I recently joined a couple of Facebook groups related to my type of cancer: Triple Negative Breast Cancer. Now it's true that I have been cancer free for over 10 years so I'm not as familiar with current protocols as some. However, I was stunned to read how many of my Trip Neg sisters were opting to have single and double mastectomies. It's by far the most talked about aspect of their treatment/care in the FB group, and seems almost commonplace. In a recent conversation with a physician friend, I shared my concern about this trend - wondering out loud why the sudden turn toward this more invasive surgery. I assumed that there must be new, updated data reflecting improved recurrence or survival rates. He suggested I do a deep dive into the research, to determine whether there is new data that supports better outcomes/survivability with mastectomy vs. lumpectomy (better known as breast conservation therapy - BCT). Unable to sleep, later that night I spent a few hours digging into the PubMed studies in this area. What I found was very interesting.
Depending upon which study you site, at best the outcomes are equal or statistically insignificant. At worst, BCT has BETTER outcomes in both recurrence rates and survivability. I have posted links to 4 recent PubMed studies on this topic on the 'Cancer Research' section of our website. Now, let me be clear. I don't have a preference and don't advocate for one treatment choice over another. I'm merely pointing out that:
A. There seems to be a huge upward trend toward mastectomy in breast cancer patients of all stages and types in the US.
B. There doesn't seem to be a therapeutic reason for it.
Now, I know how much fear presents itself when you are diagnosed with breast cancer. I was 42 years old the first time and I was scared to death. The year was 2006 and I had a 9 month old baby at home. I remember begging my oncologist to just surgically remove 'EVERYTHING' that wasn't necessary. I was so afraid and this just seemed like the best idea. But he was patient with me and encouraged me to slow down. He let me know that my cancer would most likely return somewhere else (if it returned at all) and very UNLIKELY to return in my breast. He encouraged me to think carefully about my decision - that mastectomy was a very complicated procedure and could prove to be entirely unnecessary. I am so very thankful for that advice. My fear is that our sisters today are hearing another speech entirely.
Friends, if you or a loved one is facing this decision I encourage you to look at the research and then make the best decision for you and your family. There is so much to consider !
First, are there extenuating circumstances that make mastectomy particularly interesting to you. For example, perhaps you always wanted either a breast enhancement surgery or a breast reduction surgery. If so, this is the perfect time to do so and, perhaps, be covered by insurance. Second, you might carry a gene that predisposes you to recurrence. Or, if you have the type of cancer that isn't a single tumor but rather a grouping of multiple pellet sites that require biopsies over and over again, I can fully understand your choice of mastectomy.
But, if you are under the impression that the pain and discomfort of undergoing mastectomy and possibly reconstruction will lead to better survival or recurrence rates, you are being mislead. The data does not bear that out.
Friends, my concern is that health care practitioners are leading our sisters to the trough of surgery before they even have a moment to breathe. And an uneducated patient is more likely to follow the lead of their medical professional than to chart a different course.
I promise to do what I can to reach our local medical professionals with this information. I will do what I can to inform patients and their loved ones of the truth about the efficacy of both choices.
Again, I need your help, though. Help me spread the word. I'm counting on each of you to be members of my informational army!
Let‘s make sure that every woman who chooses mastectomy does so based on a solid understanding of the truth !