Women who require a mastectomy are more likely to also need chemotherapy and radiation. "They're facing a lot of treatment, and they're thinking they just don't want to deal with this in the future," she said.
On the other hand, the rate of preventive mastectomies in women without a diagnosis of breast cancer but with a strong family history of the disease has stayed relatively low and stable over the past 10 years, the study found. The evidence of a benefit of prophylactic removal of a breast is more robust in this group of women.
The study also found that the overall rate of mastectomy as a treatment for breast cancer is going down.
The findings echo a study from 2007, which found that the rate of contralateral prophylactic mastectomy more than doubled from 1998 to 2003. That paper noted that the procedure is often inappropriate and unnecessary.
That trend "tends to be a little concerning," said Edge, who is a professor of surgery and oncology at the New York cancer institute. "It's going up an awful lot, with probably little value, and it's a big deal -- a big operation. It's not trivial."
For doctors, the findings point out that "we need to redouble our efforts to counsel women," he said.
Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La., said that "getting unnecessary surgery is expensive, and a lot of women who have this done tend to have post-operative complications and tend to delay the treatment of their primary cancer," said
One reason for the increase, he said, was that more women are getting MRIs, which pick up many "spots" in the breast, most of which mean nothing.
But the study leaves many questions unanswered, Willey said.
"It doesn't tell you what the motivating force was," she said. "Were physicians rec
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