"Mastectomia bilaterale e mortalità per carcinoma mammario"
California women with stages 0-III breast cancer less than 5 cm in size,
rates of double mastectomy have increased steadily, from 2% of women
receiving double mastectomy in 1998 to more than 12% in 2011. The
rate of increase was fastest among women younger than age 40 at
diagnosis, among whom more than one-third of women in 2011 had a double
mastectomy. We found no evidence of lower mortality in comparison
to breast conserving surgery plus radiation, even after accounting for
characteristics of the women themselves, their tumor type, and where
they were seen. This pattern was seen across all age groups.
We need to understand more about why patients choose a particular
surgery, and how to communicate clearly with patients about the risks
and benefits of different surgical options. We also need to learn
more about the women who underwent single mastectomy and had higher
mortality; this probably reflects healthcare disparities such as access
to healthcare, treatment intensity, and/or co-morbid diseases that need
to be addressed.