As many women facing breast cancer opt to have a second breast removed as a preventative measure, the trend seems to be spilling over to men as well. A new study found that the number of men getting a double mastectomy has almost doubled since a decade ago.
Ahmedin Jemal, DVM, PhD, who is Vice President of Surveillance and Health Services Research at the American Cancer Society, and colleagues published a report in the journal JAMA Surgery. They looked at data from the North American Association of Central Cancer Registries to find out more information on the rate of mastectomies in the years 2004-2005 and 2010-2011. The registries included 6,332 men who were diagnosed with stage I to III breast cancer in one of their breasts between 2004 and 2011.
Of those men, 1,254 opted to have surgery that would conserve their affected breast, 4,800 had a mastectomy, and 278 chose to have a bilateral mastectomy, called a contralateral prophylactic mastectomy (CPM). However, when the researchers compared the dates of these surgeries, they saw a trend. In the years 2004-2005, 3 percent of the men with a breast cancer diagnosis chose a double mastectomy. However, by 2010-2011, this had increased to 5.6 percent of the men. There also seemed to be a trend related to age, with more younger men choosing a double mastectomy versus older men. While 16.5 percent of men aged 20 to 39 chose to have a double mastectomy, that percentage dropped to 6.9 percent of men 50 to 59 and just 1.4 percent of men over the age of seventy. Race as well as the use of public versus private insurance also seemed to be correlated with the mastectomy choice.
What the researchers found is that the rate of men opting for a double mastectomy almost doubled between 2004 and 2011. This correlates with data for women, who have also been opting for double mastectomies with a breast cancer diagnosis. One of the most famous cases is Angelina Jolie, the actress who chose to have her breasts removed as a preventative measure since she had a high risk of developing breast cancer. This has prompted many others to follow suit with double mastectomies of their own.
Of 1.2 million women diagnosed with breast cancer, about 2 percent chose a double mastectomy in 1998, but by 2011 that number had risen to 11 percent. There were various reasons for the increase in women choosing a double mastectomy, including MRI being used more often to detect more cases of breast cancer, more testing to find BRCA mutations that indicate a risk for breast cancer, and simply to have symmetry between their two breasts.
Although researchers have an idea why women are increasingly choosing to have a double mastectomy, there is little information about men. More studies would be needed to determine whether men choose mastectomies for similar reasons as women or if there are different factors in their decision.
While many patients see a double mastectomy as a way to prevent breast cancer, doctors do urge caution. The surgery can be costly and may not provide an increased chance of survival to the patient. While doctors are urged to discuss the potential benefits and risks with their patients, this study seems to indicate that men need this discussion with their doctors just as much as women who are considering the surgery. That way, the men can make an informed decision as to whether the double mastectomy is the best option in their case.
Breast cancer is much more common in women than men, but about one percent of all breast cancer cases are men. While much of the focus of breast cancer research may be on women, this study seems to indicate that more research specifically on men is needed to help them decide whether a double mastectomy is really the best choice.