More American men with cancer in one breast are opting to get both their breasts removed, even the healthy breast, according to a new study.
The rates of contralateral prophylactic mastectomies in men nearly doubled between 2004 and 2011, with 5.6% of men with breast cancer undergoing the operation in 2011, compared with 3% in 2004. A contralateral prophylactic mastectomy is an operation to remove a healthy, unaffected breast after a diagnosis of invasive cancer in the other breast. This is the first research study to identify the trend in men which has previously been observed among American women for the past two decades.
"The increase in the rate of this costly, serious procedure with no evidence of survival benefit comes, paradoxically, at a time of greater emphasis on quality and value in cancer care," said study leader Dr. Ahmedin Jemal, vice president of surveillance and health services research at the American Cancer Society.
The study published in the journal JAMA Surgery
, included more than 6300 men who had surgery fop cancer in one breast. Their surgeries occurred between 2004 and 2011. Over the study period, the researchers found that 1,254 men underwent breast-conserving surgery, 4,800 men underwent a single-breast mastectomy and 278 men underwent contralateral prophylactic mastectomy. On average, the men who opted to remove both breasts were younger than those who didn't, and rates of these mastectomies decreased with the men's age, the researchers said.
"Health care providers should be aware that the increase we've seen in removal of the unaffected breast is not limited to women, and doctors should carefully discuss with their male patients the benefits, harms and costs of this surgery to help patients make informed decisions about their treatments," Jemal said in a journal news release.
Only about 1% of breast cancer patients in the US are men. The percentage of women with invasive breast cancer in one breast who have their cancer-free breast removed rose from 2% in 1998 to 11% in 2011. This is despite the risk of complications and a lack of evidence that it improves the chances of survival, according to background information from the study.