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A double mastectomy is a surgical procedure involving the removal of both breasts, often employed to treat or prevent breast cancer in individuals at high risk of the disease. However, recent research suggests that this approach may not significantly improve survival rates for breast cancer patients.
A study published in JAMA Oncology on July 25 analyzed over 661,000 women diagnosed with breast cancer between 2000 and 2019. It found that women who had a lumpectomy or mastectomy had only a 7% chance of developing cancer in the other breast later. The study also revealed that opting for a double mastectomy did not offer any survival benefit. Over the 20-year period, breast cancer death rates were similar across different treatment groups, with 8.5% of women who had lumpectomies and 9% of women with other treatments experiencing breast cancer deaths.
The study assessed different treatments such as a lumpectomy, mastectomy or double mastectomy.
Additionally, the pioneering study evaluated the effectiveness of different breast cancer treatments by examining the risk of contralateral breast cancer—cancer developing in the opposite breast after an initial diagnosis—and breast cancer mortality over a 20-year follow-up period. The study compared outcomes among women who underwent lumpectomy (removal of the tumor and a small margin of surrounding tissue), unilateral mastectomy (removal of one breast), and bilateral mastectomy (removal of both breasts).
Researchers analyzed how these treatments impacted the incidence of new cancers in the opposite breast and overall survival rates. Among the 661,270 women studied, while bilateral mastectomy significantly reduced the risk of developing cancer in the opposite breast, it did not result in a statistically significant decrease in breast cancer mortality. This indicates that, despite lowering the risk of new cancer in the other breast, bilateral mastectomy did not improve overall survival rates compared to other treatment options.
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A double mastectomy can be used to treat triple-negative breast cancer (TNBC), an aggressive form of cancer.
A double mastectomy involves a series of precise steps to ensure the complete removal of breast tissue and, if needed, nearby lymph nodes. The procedure is often suggested for individuals at high risk of developing aggressive cancers, such as TNBC. This type of cancer, which is known for its rapid spread and resistance to hormonal therapies and targeted treatments like those addressing the HER2 protein, poses significant treatment challenges, as noted by Breastcancer.org.
Black women are more likely to be diagnosed with TNBC than other ethnicities. They are also more likely to die from the disease, according to the American Cancer Society.
Young Black women are being diagnosed with breast cancer at higher rates. Health notes that Black women under 45 are more likely to develop breast cancer compared to their white counterparts in the same age group. Additionally, Black women under 50 are twice as likely to die from breast cancer as white women in that age range.
Additionally, the procedure can also serve as a preventive measure for individuals with a very high risk of breast cancer, such as those with BRCA1 or BRCA2 gene mutations. As highlighted by Mayo Clinic , the BRCA gene test detects DNA changes that increase the risk of breast and ovarian cancers, focusing mainly on the BRCA1 and BRCA2 genes. This testing often includes an examination of these genes along with other genetic markers that may elevate the risk of developing these cancers. Mutations in these genes significantly raise the likelihood of various cancers, including breast cancer, male breast cancer, ovarian cancer, prostate cancer, and pancreatic cancer. Researchers in the JAMA Oncology study noted that the findings may not apply to individuals who test positive for the BRCA gene. For these patients, double mastectomies are frequently necessary to effectively reduce their cancer risk.
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A breast cancer vaccine is being tested.
The recent study emphasizes the urgent need for advanced technologies to treat and potentially cure breast cancer. Thankfully, a breast cancer vaccine may soon be developed. In 2022, researchers from the University of Washington’s School of Medicine introduced an innovative experimental vaccine to treat breast cancer. The team’s clinical trial revealed that the vaccine effectively triggered a robust immune response against an essential tumor protein in breast cancer cells. According to Medical Press , these findings suggest the vaccine could play a pivotal role in future treatments, paving the way for potential advancements in breast cancer therapy.
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