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The rates of women who have double mastectomies for breast cancer vary depending on the state

A general view of a partial mastectomy scar on an unknown patient.

(iStock)

While researchers have found that an increase in the contralateral mastectomies among women with early-stage cancer in one breast, they said that the chance of a woman seeking such a procedure differs depending on the state in which they live. The study, which was published in JAMA Surgery, analyzed data collected between 2004 and 2012, more than 1.2 million women with early stage cancer in one breast.

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The share of women in the age group of 20 to 44 have opted for contralateral mastectomy rose about 11 percent to 33 percent in the country, Reuters reported. There was also an increase in women 45 years of age and older who had both breasts removed during the same time period. Although earlier medical opinions have discouraged such a practice, for women with a one-sided, or unilateral, breast cancer that has no genetic or family risk of the disease, the rates were consistently highest among women aged 20 to 44.

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However, when broken down by region, the researchers found during the last two years of the study, more than 40 percent of women in that age group who lived in South Dakota, Iowa, Colorado, Missouri, Nebraska, Tennessee, Maine, and Montana chose to have both breasts removed. In New Hampshire, Delaware, New Jersey, Louisiana, Idaho, Alaska, South Carolina, Nevada, Massachusetts, Wyoming, Hawaii and the District of Columbia, the rates were less than 25 percent.

Researchers said that the study does not explain why so many women choose contralateral mastectomies, but that the price in the U.S. is higher than in other countries. They also looked at the proportion of women who have reconstructive surgery after both breasts removed, and found that while the highest rates of double breast removals were in the Midwest, the highest rates of reconstruction were clustered in the Northeast.

“The variation is very noticeable,” senior author Ahmedin Jemal of the American Cancer Society in Atlanta, told Reuters.

During the study, there was no information about whether the participants had a genetic risk for developing cancer or a history of radiation therapy to the chest, Dr. Laurie Kirstein, a breast surgical oncologist at the Memorial Sloan Kettering Cancer Center in New York City, who was not involved in the study, said the variation can be explained by health care access, income or peer influence.

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Kirstein also told Reuters that for women with a genetic predisposition to breast cancer, bilateral mastectomy is considered “a reduce risk of the procedure.”

Jemal said that the findings indicate a need for more detailed conversations between physicians and patients.

“First, the surgeons have discussed this with the patient,” Jemal told Reuters. “Second, patients should take the time to make a decision. They don’t want to make the decision immediately, because anxiety is very high right after the diagnosis.”

Reuters contributed to this report.

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