Breast reduction instead of removal a viable breast cancer alternative

Women at high risk of developing breast cancer may have an additional preventative alternative to having their breasts removed – breast reduction surgery, according to a study published in the June issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Although the complete removal of a woman's breasts can diminish the chance of developing this potentially fatal disease, most women find it extremely difficult to elect to remove their breasts. Women may now have an additional preventative option, based on this report, to have their breasts reduced rather than removed. This represents a real alternative for someone who is a candidate for breast reduction, even though the amount of tissue removed may be small.

"Breast reduction is a risk reducer, not a preventative guarantee," said Leroy Young, MD, author of the study and chair of ASPS Emerging Trends Committee. "For the majority of women with a high inherited susceptibility to breast cancer, completely removing their breasts is not a desirable option as primary prevention. This study strongly indicates that women, who are breast reduction candidates, can choose to have their breasts reduced instead, thus decreasing their chance of developing breast cancer."

The report is based on six observational studies conducted in the United States, Canada, Denmark and Sweden. Collectively, the studies examined more than 32,000 women. It found that breast reduction lowered the chance of developing breast cancer 50 to 70 percent. Currently, clinical studies of high-risk women who elect to have their breasts completely removed, known as a prophylactic bilateral mastectomy, demonstrate that patients have lowered their risk by 90 percent. Because some residual breast tissue remains even after a total mastectomy, a 100 percent reduction in risk is not possible by mastectomy alone. These studies and patients in additional studies will continue.

An estimated 215,999 new invasive cases of breast cancer are expected to occur in 2004 among women in the United States, according to the American Cancer Society. This year, more than 40,000 women are expected to die from breast cancer.

"It's important that women understand their options. Having breast reduction surgery is better than what many high-risk women have done in the past because they did not want to lose their breasts – nothing," stated Dr. Young. "Educating women about breast reduction, which is often more acceptable than prophylactic mastectomy, could increase the number of women who elect risk-reduction surgery as a preventative measure, which could lead to an overall reduction in breast cancer mortality rates among high-risk women."

"While this report is based on observational studies, it's pretty clear that breast reduction could hold a key to decreasing breast cancer in high-risk patients. Undoubtedly, as we reduce the amount of breast tissue, we also reduce the risk of developing breast cancer," continued Dr. Young. "Going forward, we expect clinical studies will support our findings that breast reduction is a viable preventative alternative for many women."

More than 113,000 women had breast reduction surgery in 2003, according to ASPS statistics. Breast reconstruction was performed on more than 68,000 women in 2003, according to ASPS statistics.