No evidence of lower mortality with bilateral mastectomy for breast cancer

 

 

 

 


Among California women with stages 0-III breast cancer less than 5 cm in size, rates of double mastectomy have increased steadily, from 2% of women receiving double mastectomy in 1998 to more than 12% in 2011.  The rate of increase was fastest among women younger than age 40 at diagnosis, among whom more than one-third of women in 2011 had a double mastectomy.  We found no evidence of lower mortality in comparison to breast conserving surgery plus radiation, even after accounting for characteristics of the women themselves, their tumor type, and where they were seen.  This pattern was seen across all age groups.  We need to understand more about why patients choose a particular surgery, and how to communicate clearly with patients about the risks and benefits of different surgical options.  We also need to learn more about the women who underwent single mastectomy and had higher mortality; this probably reflects healthcare disparities such as access to healthcare, treatment intensity, and/or co-morbid diseases that need to be addressed.