More women with early-stage breast cancer choosing double mastectomies

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A University of Minnesota cancer surgeon and researcher has found a dramatic increase in the number of women diagnosed with the earliest stage of breast cancer choosing to have both breasts surgically removed.

The rate of contralateral prophylactic mastectomy (CPM) surgery among U.S. women with ductal carcinoma in situ (DCIS) increased by 188 percent between 1998 and 2005, according to Todd Tuttle, M.D., lead researcher on this study.

Tuttle is associate professor of oncologic surgery with the University of Minnesota Medical School and a researcher with the University’s Masonic Cancer Center. The National Cancer Institute sponsored this research study and the findings are published in the current issue of the Journal of Clinical Oncology.

"The 10-year survival rate for women with DCIS is 98 to 99 percent,” Tuttle said. “Therefore, removal of the normal contralateral breast will not improve the excellent survival rates for this group of women. Nevertheless, many women, particularly young women, are choosing to have both breasts removed.”
In a previous research study, Tuttle and his colleagues found more American women choosing to have both breasts removed when cancer has been found in only one breast.

This new study indicates the same attitude among women with DCIS, described as the earliest stage of breast cancer when the cancer is small and confined within a duct area of the breast. At this stage, the disease is considered highly treatable with breast-conserving surgery and radiation or hormone therapy. However, if the cancer is aggressive in nature or the woman is not in treatment, DCIS can progress either into invasive, more serious cancer in the affected breast, or it can develop in the other healthy breast.

Tuttle and his colleagues used the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database to evaluate information about 51,030 women diagnosed with DCIS in one breast between 1988 and 2005. They found that 2,072 (13.5 percent) of the women chose breast removal surgery for their DCIS treatment. Furthermore, between 1998 and 2005 the rate of women opting for the surgery increased by 188 percent.

Breast cancer affects more than 214,000 women in the U.S. each year; more than 3,000 of those women are Minnesotans.

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Researchers working with Tuttle on this study were S. Jarosek, EB Habermann, A Arrington, TJ Morris, and BA Virnig, all with the University of Minnesota in Minneapolis.

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