More US women choose double mastectomy - study

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WASHINGTON, Oct 24 (Reuters) More US women diagnosed with breast cancer are choosing to have both breasts removed, even though it is usually not necessary or even recommended, researchers reported.

They found a 150 per cent increase between 1998 and 2003 in the number of US women opting to have both breasts removed when cancer has been found in only one breast.

The operation, called contralateral prophylactic mastectomy, is not needed that often because cancer does not always spread to the other breast, said Dr Todd Tuttle of the University of Minnesota, who led the study.

''Although breast cancer is now often diagnosed at earlier stages, we're seeing more women having contralateral prophylactic mastectomy, even though there are very little data showing that this irreversible procedure improves overall survival,'' Tuttle said in a statement.

''We need to determine why this is occurring and use this information to help counsel women about the potential for less invasive options.'' Writing in the Journal of Clinical Oncology, Tuttle and colleagues said they used a National Cancer Institute database on cancer statistics to review the cases of patients diagnosed with cancer in one breast between 1998 and 2003.

They found 152,755 women diagnosed with stage I, II or III breast cancer. Of them, 59,460 had one breast removed. But 4,969 other women who medically should only have been candidates for a single mastectomy chose to have the other breast removed as well.

The rate of women doing so rose from 4.2 per cent in 1998 to 11 per cent in 2003, Tuttle's team found.

Tuttle said women often make the decision to have a double mastectomy quickly and at a vulnerable time. He said women should be counseled to think more about this.

''Many women choosing bilateral mastectomy are so afraid of cancer that they don't realize that the surgery is unnecessary,'' Diana Zuckerman, president of the National Research Center for Women and Families, said in a statement.

In 2001, a team at the Mayo Clinic in Minnesota found that removing both breasts lowered the risk of a second breast cancer by 89.5 per cent or more -- but this was among women who have the BRCA1 and BRCA2 genetic mutations that greatly raise the risk of breast cancer.

Just five per cent to 10 per cent of breast cancer cases are among women with these mutations.

A second Mayo Clinic survey found that women who had the double mastectomies were happy with the decision. Of 583 women surveyed in 2003, 83 percent said they were highly satisfied with their decision.

The American Cancer Society estimates that 180,000 US women and men will be diagnosed with breast cancer this year and 40,000 will die of it.

Reuters ARB GC0931

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