Are full mastectomies on the decline today?
Breast cancer no longer automatically results in breast removal -- but researchers say they are surprised to find why so many of the procedures are still conducted.
There was a time when it seemed a woman with breast cancer underwent a “radical mastectomy,” the full removal of the mammary glands, lymph nodes and pectoralmuscles. A disfiguring procedure, it was dreaded – and even declined by some women, such as French movie star Brigitte Bardot, who considered dying of the disease rather than being “less a woman.”
The first recorded mastectomy for breast cancer was performed around 548 AD, when it was proposed by the court physician Aëtius of Amida to Theodora, the wife of Emperor Justinian I, considered by some to be the most influential and powerful woman in the Roman Empire’s history. Some sources even mention her as empress regnant with Justinian as her co-regent. She declined the surgery and died a few months later.
Fortunately, science has advanced and according to a study published in the Journal of the American Medical Association, the procedure is increasingly rare. The study was led by Monica Morrow, M.D., chief of the Breast Service in the Department of Surgery at Memorial Sloan-Kettering Cancer Center, along with Steven Katz, M.D., M.P.H., and colleagues at the University of Michigan Comprehensive Cancer Center.
They found that during a nine-month period, a group of 1,984 women aged 20 to 79 years with stage 1 and 2 breast cancer experienced the following:
67 percent of women reported that their first surgeon recommended breast-conserving surgery and that they had successful procedures
13 percent had mastectomies after initial surgical recommendation
8.8 percent had mastectomies when there was no clear surgical recommendation for either procedure
8.8 percent reported having unsuccessful breast-conserving surgery that required revision with mastectomy.
This is a far cry from the days when a full breast removal was the only thing the doctor would recommend.
The study concluded that, surprisingly, many women choose a mastectomy, “especially in the absence of a surgeon recommendation favoring one procedure over another.
“This is consistent with previous studies performed by these investigators that have shown that when both procedures are medically appropriate, increased patient involvement in breast surgery decisions is associated with greater probability of mastectomy,” reported Morrow and Katz.