Angelina Jolie made headlines when she decided to remove both her breasts before cancer had the chance to strikeÃ¢â‚¬”but sheÃ¢â‚¬â„¢s hardly the only brave woman who has gone this route. Recent studies suggest that rates of preventive breast cancer surgeries are rising, especially the rate of contralateral prophylactic mastectomy (CPM), a surgery to remove the unaffected breast when a diagnosis is made in the other breast. When asked why they chose CPM, most women said the major reasons were to improve their chances of survival and to cut their risk of breast cancer in the unaffected breast, according to a new study published in the Annals of Internal Medicine.
But hereÃ¢â‚¬â„¢s the thingÃ¢â‚¬”the risk of getting cancer in the unaffected breast is already very low for most women without a known genetic mutation: about 2 to 4 percent in the five years after treatment, says lead study author Shoshana Rosenberg, Sc.D., M.P.H., researcher at Dana-Farber Cancer Institute. But when the researchers asked the participantsÃ¢â‚¬”123 women aged 40 and under who had undergone CPMÃ¢â‚¬”they overestimated this risk, reporting that 10 percent of women would get cancer in the other breast in the five years after treatment.
Another huge caveat: CPM has not been proven to have an effect on survival rates. In fact, more than 70 percent of the women accurately answered a question about this, yet the majority still said that improved survival was a major reason for choosing CPM. Ã¢â‚¬Å“It implies how theyÃ¢â‚¬â„¢re viewing their own personal risk on an individual level when making this decision,Ã¢â‚¬Â says Rosenberg. Ã¢â‚¬Å“And thatÃ¢â‚¬â„¢s not in line with what they objectively know to be true.Ã¢â‚¬Â
So why are women making drastic surgical decisions that donÃ¢â‚¬â„¢t necessarily match up with the facts? Rosenberg suggests it has to do with anxiety that maybe isnÃ¢â‚¬â„¢t being addressed early on in the decision-making process.Ã‚Â Ã¢â‚¬Å“The information is not necessarily enough,Ã¢â‚¬Â says Rosenberg. Ã¢â‚¬Å“There needs to be some component of correcting these misperceptions, finding a better way to communicate risk, and addressing fear and concerns.Ã¢â‚¬Â
That said, CPM is certainly not a bad option for some women. ItÃ¢â‚¬â„¢s a safe and effective procedure that can dramatically reduce the risk of breast cancer in the unaffected breastÃ¢â‚¬”even if it is a small one. The bottom line is that itÃ¢â‚¬â„¢s crucial to consider all options with your doctor before deciding on treatment. And if you feel that fear and anxiety are clouding the facts in your mind, donÃ¢â‚¬â„¢t be afraid to bring that up with your doctor. Ã¢â‚¬Å“For some women, any risk is too much risk,Ã¢â‚¬Â says Rosenberg.
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