Why Are Women Choosing to Remove Healthy Breasts?

Tuesday, May 2, 2017 - 4:54pm

In recent months, many news outlets have featured stories about the rising rates of women with breast cancer choosing elective double mastectomies. The reasons why these patients opt for healthy breast removal are very personal, but Dr. Kazuaki Takabe and Dr. Jessica Young joined us on Facebook Live to discuss the medical considerations surrounding this trend.  

What trends are you seeing?

For the last two to three years, we’ve observed a surge in patients asking for double mastectomies. This trend has been especially evident in younger female patients. 

What exactly does this mean?

Breast cancer patients, who have cancer in only one breast, are requesting to have both breasts removed completely, even if their doctor does not recommend this.

What reasons do these women give for their decision?

There are two main reasons women elect to have double mastectomies. The first is a fear of cancer spreading to the other breast, and the second is a concern about her breasts appearing lopsided if she only removes one. Some women may also be driven to remove both breasts because they misunderstand that celebrities, like Angelina Jolie, chose to have a double mastectomy due to a very specific and rare genetic mutation.

What does the research say?

It would be extremely rare for breast cancer, in a patient who does not have any genetic mutations, to spread from one breast to the other. If you get cancer in both breasts, which is still very unusual, they would most likely be completely separate cancers. Breast cancer can spread to a number of different areas, but the other breast is not often one of them. There is no scientific reason to remove both breasts.

Women with worries over their appearance should fully consider the impact of a double mastectomy. Removing both breasts, even with reconstruction, will affect their sensations and feelings. Women often underestimate the psychological implications of a double mastectomy; it will reshape how you relate to and feel about your body, so it is not a decision that should be taken lightly.  

Watch Dr. Takabe and Dr. Young's full discussion.

What do you say to patients who want a double mastectomy?

Patients who ask for a double mastectomy may have misinformation about breast cancer treatment. In reality, removing a healthy breast has never shown, in any study, to improve survival. It’s crucial to talk to these patients about all their options and what the research shows. Surgery should be taken very seriously as there are always associated risks. 

In fact, decades and decades of research have shown us that, many times, we do not even need to remove the whole breast that does have cancer. We can just remove the tumor and some healthy tissue (called a lumpectomy) and treat the remaining breast with radiation. The most important thing is to have an open and honest discussion with your doctor before making any decisions.

If you're a woman over 40, one of the best things you can do to be proactive about your health is to schedule a mammogram. If you're concerned you may be at high risk for breast cancer, fill out our Risk Assessment Form.