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One of the options for preventing the development of breast cancer is a bilateral mastectomy. The frequency of preventive mastectomy increased from 5% to 12% in the United States between 2004 and 2012 (Lim et al., 2021). The rise in popularity is mostly explained by the maximum reduction in the risk of relapse in the eyes of patients with all the genetic markers of the disease. Since the consequences of this procedure are irreversible, it is important to approach this choice with increased responsibility and consider all the advantages and disadvantages of bilateral mastectomy. Bilateral mastectomy may not be a good preventive choice for genetic markers of breast cancer since such surgery does not increase the chances of recovery.
The main argument against bilateral mastectomy is that it does not influence the positive outcome of cancer treatment. Breast cancer does not pose a mortal danger in itself, but it is a spread to other body parts that can be fatal (Schnipper, 2020). In this context, with a sufficiently rapid spread, the operation will not bring an actual positive result and may lead to a relapse. Studies on the possibility of reducing the risk of recurrent disease have shown that bilateral mastectomies can influence the opportunity of recurrent breast cancer in around 40 cases per 10,000 person-years (Schnipper, 2020). These results are a minor indication for considering surgery as a good preventive choice. The emotional attachment of patients with genetic markers of cancer to the possibility of finally getting rid of cancer becomes the fundamental reason people take such a desperate step. Nevertheless, removing a healthy breast will be useless if the disease has already progressed and poses a danger to other body parts.
This argument is also supported by a higher risk of negative consequences. Bilateral mastectomy involves the surgery on the removal of both breasts, which increases the duration and complexity of the surgical process (Schnipper, 2020). Moreover, the risk of infection and healing problems is doubled compared to surgery to remove only one breast. Despite this, people may voluntarily agree to remove a healthy breast due to the risk of cancer spreading to other areas. The patients decision to resort to surgery is caused mainly by fear of contralateral cancer (Lim et al., 2021) while ignoring other process complexities. The list of emotions and irrational fear can sometimes be stronger than the recommendations of doctors and surgeons, forcing a patient with genetic markers of breast cancer to resort to radical methods of treatment. As a result, the risk of recurrent disease may be provoked rather by complications after surgery, which is also a weighty argument against the perception of bilateral mastectomy as a sustainable preventive measure.
In conclusion, bilateral mastectomy cannot be a reliable preventive measure for patients with genetic markers of breast cancer. Surgeons respect the patients autonomy and cannot interfere with the choice, even if the general recommendations do not encourage the procedure (Lim et al., 2020). Nevertheless, there are good reasons not to consider mastectomy a good preventive choice. The lack of solid evidence based on the advantages of bilateral mastectomy over other operations, the risk of complications, and the patients irrational fear of relapse as a main reason for the surgery become the main justifications against the procedure. Thus, removing a limited area has much more benefits in the context of cancer treatment.
References
Lim, D. W., Metcalfe, K. A., & Narod, S. A. (2021). Bilateral mastectomy in women with unilateral breast cancer: A review. JAMA surgery, 156(6), 569-576. Web.
Schnipper, H. H. (2020). Pros and cons of preventive bilateral mastectomies. Beth Israel Deaconess Medical Center. Web.
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