More women who are diagnosed with cancer in only one breast are choosing to remove both breasts, a new U.S. study says.

The research shows the rate of double mastectomies has more than doubled in six years.

It's still a rare option: Most breast cancer in the United States is
treated by lumpectomy, removing just the tumour while saving the breast.

But the new study suggests 4.5 per cent of breast cancer surgery in 2003 involved women getting a cancerous and a healthy breast simultaneously removed through a double mastectomy, a 150 per cent increase from 1998.

Young women are most likely to choose the aggressive operation, researchers reported Monday in the Journal of Clinical Oncology.

The concern is whether they're choosing in the heat of the moment — breast cancer surgery south of the border is often within two weeks of diagnosis — or with a good understanding of its pros and cons.

"Are these realistic decisions or not?" said Todd Tuttle, cancer surgery chief at the University of Minnesota, who led the study after more women sought the option in his own hospital.

"I'm afraid that women believe having their opposite breast removed is somehow going to improve their breast cancer survival. In fact, it probably will not affect their survival," he said.

The initial tumour might have already sent out the seeds of spread to key organs, Tuttle explained.

But removing the remaining healthy breast does greatly lower, although not eliminate, chances of a new cancer developing on the opposite side.

Fear a big factor

Don't underestimate the peace of mind that brings, said Trisha Stotler Meyer of Vienna, Va., who had her breasts removed three weeks ago.

"Doctors are not up at night crying" in fear of their next
mammogram, said Meyer, 37, who went back for a double mastectomy after her initial cancer surgery. "I don't want to have to deal with the stress."

Meyer is far from alone. In a single day last week, Dr. Shawna Willey of Georgetown University's Lombardi Cancer Center had two patients seek the operation.

One needed her entire cancerous breast removed, and immediately asked to have the healthy one removed, too.

Another woman had recently undergone a lumpectomy and was sick from chemotherapy — and returned to ask that both breasts be fully removed.

"Her perception is, 'If I have my breasts taken off, I never
have to do this again,' " said Willey, who asked the woman to see a counsellor and finish chemo before deciding.

"I can understand that point of view," she added. "But I always tell them, it's not a guarantee."

In Canada, an estimated 22,300 women will be diagnosed with breast cancer in 2007 and 5,300 will die from it.

The study is the first U.S. nationwide look at how many women choose to remove both a diseased and a healthy breast together. The authors used a government cancer registry that covers 16 regions, a representative sample of the U.S. population, to track more than 150,000 breast cancer surgeries between 1998 and 2003.

Lumpectomies accounted for almost 60 per cent of those surgeries in 2003 and single mastectomies were the second-most-popular option. 

But double mastectomies increased for every stage of cancer. Even women who qualify for anti-hormone drugs that greatly protect the remaining breast were as likely to choose removal as women with harder-to-treat tumours.