Upfront

Double mastectomy falls short

Upfront is a quick look at the latest developments from Stanford Medicine

It’s a case where less is more, literally.

Opting to have both breasts removed after a cancer diagnosis in one breast is no more likely to prolong life than the selective removal of cancerous tissue plus radiation therapy. And a bilateral mastectomy can require significant recovery time — longer than the alternative.

The results came after a study, published in the Journal of the American Medical Association, of nearly 190,000 California women diagnosed with the disease between 1998 and 2011.

The researchers, including assistant professor of medicine and of health research and policy Allison Kurian, MD, found that increasing numbers of women received a bilateral mastectomy during the study period. Younger, more affluent women were particularly likely to undergo the complex surgery; in 2011 about one-third of women under 40 had both breasts removed.

The data came from the California Cancer Registry, which holds information about all cancer diagnoses in the state — including details on a patient’s socioeconomic and health insurance status.

“We can now say that the average breast cancer patient who has bilateral mastectomy will have no better survival than the average patient who has lumpectomy plus radiation,” says Kurian, a member of the Stanford Cancer Institute

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