More women opting for prophylactic mastectomy
MedWire News: The number of women undergoing prophylactic contralateral mastectomy has more than doubled in New York State, USA since 1995, say researchers.
In contrast, the number of women who choose to undergo bilateral mastectomy because of a strong family history of breast cancer is relatively low and has changed little in the past decade.
Prophylactic mastectomy can reduce the risk for developing breast cancer, but there is little information on the prevalence of such surgery, note Coleen McLaughlin (New York State Department of Health, Albany) and colleagues.
In the current study, published in the journal Cancer, McLaughlin and team examined the frequency of prophylactic mastectomy in New York State between 1995 and 2005 using mandated statewide discharge data combined with data from the state cancer registry.
There were 6275 women who underwent prophylactic mastectomy (9% of all mastectomies) during the 11-year study period. Of these, 81% had been diagnosed with cancer in one breast, while the remainder had no personal history of breast cancer.
The researchers found that the number of prophylactic mastectomies increased over time. They note that the prevalence of bilateral prophylactic mastectomies among women with no personal history of breast cancer increased only slightly, from 106 in 1995 to 128 in 2005, whereas the number of prophylactic contralateral mastectomies more than doubled from 295 in 1995 to 683 in 2005.
McLaughlin and co-authors also report that the International Classification of Diseases(Ninth Edition) Clinical Modification diagnostic code for prophylactic mastectomy introduced in 1995 had low sensitivity for identifying prophylactic mastectomies in coded discharge data.
“The results of the current analysis demonstrate that, although the discharge data alone are inadequate for surveillance purposes, combining these data with the cancer registry data allowed for the detailed examination of the prevalence of prophylactic mastectomies,” they remark.
Study leader Stephen Edge (State University of New York at Buffalo) concluded: “Although the total number of prophylactic mastectomies performed per year was small, it appears that the use of the surgery is increasing."
He added that women with breast cancer should have careful counselling regarding benefits and risks before proceeding with prophylactic mastectomy of the other breast.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
By Laura Dean