In some states, women are more likely to get mastectomies


In midwestern states, women with breast cancer are more likely to opt for a contralateral prophylactic mastectomy (CPM) than women living elsewhere, reported CNN.

Unlike other types of mastectomies, a CPM removes the cancerous tumor as well as the surrounding healthy breast tissue. Each patient may have her own reasons for opting for this more extreme procedure, but researchers have found that geographical location may play a role in the decision.

Mastectomies in the midwest

Specifically, women aged 20 to 44 with breast cancer in the midwestern states of Colorado, Iowa, Missouri, Nebraska and South Dakota are about 42 percent more likely to opt for CPM.

Across the country, rates of young breast cancer patients opting for CPM have increased since the turn of the century. For instance, in New York, only 11 percent of women chose CPM over other forms of mastectomy between the years 2004 and 2006.  Between 2010 and 2012, that rate grew to 28 percent. At a national level, rates of CPM procedures tripled over a 10-year period.

Young breast cancer patients in the midwest are more likely to get CPM.Young breast cancer patients in the midwest are more likely to get CPM.

Why are women opting for CPM?

There's no one reason why younger breast cancer patients would opt for CPM when a lumpectomy - removing only the cancerous tissue - would suffice. However, some theories have been put forward.

One potential cause may be the influence of actress Angelina Jolie, who received the CPM procedure in 2013. Jolie did not have cancer, but had recently learned that she carried the BRCA1 gene mutation, reported Business Insider.

The BRCA1 gene mutation increases a person's risk of developing cancer and only about 0.25 percent of the population is thought to carry the gene. The risks presented by the mutation are significant. Women with the gene may have an increased lifetime breast cancer risk of 60 to 85 percent.

Many women may also fear another occurrence of breast cancer after the original lump is removed. According to the American Cancer Society, the most common second cancer after breast cancer is another form of breast cancer.

Should younger cancer patients choose CPM?

Speaking with CNN, Deborah Axelrod, a breast surgeon based in New York, urged younger cancer patients to consider other forms of mastectomy. Axelrod said that, unless a patient has other risk factors, such as the BRCA1 gene mutation, her chances of developing a second cancerous tumor on her are extremely low.

On an individual case level, each woman should talk to her doctor to understand the benefits of each type of mastectomy.

John Hopkins Medicine explained that there are three major types of mastectomy. They are:

  • Radical mastectomy: This is the oldest form of mastectomy and is much more invasive than most modern procedures. A radial mastectomy completely removes the breast as well as some of the lymph nodes under the arm and the chest muscles. Today, it's only used when cancer has spread to the chest muscles.
  • Modified radical mastectomy: This procedure is nearly the same as the above, but spares the chest muscles.
  • Simple Mastectomy: This procedure removes only the breast, including the overlaying skin.

Doctors should talk with younger breast cancer patients about each of these options in addition to a lumpectomy.

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