Celebrity cases may have led to rise in double mastectomies

April 27, 2016 | by City of Hope

A noted rise in double mastectomies may be due to skewed media coverage of celebrities with breast cancer, according to a new study published online in the Annals of Surgical Oncology.

Research by the University of Michigan Comprehensive Cancer Center revealed that such media coverage is not always balanced or thorough, leading to breast cancer patients possibly making misinformed choices. The media coverage, according to the study, betrays a bias that makes people think that double mastectomy is the best treatment choice for breast cancer, when often it is not.

In the study, Michael Sabel, chief of surgical oncology at the University of Michigan Comprehensive Cancer Center, and his team examined data for 17 celebrities who publicly disclosed their breast cancer diagnosis between 2000 and 2012. This list included Christina Applegate, Sheryl Crow, Melissa Etheridge, Joan Lunden, Cynthia Nixon, Suzanne Somers and Wanda Sykes.

Four of the 17 received a double mastectomy, and 45 percent of the media coverage about their breast cancer mentioned the surgery, the study found. However, only 26 percent of media coverage mentioned surgery when reporting on 10 celebrities who had a single mastectomy or breast-conserving therapy, the study revealed.

At the same time, during the period of the study (between 2000 and 2011), the rate of double mastectomies at the University of Michigan Comprehensive Cancer Center rose from 4  to 19 percent.

“We are seeing a tremendous rise [of double mastectomies] in those who don’t have high risk,” Sabel said. His team analyzed more than 700 articles from major U.S. print publications such as the Los Angeles Times, Chicago Tribune, USA Today and others.

“The media coverage represents a kind of bias that makes people think this [double mastectomy] is the [best] treatment for breast cancer,” Sabel said. “Celebrities do have a significant impact on medical decision-making, but in this case it might be a negative effect.” Women may come in with their minds made up instead of asking about treatment options, he said.

While such radical surgery is sometimes warranted, such as in the case of a strong family history or genetic mutations that dramatically raise cancer risk, often it is not, he explained.

Courtney Vito, M.D., an assistant clinical professor of surgical oncology at City of Hope, agreed that celebrity coverage can give women some incorrect ideas. She told HealthDay that the study findings reflect questions she often gets from her breast cancer patients.

“Some patients view a bilateral [double] mastectomy as a benchmark of quality, even when it is sometimes medically inappropriate,” Vito said. In certain cases it can increase the risk of medical complications, such as when a woman also has other health issues such as obesity or high blood pressure, she said.

“Many women who have had bilateral mastectomy said they feel empowered,” Vito said, even though it does not improve their survival odds. For others, the drastic surgery has been said to provide peace of mind.

“Because breast cancer treatment is tailored to personal history, family history, tumor biology and personal wishes,” added Vito, “you must choose a physician with whom you can have a collaborative relationship,” and not make your medical decisions based on what celebrities did or did not do.

Patients need to be educated about the pros and cons of all of the treatment options for breast cancer, Sabel said, to dispel the notion that double mastectomy is always best.

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