It has been much publicized as almost an ‘insurance’ policy for women who after having been diagnosed with cancer in one breast, decided to have both breasts removed. The procedure, known as contralateral prophylactic mastectomy (CPM), is presented as something that will greatly reduce the odds they will not get breast cancer again.
The numbers of women undergoing this treatment are increasing (150% more in the US), but there has been no clinical evidence that is worthwhile. Now, researchers from the Perelman School of Medicine at the University of Pennsylvania have just announced the results of research that is a double whammy for women having had the surgery. It shows first that CPM provides little significant benefit but secondly – and more importantly – that it can have significant negative health effects on women who undergo it.
The study shows that the surgery actually reduces the measure of life expectancy that takes into account quality of life among women who do not have hereditary breast cancer. That is the vast majority – around 90 percent – and they are the ones being affected most after a mastectomy.
Robert G. Prosnitz, MD, MPH, assistant professor of Radiation Oncology in the Perelman School of Medicine, was the lead researcher and he expressed the hope that their findings will assist patients and doctors to make informed decisions about treatment strategies, based on a clear understanding of the real benefits and risks involved in preventive mastectomies.
He said: “We suspect that many of the women who elect to undergo CPM are acting on the belief the surgery will substantially reduce their overall risk of dying of breast cancer, however, our study shows that a woman’s risk of death from her primary breast cancer far outweighs her risk of death from a potential breast cancer developing in the unaffected breast. Additionally, the modest increase in life expectancy resulting from CPM may ultimately be negated by a reduction in quality of life.
The study showed that CPM produced modest gains in life expectancy, primarily in younger women with early-stage cancers whose type is known to carry a favorable prognosis anyway. However, even in these women, their risk of dying from their primary breast cancer far exceeded any risk of dying from a breast malignancy that might develop at some time in the future in the opposite breast.
The conclusion that surprised the researchers was how small the benefits were for women with even the most favorable breast cancers.
What is not really discussed by either doctors or patients is that the operation appears to reduce the quality of life as the result of surgical complications, loss of sensation in the breast, and other medical problems. Dr. Prosnitz and his colleagues concluded that not undergoing this procedure is the preferred strategy for all patients, regardless of age, cancer stage or tumor molecular subtype.
Such a drastic response could be avoided if oestrogen dominance was dealt with in the early stages and the protective action of bioidentical natural progesterone on breast was paid more attention to.
If you would like to read more on this subject then this excellent article by Dr David Zava explains progesterone’s role: http://www.bio-hormone-health.com/2011/05/18/natural-progesterone-as-a-preventive-for-breast-cancer-by-dr-david-zava/