Receiving a breast cancer diagnosis can be profoundly unsettling. Once the initial shock subsides, many patients seek ways to enhance their chances of survival and reduce the likelihood of facing cancer again.
However, a recent study published in JAMA Oncology has challenged the widespread belief that undergoing a double mastectomy—surgical removal of both breasts—improves survival rates compared to other standard treatments for breast cancer. The study, which analyzed data from over 661,000 women diagnosed with various forms of breast cancer between 2000 and 2019, found no significant survival advantage for those who opted for a double mastectomy over those who chose lumpectomy (removal of the tumor and surrounding tissue while preserving the breast) or single mastectomy (removal of one breast).
According to lead study author Vasily Giannakeas, PhD, from the Women’s College Hospital Research and Innovation Institute, while a double mastectomy effectively reduces the risk of developing cancer in the other breast, it does not decrease the risk of dying from breast cancer. Giannakeas emphasized that the study aimed to clarify which surgical options actually improve survival outcomes for breast cancer patients.
Medical experts have expressed little surprise at these findings. Janie Grumley, MD, a breast surgical oncologist at Providence Saint John’s Center and Associate Professor of Surgery at Saint John’s Cancer Institute in Santa Monica, California, noted, “A lot of patients feel inclined towards more extensive surgery, but we’ve never seen evidence of a survival benefit from bilateral mastectomy.”
Similarly, Brian Czerniecki, MD, a surgical oncologist at Moffitt Cancer Center, concurred, stating, “For years, it has been known that bilateral mastectomy does not offer a survival advantage. Most patients opt for it for cosmetic reasons or to achieve breast symmetry.”
Grumley underscored that these findings do not apply to women with genetic mutations like BRCA gene mutations, which significantly increase the risk of breast cancer. However, for the average breast cancer patient without such genetic predispositions, the study suggests that more extensive surgery does not translate into improved survival outcomes.
The study’s attention has sparked hope among experts like Grumley that it will help dispel misconceptions about the benefits of more extensive breast surgeries. She remarked, “There is a misconception that more extensive surgery equates to better outcomes. But with larger operations come greater risks. If there is no survival benefit, why take on those risks?”
Ultimately, while a double mastectomy may offer psychological benefits or peace of mind to some patients, the study underscores the importance of informed decision-making in breast cancer treatment, guided by a clear understanding of the risks and benefits associated with different surgical options.
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