EBCC: Breast Cancer Patients May Overestimate Future Risk

Those who request contralateral prophylactic mastectomy may not understand their actual risk
By Rick Ansorge
HealthDay Reporter

FRIDAY, March 26 (HealthDay News) -- Breast cancer patients who request a contralateral prophylactic mastectomy may significantly overestimate their risk, according to research presented at the European Breast Cancer Conference, held from March 24 to 27 in Barcelona, Spain.

Ajay Sahu, M.D., of the Frenchay Hospital in Bristol, U.K., and a colleague studied 27 patients ages 31 to 65 who were diagnosed with breast cancer between April 2008 and October 2009, underwent surgery on one breast, and requested a contralateral prophylactic mastectomy.

The researchers found that the reasons behind the requests included young age, but without a family history (three patients); lobular cancers (seven patients); family history, which was deemed low risk by the surgeon (12 patients); a poor treatment outcome among family or friends (four patients); and a desire to avoid radiotherapy (one patient). They also found that all of the patients feared they would not survive more than five years, and that they overestimated their risk of contralateral breast cancer by a factor of five to 10. After 12 months, all were less anxious about their risk, and only four still asked for prophylactic surgery.

"Breast cancer risk perception by patients at the time of initial diagnosis is always overestimated," the authors conclude. "Therefore, women requesting bilateral mastectomy should receive adequate counseling of actual risk and be encouraged to defer such measures if they fall into the low to moderate risk group, so as to not undergo unnecessary, irreversible procedures. Given time to rethink, patients are able to have a better understanding of their actual risk and fewer then request bilateral or prophylactic mastectomy."

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