Preventative Mastectomies; Another Case of Too Much Treatment Causing Harm for Patients?

Doctors have recognized a somewhat disturbing trend of the past few years. When women, particularly younger women, have cancer throughout a single breast-where a lumpectomy would not solve the problem-and a mastectomy is the only viable treatment, more and more women have the other breast also removed for preventative measures.

In fact, according to a study published in the Annals of Surgical Oncology, between 1998 and 2007 this very scenario has increased ten-fold! Other studies have confirmed this growing trend including one finding that this happened about 7% of the time in 1997 and increased to 24% in 2005. Another study found that almost one-third of breast cancer patients had both breasts removed, whether or not they both needed to.

Understandably, one reason is to take control over the disease. If a patient gets breast cancer in their left breast, there will always been doubt, insecurity, if not outright fear about having it return-possibly detecting it when it is too late-in the future. Whether or not this is the case, doctors are conflicted.

This year, doctors from the Memorial Sloan-Kettering Hospital thought that young women were really undergoing unnecessary surgery. They remarked that in most women having the preventative mastectomies, they were not at a high risk for relapse in the first place. However when it comes to cancer, doctors cannot always predict who has the greatest risk of dying.

In the past few weeks I have particularly addressed unwanted, overly aggressive, or just downright unnecessary treatment and the fear that some medical care providers have. It is believed that now-a-days, too many patients are getting these unnecessary surgeries and in fact, they might be causing more harm than good. For example, having prostate biopsies on a regular bias can introduce infections and increase the harm down to the patient.

But should this practice continue? On one hand, if one is prone to breast cancer and had it once I really can understand that fear of it always lurking and possibly returning. However as doctors noting, a lot of those patients getting the preventative mastectomies are not prone to relapse. Now you are doubling the surgery, which is essentially doubling the chance of complications, chance for infections, and another important issue these days, doubling the costs.

Unless the mental/cognitive element of fear is really affecting the patient's life, I think that with the great technological and advancements in breast cancer detection that women who have found cancer in one breast and had/need to have removed, she should not automatically remove the other. Granted, if she is at a high risk for relapse, or if there are other compounding issues the medical staff strongly recommends a double mastectomy, she should get it. But if those conditions are not there, preventative mastectomies are just going to cause more harm than good to patients, increase the costs of health care, and limit the already scant resources available to patients who might really need such care (recall a few weeks ago my post on hospital drug shortages).

But what do you think? I would love to hear from you! I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at jfisher@mmolaw.net. You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com.