Does a mastectomy guarantee no more cancer?

February 26, 2010 7:53:58 AM PST
It's an agonizing decision for many women with breast cancer: Whether to sacrifice a part of her body that does not have cancer, in hopes of preventing the cancer from returning. But increasing numbers of women are choosing to have a preventative mastectomy. A major new study from Houston scientists, shows the sacrifice for many women, may not be worth it.

"I did not want to have my breast removed, I was 38 years old, a vegetarian and I was fairly healthy," said patient Jill Butler.

But when Jill Butler was diagnosed with breast cancer two years ago, she kept thinking of her mother who was diagnosed at 44.

"I really made the decision, watching her go through all that that and ultimately die three years later," she said. "I was going to be as aggressive as I possibly could."

So she had a mastectomy and then an elective mastectomy on her other breast which did not have cancer. The number of women like Jill having elective mastectomies has increased by 150 percent. But will it increase their survival? There's been little science to guide them. Now a study by M.D. Anderson scientists found that most of the women who had an elective mastectomy did not live longer.

"If 100 women underwent a prophylactic mastectomy, five women would have benefited from it and the other 95 would not have seen a difference," said Dr. George Chang, M.D. Anderson study co-author.

In the study, the women who did benefit from the elective mastectomy were women under age 50. Who found it early at stage 1 or stage 2 and whose cancer was estrogen negative, their survival rate increased by 5 percent.

"I think the benefit of 5 percent is a relatively small benefit for what is a significant procedure," said Dr. Chang.

Study authors say women 60 and older did not benefit from the elective procedure. The results for women 50 to 60 weren't clear.

"The majority of women probably could be reassured that they're making a good decision if they don't elect to undergo a prophylactic mastectomy," said Dr. Chang.

"I think it's fantastic they're starting to do these kinds of studies to help women and men make these hard decisions and get some science behind these decisions," said Jill.

But for herself, Jill has no regrets.

"It was the absolute right thing for me and I still absolutely feel that way to this day," she said.