Fear Driving Many Mastectomies Among Younger Women

Fear, not facts, appears to be the driving force behind many young women's decision to have both breasts removed even when cancer is present in just one, according to a study published in the journal Annals of Internal Medicine.

The procedure, known as a contralateral prophylactic mastectomy (CPM), is unlikely to improve a person's chance of survival, studies have shown. Still, the number of women -- especially younger women -- opting to have it done is on the rise, according to Dr. Shoshana Rosenberg of the Dana-Farber Cancer Institute.

To better understand why this is, Rosenberg and her colleagues surveyed 123 women age 40 or younger who had undergone a bilateral mastectomy despite only having cancer in one breast.

The response revealed a significant disconnect between perceived and known benefits regarding the situation, with nearly all saying they opted for CPM in hopes of improving their chances of survival despite knowing that doing so was unlikely to alter their prognosis. The only exception to this is, as in the well-publicized case of Angelina Jolie, a person has inherited a genetic predisposition to breast cancer.

"Most women acknowledge that CPM does not improve survival, but anxiety and fear of recurrence probably influence them during the decision-making process," Rosenberg said in a statement.

One reason for this, the study found, was a further disparity in just how unlikely a woman is to develop breast cancer in both breasts. The majority of participants estimated that 10 percent of women with cancer in one breast would develop cancer in the second within five years, while the actual risk falls between 2 to 4 percent.

"Our findings underscore how important it is that doctors effectively communicate the risks and benefits of CPM to women," Rosenberg said. "We need to be sure that women are making informed decisions, supported decisions, based on an accurate understanding of the pros and cons of the procedure, and in a setting where anxiety and concerns can be addressed."