Young Women Diagnosed with Breast Cancer Overestimate the Risk of Cancer in the Other Breast

The results of a study published in the internal medicine journal Annals of Internal Medicine showed that young women with breast cancer generally greatly overestimate the risk of developing cancer in the other breast and the idea of undergoing removal of the second breast for protection.

Approximately 20 thousand women in Turkey develop breast cancer every year. Another characteristic of this type of cancer is its increasing incidence. Before the 2000s, breast cancer occurred in one in eight women in the United States, and its incidence increased each year thereafter; this increase was observed in all developed Western countries. However, advances in technology and the increased availability of early diagnosis have kept the mortality rate from breast cancer unchanged and have not caused any increase.

Some women diagnosed with breast cancer may also develop cancer in the other breast. This condition is defined as contralateral breast cancer. Some women have their healthy breast removed as well to reduce the risk of developing cancer in the other breast. In fact, the data show that an increasing number of women are undergoing this procedure unnecessarily. Interestingly, the women showing this tendency are more often young. In this situation, the first question that comes to mind is whether surgically removing the healthy contralateral breast for preventive purposes is beneficial or necessary..

Women with hereditary breast cancer have a high risk of developing cancer in the other breast. However, among women with breast cancer who do not carry a genetic mutation—that is, who do not have a hereditary form—the chance of developing cancer in the second breast is quite low. Moreover, the evidence obtained has also shown that removing the healthy breast that does not contain cancer does not extend survival.

To examine risk perception, the researchers conducted a study involving 2006-2010 women aged between 26 and 40 who underwent bilateral mastectomy after being diagnosed with cancer in one breast during 123. One of the study’s findings was that most of the women decided to have both breasts removed, making a very important decision for themselves, in the hope of extending their lives. Another conclusion was that many of the women greatly overestimated their cancer risk, believing through hearsay that the risk of developing cancer in the second breast was %2-%4, as commonly stated, rather than %10.

In addition, women with BRCA1 or BRCA2 gene mutations had a more accurate perception of the risk of contralateral breast cancer, whereas women without these mutations did not develop the same perception.

The researchers concluded that many women chose to have the healthy contralateral breast surgically removed for preventive purposes, even though they knew it did not affect survival in breast cancer. Some female patients may benefit from this procedure. However, the cancer risk associated with hereditary or primary breast cancer in women diagnosed with breast cancer should be investigated in detail, and such surgeries should be considered when the physician deems them necessary.

We also observe in our daily oncology practice that our patients’ requests in this direction are increasing. In particular, media coverage of the removal of both breasts from a famous film star such as Angelina Jolie because she had a hereditary type of breast cancer has seriously affected patients. Although the main emphasis in reports about Angelina Jolie was on hereditary breast cancer, the details of the event were not sufficiently understood by those who read the news, leading to the erroneous perception that “having both breasts removed is more beneficial” becoming fixed in people’s minds.

It is important to know that surgically removing the healthy contralateral breast for preventive purposes may reduce the risk of secondary breast cancer; however, the primary concern should be the risk of metastatic (spreading) cancer developing as a result of the primary cancer. Surgically removing the healthy contralateral breast for preventive purposes does not prevent this risk. Therefore, to make the best decision, it is important for communication between the doctor and patient to be at the highest level and for all positive and negative considerations to be evaluated together.