Preventive mastectomy was too well advertised

Fear of breast cancer makes American women follow Jolie's example

Copper news

Young American women with a diagnosed malignant tumor in one of the mammary glands are increasingly deciding on preventive removal of the second, healthy breast, in fear that cancer will affect her, hoping thereby to increase their chances of survival, the authors of the study published in the journal Annals of Internal Medicine (Perceptions, Knowledge, and Satisfaction With Contralateral Prophylactic Mastectomy Among Young Women With Breast Cancer: A Cross-sectional Survey). However, as it turned out, patients often overestimate the risk, and in some cases, the tactics of preventive mastectomy does not justify itself.

Trying to understand the reasons for the significant increase in the number of contralateral preventive mastextomy operations observed in the United States in recent years, especially among women younger than 40 years – from 4-6 percent in the late 1990s to 11-25 percent a decade later - the authors, led by Shoshana M. Rosenberg from the Dana–Farber Cancer Research Institute and the Harvard School of Public Health interviewed 550 patients who were diagnosed with cancer of one of the mammary glands. 123 of them decided to remove the second, healthy breast.

The survey showed that there is some cognitive dissonance among those who have gone for a double mastectomy. On the one hand, women admitted that they were driven by fear and anxiety – 98 percent of them said that they took this step because of fear of cancer in a healthy breast, and 94 percent indicated that they hoped this way to increase their chances of getting rid of cancer completely. At the same time, all of them reported that they have no information that preventive removal of the second breast really saves from relapse of the disease.

Meanwhile, as the authors note, the real situation in this area is as follows: most women who are not carriers of oncogenic mutations in the BRCA1 or BRCA2 genes overestimate the risk of developing cancer in an unaffected breast – recent studies have shown that for such a group of patients, this indicator is only 2 to 4 percent within five years after diagnosis diagnosis, while the study participants estimated this risk at 10 percent.

On the other hand, although double mastectomy generally reduces the chances of developing a tumor in the second breast, the greatest danger is the appearance of metastases in other organs and tissues of the body as a result of the primary tumor. The removal of the second breast cannot affect such a development in any way, which means the actual uselessness of preventive mastectomy in the light of increased chances of survival, Rosenberg noted, quoted by Reuters Health (Women with breast cancer may overestimate secondary risks).

In light of the results obtained, Rosenberg and her colleagues consider it important to draw the attention of attending physicians to the need to work more closely with each patient, raise her awareness and help with the assessment of all the pros and cons of contralateral preventive mastextomy in each case in order to prevent a woman from taking such a step simply under the influence of panic.

Recall that Hollywood actress Angelina Jolie, who is a carrier of a mutant copy of the BRCA1 gene, decided on a double preventive mastectomy in early 2013. This decision of the actress was associated with an increased risk of developing breast and ovarian cancer, which doctors identified as 87 and 50 percent, respectively. In general, a mutation in the BRCA1 gene increases the risk of breast cancer by an average of five times (compared to normal), and the risk of ovarian cancer by 10-30 times. Slightly less likely to develop malignant tumors in women with mutations in the BRCA2 gene. Mutations in these genes are not too common – 5-10 percent of the fairer sex suffering from malignant neoplasms of the mammary glands are their carriers

Portal "Eternal youth" http://vechnayamolodost.ru 17.09.2013