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Reprinted from:
ABCNEWS.com

Unnecessary Mastectomies

Poor Women Often Face Ill-Advised Breast Removal

Opinion by Nicholas Regush, ABCNews.com

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cancer, the actual treatment for breast cancer that many women receive, especially poor ones, is often outrageously out-of-date, if not bordering on the criminal.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.

Studies show that this appalling trend to perform mastectomy exists in most parts of the country.

You have to wonder what type of information many women are receiving from their doctors and why they agree to radical surgery.

"Limited information and biased recommendations are undermining breast cancer patients' choices," says Zuckerman.

"After all the research that has been done, why are so many women undergoing mastectomies they don't need?"

Not Discussed, Though Known

An excellent question. Why is it that performing unnecessary mastectomies is not a priority question in women's health care? Where are the activists to challenge this medical stupidity? Where are the women's groups that are engaged in educating women to examine their breasts? Is this subject matter a little too confrontational for them? Is breast self-examination a gentler and kinder issue?

Both activists and the medical establishment should be condemned for their silence. And it wouldn't hurt to have a little more media attention focused on this issue. Come on medical reporters. It's really not that complicated a story.

Let's get our priorities straight on treatment for breast cancer. This butchery must stop.

ABC News Second Opinion October 27, 2000


Nicholas Regush produces medical features for ABCNEWS. In his weekly column, published Thursdays, he looks at medical trouble spots, heralds innovative achievements and analyzes health trends that may greatly influence our lives. His latest book is The Virus Within.

Reprinted from:
ABCNEWS.com

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