Second Opinion: Unnecessary Mastectomies

Oct. 27 -- It’s time for some hard answers from breast cancer specialists and surgeons. They’ve been sitting on a powder keg issue concerning the health of women for far too long.

While we hear news almost daily of the need for women to have mammograms and to inspect their breasts for changes that could suggest breast cancer, the actual treatment for breast cancer that many women receive, especially poor ones, is often outrageously out-of-date, if not bordering on the criminal.

An article published this month in the Journal of the American Medical Women’s Association provides a summary and analysis of key studies on breast cancer treatment and raises serious questions about medical conduct.

Poor Get Poor Medical Advice

According to the medical review by Diana Zuckerman, the author of the journal article and head of the Washington, D.C.-based National Center for Policy Research for Women and Families, many women are getting their breasts removed for no good reason — meaning that such decisions are often not based on sound medical judgment but more on the basis of other factors, such as a woman’s income, the training of her doctor and where she lives.

For instance, if a woman is poor, chances are good that she’ll have a mastectomy rather than a lumpectomy (removal of the cancer but not the breast.). It’s cheaper to remove a breast. Lumpectomies also require follow-up radiation.

In Texas, for example, a study of breast cancer treatment at one large urban hospital revealed that 84 percent of the women with early stage breast cancer had mastectomies and only 16 percent had lumpectomies. The women who lost their breasts were mostly poor.

Other Treatments Exist, But Are Costly

If a doctor was trained before 1981, his patient is much more likely to have a mastectomy. Obviously old medical habits die hard. Research is clear that lumpectomies are as safe as a mastectomy for most women with early stage disease. The offending doctors should be hauled in front of a medical inquiry. They are needlessly disfiguring women and causing them to endure possible further problems, including pain and illness, associated with breast reconstruction, which can involve risky breast implants.