Rates of prophylactic mastectomy for DCIS rising in US

NEW YORK (Reuters Health) - Between 1998 and 2005, the rate of contralateral prophylactic mastectomy among women with ductal carcinoma in situ (DCIS) climbed by 148%, new research shows.

Exactly why more and more women are opting for this treatment, however, is unclear.

"The 10-year survival rate for women with DCIS is 98% to 99%," lead author Dr. Todd Tuttle, from the University of Minnesota, Minneapolis, said in a statement. "Therefore, removal of the normal contralateral breast will not improve the excellent survival rates for this group of women. Nevertheless, many women, particularly young women, are choosing to have both breasts removed."

The findings, reported in the Journal of Clinical Oncology for March 20, stem from a study of 51,030 women who had unilateral DCIS and were entered in the Surveillance, Epidemiology, and End Results database.

Overall, 2072 patients chose to undergo contralateral prophylactic mastectomy, the report indicates. The contralateral mastectomy rates for all surgically treated patients and for those treated with mastectomy were 4.1% and 13.5%, respectively.

Among all surgically treated patients, the contralateral mastectomy rate climbed from 2.1% to 5.2% (148%) between 1998 and 2005. For those treated with mastectomy, the rate increased from 6.4% to 18.4% (188%).

In the overall surgery group and in the mastectomy group, young age, white race, recent year of diagnosis, and lobular carcinoma in situ were predictive of undergoing contralateral prophylactic mastectomy. Large tumor size and higher grade predicted contralateral mastectomy in the overall group, but was associated with lower rates in the mastectomy group.

"Future prospective studies are critically needed to evaluate the complex decision-making processes leading to contralateral prophylactic mastectomy," the authors conclude.

Copyright © 2009 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.