Many with Breast Cancer Unnecessarily Choose Double Mastectomy

Many women with early stage breast cancer choose to have their healthy opposite breast removed, even when there are no medical indications that such a step is necessary, a new survey finds.

That’s especially true when the surgeon doesn’t offer a recommendation either way, the researchers said.

“We are seeing that one in six breast cancer patients are choosing bilateral mastectomy when this aggressive procedure is not going to benefit them in terms of survival,” said Dr. Reshma Jagsi.

Jagsi, who led the study, is a professor and deputy chair of radiation oncology at the University of Michigan School of Medicine.

Cancer specialists say no compelling evidence suggests a survival advantage for most patients to choose a double mastectomy. Also, the risk of getting cancer in the opposite healthy breast is low for most patients, they note.

However, after actress Angelina Jolie publicized her decision to undergo removal of both breasts, more women became aware of the option. Perhaps they think more is better, the researchers said.

Jagsi said she is disturbed that so many women choose such a radical approach. However, she understands how they perceive they are doing everything they can to avoid cancer.

Women for whom the double procedure might be warranted, she said, include those who have a very high cancer risk, such as the BRCA 1 or BRCA 2 gene mutations.

However, “for women with garden-variety breast cancer in one breast, the medical risks [of a preventive mastectomy in the opposite breast] really seem to outweigh the medical benefit,” Jagsi said.

Wisdom Wednesday: Iatrogenic Disease

Iatrogenic – induced inadvertently by [the words or action of] a physician or by medical treatment or diagnostic procedures.

I have experienced many examples of iatrogenic disease over the course of 39 years of practice. In the early years of my chiropractic career, it was trying desperately to treat patients that had failed back surgery syndrome. I have also treated a number of patients that became ill from bowel resections and cholecystectomies. But those number pale compared to the escalating numbers of patients developing new diseases from their medications.

This week alone I have two patients that appear to have developed type II diabetes from taking statin drugs. In both cases they have been taking statin drugs for years. When the diabetes was detected, their PCP (primary care physician) just added metformin and glyburide to their growing list of prescription drugs. One patient was on five meds, the other on ten. Neither case responded to the diabetic medications and they ended up in my office.

In another case this past week, a patient’s insomnia was due to her thyroid medication and another patient’s memory loss was secondary to his heart medication. His memory loss mimicked intermittent, advanced dementia. It was the radical swing in memory issues that keyed me in to the medications as the cause. Of course, he is on ten additional medications daily, so some the effect is probably from drug interactions.