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Reader Remarks on:

Mastectomy Rates Are Rising

• Mastectomy over Lumpectory and Radiation
• Why is mastectomy "troubling"?
• possible cause

Mastectomy over Lumpectory and Radiation

Richard R Thornton, MD;ACOG, Retired, 4 Oct 2009 4:01 AM EST

Competing interests: None declared

What is the trade off here? What is the function for retaining the breast which developed a focus of cancer?

What is the risk of injury to normal tissues in the field of radiation?

What is the risk of subsequent recurrence Finally what is the cost in dollars and anxiety?

My wife had a simple mastectomy in her eighth decade, with negative sentinal node and a Stage I ductal Ca(Dukes)

She is now 7 years post operative . She had 4 years of Tamoxifen, complicated by a pulmonary embolus.

She now thinks of herself as normal same for he annual visits for mammogram and Zometa.

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Why is mastectomy "troubling"?

M.L. Henneman, 10 Nov 2009 11:14 PM EST

Competing interests: None declared

We hear this over and over again, that women *should* be choosing lumpectomy and radiation over mastectomy, as if "survival' were the only variable that matters. Other things matter, such as:

- hassle and possible damage caused by radiation

- hassle and stress of having to continue mammograms

- higher likelihood of recurrence, because you still have breasts! requiring yet more treatment.

Has anyone stopped to ponder that perhaps the higher mastectomy rate is because women are defining themselves less and less by their breasts, because at the age most of us get cancer, they serve absolutely no function? I had bilateral mastectomy, with removal of a disease-free contralateral breast. I was happy on the day I threw out my bras. I find it incredibly patronizing for doctors to assume that keeping breasts is preferable, simply due to equivalent survival. There are other considerations!

(I am curious though about cost comparison - how does cost of lumpectomy + radiation compare to mastectomy?)

http://bioblog.biotunes.org/bioblog/2008/12/17/does-mastectomy-equal- selfectomy-part-i/

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possible cause

Dr.KEWAL. KRISHEN THASSU, 10 Nov 2009 11:23 PM EST

Competing interests: None declared

With increasing bombardment of cancer related Ads. on T.V. and Media ,there is increased fobia among people about cancer.Probably people feel that removing the whole breast will root out the cancer from their body.

At the same time due to Consumer Protection Acts Surgeons also seem to suffer from same mindset ,otherwise there doesnt seem to be any other plausible reason.

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