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Are mastectomy rates really increasing in the United States?

June 22, 2010

A national population-based study using data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry examined trends in breast cancer surgery across the United States from 2000-2006. Among 233,754 women diagnosed with unilateral (on one side) ductal carcinoma in situ (DCIS) or stage I, II, or III invasive breast cancer, researchers found that the percent of women treated with mastectomy has decreased overall from 40.8% in 2000 to 37% in 2006. These findings contrast with prior studies of data from single large institutions that found mastectomy rates increasing over time. The researchers state that possible explanations for these differing findings include patients selecting large institutions for more aggressive treatment (e.g. mastectomy) or breast reconstruction, and doctors referring patients with a strong family history or a BRCA gene mutation to large institutions.

In this study, researchers found that older women, non-Hispanic white patients, those with small, low-grade, ER-positive or non-lobular tumors, and those with DCIS or stage 1 breast cancer were less likely to undergo mastectomy than other patients. Interestingly, at the same time, the data showed that the rate of bilateral mastectomy (removal of both the breast with cancer and the opposite healthy breast) has increased over time.