Contralateral prophylactic mastectomy (CRM) is a surgical procedure that removes the unaffected breast in patients with cancer in one breast. Younger women with breast cancer are often offered this procedure as a preventive measure. There has been a 150 percent increase in the number of CRM procedures in recent years.
But researchers at the Perelman School of Medicine at the University of Pennsylvania have found that CRM has only a slight benefit and produces only modest gains in life expectancy. Robert G. Prosnitz, as assistant professor of radiation oncology at Penn, stated, “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.”
Dr. Prosnitz and his research team plan to develop and test decisions aids that will help patients decide if CRM or other alternative treatments are right for them.
How is “a reduction in the quality of life” defined for a patient with one breast removed versus two? Personally my quality of life after double mastectomy is much improved not worrying about when breast cancer will turn up in my second breast. And, to prove my point, when the pathology came back on my “unaffected breast” there were signs of early DCIS! The peace of mind following double mastectomy totally outweighs the old fashioned notion that conserving one, non-matching breast, is worthwhile.