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Are mastectomies over-used?

by JEAN ENERSEN / KING 5 News

NWCN.com

Posted on October 20, 2009 at 11:55 AM

Are mastectomies still being over-used in breast cancer treatment?

Study after study has shown that the radical surgery isn't necessary in many cases, but do surgeons follow the guidelines?

When Denise Moscatiello was diagnosed with breast cancer last February, she automatically assumed she'd need aggressive treatment.

"When I got the phone call with the news, which came from the radiologist originally, that's the first thing that pops into your head is oh my god, I'm going to need a mastectomy," she said.

Concerns exist that surgeons are too quick to recommend mastectomies when less radical surgery - a lumpectomy - would be sufficient.

"Most women would prefer to keep their breast if that option was open to them but over time it's turned out that mastectomy has persisted in the United States as a treatment which raised concerns about whether or not surgeons were even offering a choice in treatment," said Dr. Monica Morrow, of Memorial Sloan-Kettering Cancer Center.

Dr. Morrow and her colleagues wanted to find out if patients are being given a choice. They looked at 2,000 women with early stage breast cancer. They discovered that most patients received the procedure recommended by their surgeons and that over 75 percent reported having breast-conserving surgery as an initial surgical therapy instead of a mastectomy

"I think the message is that surgeons pretty reliably recognize which women are best treated by mastectomy and that if you're advised to undergo breast-conserving surgery, or you're offered a choice, the lesser surgical procedure is one which is highly likely to work and provide a good outcome."

Denise ended up having breast-conserving surgery.

"I didn't really feel like I was gonna benefit by doing it the other way," she said.

The JAMA study found that breast-conserving surgery is recommended for most women with early-stage breast cancer.

Of course, this only applies to early-stage breast cancer patients so early detection is key.

At the same time, mammogram screening is on the decline.

That's the reason behind the local make-a-mammogram-promise.

The campaign is going on through the month of October.

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