mastectomy

Double Mastectomy Is Rising in Male Breast Cancer Patients
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Male breast cancer patients are opting to remove healthy breasts more than ever before. That is what a new research published in JAMA suggests.According to the research, a substantial increase has… http://dlvr.it/C2qfC7
Rise Seen in Preventive Mastectomy for Male Breast Cancer Patients

Breast cancer much more commonly afflicts women—only about 1 percent of cases in the U.S. are diagnosed in men—but men are still at risk and face many of the same treatment decisions. Women and men who survive breast cancer all share the same fear: that they’ll be diagnosed with it again in the future. This is why so many breast cancer patients choose to undergo contralateral prophylactic mastectomy (CPM), surgery to remove the healthy breast in addition to the breast with malignant tissue, to hopefully reduce the risk in a future diagnosis.

A new report, published Wednesday in JAMA by researchers at the American Cancer Society and the Dana Farber Cancer Institute, finds the number of male breast cancer patients who undergo prophylactic mastectomy is steadily on the rise. The study found the rate of male breast cancer patients who choose to have CPM nearly doubled, from 3 percent to 5.6 percent, between 2004 and 2011. This is equal to a relative increase of 86.7 percent. By comparison, the rate of CPM among female breast cancer patients increased from 4.5 percent to 11 percent between 2003 and 2011.

“We don’t know why it’s happening in men, but we do know the sociodemographic factors that have been associated with contralateral prophylactic mastectomy in women are also associated with men,” says Ahmedin Jemal, vice president of surveillance and health services research at the American Cancer Society and author of the study. As with women, male breast cancer patients who opt for CPM are more likely to young, white and privately insured.

For the report, Jemal and his fellow researchers analyzed breast cancer treatments among 6,332 men who opted to have only the breast with cancer removed, between 2004 and 2011. The report is based on data from the North American Association of Central Cancer Registries.

While breast cancer in men is rare, men with who are afflicted with the disease are more likely than women to develop breast cancer in their healthy breast at some point in the future. Men who are breast cancer survivors have a twentyfold increased risk for breast cancer, compared with men who don’t have a history of the disease, Jemal says. Comparatively, women who are breast cancer survivors are up to five times more likely to be diagnosed with breast cancer than the healthy population.

The broad increase in CPMs has occurred despite a lack of research to show the procedure can affect patients' survival rates. Some experts point to the impact of genetic testing and the “Angelina Jolie effect.” Two years ago, the actress went public with her decision to undergo a preventive double mastectomy after learning she carried the BRCA1 gene mutation, which significantly raises the risk for the disease by as much as 87 percent.

However, Jemal points out that the data indicate the trend began well before the Jolie news. One contributing factor to the decade-long trend may be that most insurance companies are now required to cover breast reconstructive surgery, which makes the decision for some patients much easier.

Jemal says it’s important for male patients to ask a physician about their individual risk for contralateral breast cancer before making any decisions about the surgery. “Men can benefit from this procedure,” he says. “What they need to do is talk to their doctors about the benefits, risks and costs. It’s only the patients at high risk who are likely to benefit from the procedure. They need to discuss with the doctor if they’re a candidate. They have to have the information so they can make an informed decision, but it has to be based on scientific evidence.”

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speaking of prayers, when my stepmom was diagnosed with breast cancer and had to get a mastectomy I tweeted about it and asked for positive thoughts and prayers and someone subtweeted me and essentially was like “I’m not gonna pray for your stepmom who has CANCER because you don’t believe in god”

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A colleague complained that during a particular type of critical conversation his advice is ignored. Women with breast cancer deciding whether to have mastectomies disregard his guidance and seem to have reached a conclusion before he discusses the issue. Given that this physician has committed his career to the study and treatment of breast cancer, […]

In Men with Breast Cancer, Double Mastectomies Are on the Rise

More men with breast cancer are opting to get both breasts removed, even the healthy one, a new study finds.

Between 2004 and 2011, the rates of contralateral prophylactic mastectomies in men nearly doubled, with 5.6 percent of men with breast cancer undergoing the operation in 2011, compared with 3 percent in 2004, according to the study. A contralateral prophylactic mastectomy is an operation to remove a healthy, unaffected breast after a diagnosis of invasive cancer in the other breast.

However, this type of mastectomy isn’t always necessary, the researchers cautioned in their study, published today (Sept. 2) in the journal JAMA Surgery.

“[The operation] is only recommended for a small proportion of men,” and the rates observed in the new study are higher than this proportion, said Dr. Ahmedin Jemal, vice president of surveillance and health services research at the American Cancer Society and the lead researcher on the study.

Moreover, there’s a lack of evidence to suggest that such mastectomies help patients live longer, Jemal told Live Science.

In the study, the researchers looked at data from the North American Association of Central Cancer Registries on 6,332 men who had breast cancer in one breast. All of the men underwent surgery between 2004 and 2011.

The researchers found that, over the study period, 1,254 men underwent breast-conserving surgery, 4,800 men underwent a single-breast mastectomy and 278 men underwent contralateral prophylactic mastectomy. On average, the men who opted to remove both breasts were younger than those who didn’t, and rates of these mastectomies decreased with the men’s age, the researchers said.

The researchers were not surprised by the increase in rates, especially because the pattern has already been observed in women, Jamel said. The rates of such mastectomies in women drastically increased in the past two decades, rising from 2.8 percent of women with cancer in one breast in 1998 to 11 percent in 2011.

Increased genetic testing and the use of MRI during diagnosis may contribute to the increase in women’s rates of these operations, the researchers said. The exact cause of the increase in men is unknown, but the researchers think the reasons may be similar to those in women.

For both men and women with BRCA mutations, the procedure is recommended, he said. However, only a small proportion of people who are diagnosed with breast cancer have these mutations, he noted.

Jemal advised that all men diagnosed with breast cancer in one breast talk to their doctors about the benefits and harms of this type of mastectomy in order to make an informed decision. Each decision is individual, but it should be based on evidence, he said.

According to the American Cancer Society, breast cancer is about 100 times less common in men than in women. An estimated 2,350 men in the United States will be diagnosed with breast cancer in 2015. As with women, the most common type of breast cancer is ductal carcinoma, which begins in the milk duct.

Mastectomies are the most common type of surgery for breast cancer in men, according to the Susan G. Komen Foundation. Because men have less breast tissue than women, breast-conserving surgery, or lumpectomy, is rarely used.

Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.

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Rita Wilson, l'épouse de Tom Hanks: "Qui aurait cru que mon cancer nous rapprocherait?"

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