ovarian cancer at 50 percent. Having a preventive double mastectomy lowered that risk. The risk is different for each woman, however, and before deciding this is the best option, you should discuss your health history, your family health history and results of gene testing with your doctor.
According to the Dana-Farber Cancer Institute, some of the reasons women choose to have a preventive double mastectomy include:
- A family history of breast cancer at a young age and testing showing the BRCA1 or BRCA2 genes are present
- Young children at home
- Anxiety about screenings and developing breast cancer
Usually women opting for this procedure are in their 30’s or 40’s, however, some are either younger or older, depending on when they found out about their increased risk for breast cancer and the age which family members were diagnosed with breast cancer. As with all surgery, there are also risks, including infection.
The Emotional Impact of Mastectomy
Having one or both breasts removed can have psychological and emotional implications as well. Because breasts are tied into our sexuality, some women feel less sexually attractive after surgery and are self-conscious about the scars from the surgery. According to a study completed in 2008, some women were less satisfied with sex after the surgery although it did not affect how often they engaged in sex or did not cause any discomfort during sex.
According to the Dana-Farber Cancer Institute, most women reported that their partners supported their decision to have a mastectomy and felt it was more important to reduce the risk of dying. While their sex life needs to adapt to the change, many women felt it did not reduce theirs or their partner’s enjoyment from sex. Some felt going through the experience together, with their spouse, brought them closer together. Other women did not adjust as easily but benefited from talking with a psychologist or psychiatrist.
The decision to have a preventive mastectomy is a deeply personal decision. It is not one that should be taken lightly or rushed into. You should discuss, at length, your risk for developing breast cancer, the pros and cons of the surgery and all other options before making a decision. If you are in a relationship, your partner should be included in these discussions so that both people feel comfortable.
“Ask the Cancer Genetics Team: Medical and Psychological Considerations of a Preventitive Mastectomy,” Date Unknown, Staff Writer, Dana-Farber Cancer Institute
“More Women Opting for Preventive Mastectomy - But Should They Be?” 2013, May 15, Maggie Fox and Jonel Aleccia, NBCNews.com
“Preventive Mastectomy Does Little to Extend Life of Breast Cancer Patients.” 2014, July 16, Kathleen Doheny, CBSNews.com
“Psychological Reactions, Quality of Life, and Body Image After Bilateral Prophylactic Mastectomy in Women at High Risk for Breast Cancer: A Prospective 1-Year Follow-up Study,” 2008, Y. Brandberg et al, Journal of Clinical Oncology