Breast cancer

05 June 2013

Young breast cancer patients opt for mastectomy

Research shows that more and more young women who are diagnosed with breast cancer are opting to have a mastectomy.

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Most young women with breast cancer choose to undergo a mastectomy, new research shows.

The other option is to have a lumpectomy, a surgical procedure that removes the tumour and some surrounding healthy tissue, but spares most of the breast. Researchers from the Dana-Farber Cancer Institute in Boston said women dealing with breast cancer at an early age have a unique set of medical and psychosocial concerns.

"Rates of mastectomy, particularly in young women with breast cancer, are on the rise, and it is not entirely clear why," study author Shoshana Rosenberg said in a Dana-Farber news release. "We were interested in learning from women who had a choice about surgery what factors were associated with their decisions."

The study involved nearly 300 women who were diagnosed with breast cancer when they were 40 years old or younger. All of the women, whose cancer ranged from stage 1 to stage 3, were given a choice between a mastectomy and lumpectomy.

Undergoing radiation after a mastectomy

Most women do not need to undergo radiation after a mastectomy. Many women who have this procedure go on to have additional reconstructive surgery. In contrast, following a lumpectomy women typically undergo radiation therapy to destroy any remaining cancer cells. Studies have shown overall survival rates for lumpectomy followed by radiation are the same as mastectomy, the researchers pointed out.

The study found that 62% of the women chose to have a single or double mastectomy rather than undergo a lumpectomy.

The women who chose to have a mastectomy often had a genetic mutation and this played a greater role in their medical decision. These women also tended to have at least two children and a higher level of anxiety. Among the other factors associated with women's decisions to opt for a mastectomy over a lumpectomy included an overabundance of the HER2 protein in tumor cells, signs that a tumor had spread to the lymph nodes, higher tumor grade and lower body-mass index (a measure of body fat based on height and weight; a higher BMI means a person is more overweight).

Genetic factors to the disease

"Our data suggest that disease and genetic factors may be related to choice, as well as anxiety and how the decision was made," Rosenberg said. "Further research is clearly warranted in an effort to help ensure that women can make informed, quality decisions about their breast cancer therapy."

The researchers noted other factors that were not significantly associated with the women's decision to have a mastectomy, including their age, race, marital status, tumor size, fear of recurrence, depression and whether they had an estrogen-sensitive tumor or a first-degree relative with breast or ovarian cancer.

More information

The US National Cancer Institute provides more information on breast cancer treatment.

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Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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