Breast cancer patients increasingly choose mastectomy

Surprising as it may be to women who've never heard the words, "you have breast cancer," more women with the disease are choosing breast removal than in the past.

"Now there's less stigma with mastectomy than there was, and some patients feel more comfortable with it. I've seen an upswing in the past couple of years in the number of patients who choose it over five or six years ago," said Dr. Teresa Reading, a general surgeon at LDS Hospital.

Reading will answer callers' questions regarding the myths and truths about breast cancer on Saturday during the monthly Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, she will join Dr. Brett Parkinson, medical director of the Breast Care Center at Intermountain Medical Center, to field questions by phone. Call 801-236-6061 or 800-925-8177.

One reason patients may opt for mastectomy when a lumpectomy, coupled with radiation treatment, is just as effective could be that breast reconstruction options are better than ever, she said.

"And there are many people who don't feel it's a stigma any more," to have a breast removed. "In my practice I see patients relatively routinely whose cancer is small enough that a lumpectomy would be adequate, but they choose mastectomy.

"For many it's a fear that the cancer will come back. Anxiety is a big part of any cancer diagnosis, and patients know so much about it. And they usually know multiple people who have had it."

Breast removal doesn't mean the cancer will never return, she said, noting it can do so in the skin or chest wall. "But many patients feel less anxious with that choice."

The less invasive lumpectomy means the surgeon simply removes the cancerous tissue. Radiation therapy is also employed to ensure any remaining cancer cells don't begin spreading the disease again.

Patients who choose a lumpectomy need a screening mammogram every six months for two years to catch any early recurrence of the cancer. "Many women have anxiety about (those mammograms) for a month beforehand, and if they find something new it's just too much anxiety. They don't want to deal with that," Reading said.

Studies have shown both treatments are equally effective, she said, noting decades ago, everyone with breast cancer had a mastectomy and suffered the stigma that went with it then.

Now, "it really is a patient choice. It's good treatment." When patients are debating, she tells them, "If you only want me to take out half of your tumor, I won't do that, but removing all of the tumor or all of the breast is good treatment."