Most people assume breast cancer is just a female thing. But about 1 percent of cases in the United States occur in men — and it turns out that a growing number of them are choosing to remove both breasts to reduce the risk of recurrence.
In astudy published last week in JAMA Surgery, researchers report that the share of male breast cancer patients getting contralateral prophylactic mastectomy, or CPM, which involves removing a healthy breast in addition to one with a tumor, nearly doubled between 2004 and 2011, rising from 3 percent to 5.6 percent.
This trend mirrors what’s happening in women, whose CPM rate has also risen quickly, from 4.5 percent to 11 percent between 2003 and 2011.
The new research, which was conducted by the American Cancer Society and the Dana Farber Cancer Institute, didn’t delve into why this may be happening, but experts have suggested that the trend may be due to the growing availability of genetic testing that gives people a better sense of their risk, as well as what cancer specialists call the “Angelina Jolie effect.” The actress had a double mastectomy two years ago after being told she had the BRCA1 gene mutation, which put her at increased risk of developing breast cancer.
The JAMA Surgery study comes at a time when more researchers, practitioners and activists are questioning the benefits of aggressive efforts to diagnose and treat breast cancer, arguing that all the public attention to “pink ribbon” breast cancer campaigns may have inadvertently influenced people to undergo risky and costly treatments that may not help them.
A study published last month in JAMA Oncology, for instance, found that aggressive interventions to treat the earliest stage of breast cancer, called ductal carcinoma in situ, had no effect on whether a woman was alive a decade later. The research tracked more than 100,000 women.
“We have created a culture of breast cancer awareness, and we’ve created a countercultural response of fear. When you do a mastectomy, you reduce the fear greatly,” Steven Narod, a senior scientist at the Women’s College Research Institute in Toronto, told The Washington Post. He was the leader of the JAMA Oncology study.
Another much-debated study that came out this summer looked at the utility of mammograms by analyzing data from 16 million U.S. women in 2000. Researchers found that the number of breast cancer diagnoses rose with more-aggressive screenings. That was expected. The surprise was that the rate of deaths remained the same. Study author Richard Wilson, a professor at Harvard University, argued that these findings “suggest widespread overdiagnosis.”
Ahmedin Jemal, one of the authors of the JAMA Surgery study on men, said in a statement that “health-care providers should be aware that the increase we’ve seen in removal of the unaffected breast is not limited to women, and doctors should carefully discuss with their male patients the benefits, harms, and costs of this surgery to help patients make informed decisions about their treatments.” In some cases, experts warn, it may not be the right decision.
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