High incidence of Mastectomy - Shorts

Townsend Letter for Doctors and Patients,  June, 2002  by Jule Klotter

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Diana Zuckerman, PhD, author of "The Need for Improved Informed Consent for Breast Cancer Patients" (Journal of the American Medical Women's Association, Fall 2000, 55: 285-289), reports that far too many American women with early stage breast cancer undergo mastectomies rather than the equally effective and less disfiguring lumpectomy: "... approximately one out of every two American women who have a breast removed as treatment for cancer do not need such radical surgery." She points to several factors that contribute to this high incidence of mastectomy. "In many facilities, it's actually cheaper to remove a breast than it is to perform a lumpectomy and provide the necessary follow-up radiation therapy." Doctors' bias also plays a large role. "In a study of 157 hospitals, patients treated by doctors trained before 1981 were less likely to have lumpectomies or other breast-saving surgery than women who had younger doctors." "A study of 175 surgeons found that even doctors who know that lumpectomy is as safe as mastectomy may persuade their patients to get mastectomies by making subtly biased recommendations." Women who end up with lumpectomies tend to seek a second opinion.

In addition to the lack of information about their surgical choices, Dr. Zuckerman says that breast cancer patients are not being informed about the risks of reconstructive surgeries that "use synthetic breast implants or tissue transfers from other parts of the body." She says that there is a lack of published epidemiological studies that have looked at the long-term risks, failure rates, and complications of these procedures. Similarly, few studies have shown that the practice of 'prophylactic mastectomy' among healthy women with strong family histories of breast cancer is actually effective. Dr. Zuckerman states: "If objective information is not available on some aspects of breast cancer treatment because of lack of research, then the patient should be told that there is no research, or that existing research is inconclusive."

Zuckerman, Diana, PhD. Unnecessary Mastectomies. www.cpr4womenandfamilies.org

COPYRIGHT 2002 The Townsend Letter Group
COPYRIGHT 2002 Gale Group