When they looked at news stories from 1992 to 2014 about celebrities
with breast cancer, they found that double-mastectomies tended to
garner more publicity.
When a celebrity had a bilateral mastectomy, "that was not only
mentioned more in the story, in many cases it became the dominant
theme of the story," said Dr. Michael Sabel of the University of
Michigan Health System in Ann Arbor, the lead author of a report in
Annals of Surgical Oncology.
More women with breast cancer have been opting to remove both
breasts simultaneously, but there's no evidence that the practice
improves survival in women without a genetic risk for breast cancer.
A small survey published last year in Annals of Surgery found that
half of women with cancer in one breast - but no gene mutations that
increase their risk - were interested in removing their healthy
breast to avoid a second cancer there.
At their own hospital, according to Sabel and his colleague Sonya
Dal Cin, the proportion of women with a first breast cancer in one
breast who went ahead with bilateral mastectomy rose from 4 percent
in 2000 to 19 percent in 2011.
Many women with breast cancer come to their surgeon with their minds
already made up based on outside information, the two authors note -
and often, that information comes from the news media.
For the new study, the researchers searched two news databases for
reports of celebrities with breast cancer. They found 17 cases,
ranging from actress Olivia Newton-John's diagnosis in 1992 to
television personality Joan Lunden's diagnosis in 2014.
Media reports increased significantly after 2004, they found. Also,
there were dramatic increases in the number of articles mentioning
bilateral mastectomies in 2008 and 2009.
Overall, about 45 percent of news stories mentioned the surgical
procedure when the celebrities had both of their breasts removed,
compared to about 26 percent of news stories when only one breast or
just the tumor was removed.
And many stories lacked context, the researchers say. Sixty percent
had no mention of genetics, family history or risk.
For example, Sabel said, actress Christina Applegate, who was
diagnosed in 2008, had both breasts removed.
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"What a lot of people donít know is that Christina Applegate had a
BRCA (gene) mutation and she chose a bilateral mastectomy for risk
reduction," he told Reuters Health.
BRCA1 and BRCA2 mutations account for 5-10 percent of all breast
cancers, according to the National Cancer Institute (NCI). Depending
on the type of BRCA mutation, women's risk of breast cancer
increases between 33 to 53 percentage points. They're also at a
greater risk of ovarian cancer.
When women have cancer in one breast and are not at genetic risk for
cancer in their second breast, doctors generally discourage having
both breasts removed.
Women should get information from reliable sources, said Dr. Nancy
Keating, professor of healthcare policy and medicine at Harvard
Medical School and Brigham and Womenís Hospital in Boston, who was
not involved with the new study.
"That often might mean that they need to hold off on making their
decision until they can talk to their doctors," she told Reuters
Reliable sources of information include the National Cancer
Institute (http://www.cancer.gov/) and the American Society of
Clinical Oncology (http://www.asco.org/), according to Sabel.
"I would say itís important to get educated but then when you sit
down with the surgeon listen, keep and open mind and let the surgeon
help you make a decision," he said.
SOURCE: http://bit.ly/1Snddf2 Annals of Surgical Oncology, online
April 6, 2016.
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