Tuesday, March 9, 2010

After Cancer, Removing a Healthy Breast - Well Blog - NYTimes.com

For decades, advocates have fought to protect women from disfiguring breast cancer surgery, arguing that it was just as effective to remove only the cancerous tissue rather than the whole breast.

But today, a growing number of women with breast cancer are pushing surgeons in a startling new direction. Not only do they want the cancerous breast removed, but they also want the healthy breast cut off.

"I just didn't want to worry about it," explained Liliana Holtzman, 50, an art director in Ann Arbor, Mich., who had both breasts removed after a cancer diagnosis five years ago. "It was for my own peace of mind. I wanted to do everything I could."

The percentage of women asking to remove both breasts after a cancer diagnosis has more than doubled in recent years. Over all, about 6 percent of women undergoing surgery for breast cancer in 2006 opted for the procedure, formally known as contralateral prophylactic mastectomy. Among women in their 40s who underwent breast cancer surgery, one in 10 opted to have both breasts removed, according to a University of Minnesota study presented last week in St. Louis at the annual meeting of the Society of Surgical Oncology.

Surprisingly, the practice is also more popular among women with the earliest, most curable forms of cancer. Among women who had surgery for ductal carcinoma in situ, sometimes called Stage 0 cancer or precancer, the rate of double mastectomy rose to 5.2 percent in 2005, from 2.1 percent in 1998, according to a 2009 study in The Journal of Clinical Oncology.

Women with a known genetic risk for breast cancer can lower the chances of developing it by having both breasts removed before cancer appears. But for most women given a diagnosis of breast cancer, cutting off a healthy breast does not improve the odds of survival.

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