Most women don't regret preventive mastectomy

Most women who have a breast removed to prevent a second bout of cancer don't regret their decision, a new study suggests.

The study surveyed 519 women who'd had cancer in one breast but decided to have both breasts removed in order to avoid a recurrence. Overall, researchers found, 87 percent said they were still satisfied with their decision, as long as 23 years after the fact.

What's more, they were just as likely as women who did not have a preventive mastectomy to give high ratings to their quality of life.

Dr. Ann M. Geiger of Wake Forest University School of Medicine in Winston-Salem, North Carolina, led the study, which is published in the Journal of Clinical Oncology.

Women who've had cancer in one breast are at higher-than-average risk of developing a tumor in the other breast. So some women opt to have a so-called prophylactic mastectomy of the healthy breast - often because they already face an elevated risk of breast cancer due to family history or because they carry certain genes linked to the disease.

Preventive mastectomy has been found to substantially lower the risk of cancer recurrence, though it won't eliminate the risk, as some breast tissue remains after surgery.

What's been less clear, according to Geiger's team, is how women fare emotionally and psychologically in the years after making their decision. To investigate, the researchers surveyed 519 women who'd undergone preventive mastectomy between 1979 and 1999, and 61 who had not opted for the procedure.

They found that roughly three-quarters of women in both groups said they were "very" or "quite" content with their quality of life, and the large majority of those who'd had a preventive mastectomy felt good about their choice.

Women in both groups often expressed concern about their cancer coming back, but there was less worry among those who'd had both breasts removed.

Despite the encouraging findings, Geiger stressed the point that most women with breast cancer should not have a preventive mastectomy. "It is important to remember that preventive mastectomy is a major surgical procedure likely appropriate for a very small percentage of women with breast cancer," she said in a statement.

However, she and her colleagues conclude, their findings do suggest that high-risk women should not let fear about long-term emotional effects keep them from considering the surgery.

SOURCE: Journal of Clinical Oncology, March 20, 2006.