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Important to carefully consider options before opting for preventive mastectomy

Posted on Friday, 3 August 2018

The findings of a breast research project undertaken at Canterbury DHB have prompted surgeons to reiterate the importance of women who are diagnosed with non-genetic breast cancer in one breast carefully weighing up their options when considering surgery for a preventive mastectomy on the opposite breast.

ABOUT THE PROJECT

The project is being presented today at the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and the New Zealand Association of Plastic Surgeons (NZAPS) Combined Conference and looked at the long-term outcomes of all women who had breast cancer in one breast and were referred to a Plastic Surgeon to remove their opposite breast (in part or completely) for a better size and shape match with their treated breast.

This was then compared with the long-term outcomes of women who had breast reduction surgery. The study looked at the outcomes of patients treated at Canterbury DHB over a 14-year period. It found no difference in the laboratory tissue results from the two groups. No additional cases of breast cancer were found in either group.

RESULTS

These results are the first New Zealand evidence supporting the international recommendations of the American Society of Clinical Oncologists in 2015 and the American College of Breast Surgeons in 2016.

Inherited gene mutations such as BRCA1 and BRCA2 significantly increase the lifetime risk for breast cancer. A prophylactic mastectomy is an effective way of reducing the risk of breast cancer in these high-risk women. On the other hand, concurrent experts’ opinions and evidence suggest patients who have had non-genetic breast cancer in one breast, when treated, are far less likely to have cancer occur in the second breast than women with an inherited gene mutation.

The authors report, women need robust information about their likelihood of developing cancer in the other breast and about the risks and benefits of prophylactic mastectomy, so they can weigh up the options. All surgery has a risk of complications and the recovery for mastectomy and reconstructive surgery takes time. A reconstructed breast may not have the same shape, size and feel of the original breast.

The authors say there is a lot of inaccurate information available in social media and online. This can compound an already stressful situation and risks a patient opting to remove an otherwise normal breast because of fear and anxiety, despite the current evidence.

The results from this study indicate women should ask for as much information as possible and seek a consultation with a plastic and reconstructive surgeon to guide them through the breast reconstruction pathway.

The study was carried out in Canterbury DHB’s Department of Plastic and Reconstructive Surgery by Dr Eric Tan, Plastic Surgery Fellow and his senior colleagues Mr Terry Creagh and Mr Howard Klein. It has now expanded in collaboration with Miss Philippa Mercer and Mr Malcolm Ward, consultants in breast surgery at the DHB.

Ends

 

Media contacts:

ASAPS – Julia Power, email: jpower@asaps.org.au or mobile: + 61 414 276 990

NZAPS: Lizzie Price, email: liz@cmq.co.nz or mobile: +64 276 957 744

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