If 1/8 women will get BC, why aren't preventative mastectomies more common?

[Anonymous]

Anonymous wrote:Just wondering...

I’m guessing you’re not very familiar with the experience of having a mastectomy.

[Anonymous]

After a friend’s journey ended with implant removal, if I ever got it done I would just be flat. Putting foreign bodies in your body is almost never a good idea so it’s not as straightforward as you might think given how much of our identity and femininity is wrapped up in our breasts.

[Anonymous]

I had a double with reconstruction due to cancer and have very little sensation in my chest.

[Anonymous]

Unless you have a genetic mutation that increases risk of breast cancer, there isn’t really data that mastectomies increase survival. There may be good reason to get one (you have more than one location of breast cancer, it is a large area, you just prefer it). But prophylactic mastectomies are usually not appropriate.

[Anonymous]

Here is an article that cites a survival benefit for lumpectomy and radiation for early stage breast cancers.

https://www.breastcancer.org/research-news/lx-plus-rads-may-offer-surival-benefits

[Anonymous]

Because men. Same reason we're not allowed to have our tubes tied. Some man somewhere might want access to these parts. So even if you're a lesbian, you've got to keep them ready for a someday man, you just haven't found him yet.

Patriarchy, basically.

[Anonymous]

Anonymous wrote:The other question you need to consider is "how many women would a mastectomy actually have saved their life? And how many women were treated and survived, post diagnosis?"

You are casually suggesting an enormous surgery, that is not without complications and problems. It has recovery time, infection risks, etc. It is not like a vasectomy "oh, just go get one and recover on the couch for a day!". It's a massive removal of tissue, glands and sometimes lymphnodes.

Correct. If you read The Emperor of all Maladies, there’s an entire chapter about how brutal mastectomies used to be. They did not affect survival rates or diminish rates of cancer.

[Anonymous]

Removing lymph nodes in the chest can trigger lymphedema in the arms.

[Anonymous]

Anonymous wrote:Because men. Same reason we're not allowed to have our tubes tied. Some man somewhere might want access to these parts. So even if you're a lesbian, you've got to keep them ready for a someday man, you just haven't found him yet.

Patriarchy, basically.

No. Mastectomies usually do not increase survival rates. It would be silly to get one if it did nothing.

[Anonymous]

Anonymous wrote:After a friend’s journey ended with implant removal, if I ever got it done I would just be flat. Putting foreign bodies in your body is almost never a good idea so it’s not as straightforward as you might think given how much of our identity and femininity is wrapped up in our breasts.

Amen sister!
I went flat after my bilateral mastectomy (not preventative) and man this is the life! I would have done it sooner if I knew how awesome it would be. Zero regrets.

[Anonymous]

How keen would you be to cut your penis off?

[Anonymous]

Anonymous wrote:How keen would you be to cut your penis off?

Um that’s not comparable. At all.

[Anonymous]

Implants probably cause cancer for all we know.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Because men. Same reason we're not allowed to have our tubes tied. Some man somewhere might want access to these parts. So even if you're a lesbian, you've got to keep them ready for a someday man, you just haven't found him yet.

Patriarchy, basically.

No. Mastectomies usually do not increase survival rates. It would be silly to get one if it did nothing.

Having just been through this, I think it is not correct to say, "mastectomies do not increase survival rates"

I think it is more correct to say that the data is that mastectomies provided as a surgical treatment for breast cancer do not result in a better (or worse) survival rate than breast conserving surgery (BCS) with radiation.

I recently chose double mastectomy over unilateral BCS with radiation, and my surgeon (correctly) made it clear that the double mastectomy provided me with no advantage in terms of survival or recurrence. But, I choose the double mastectomy for other reasons.

There are, however, situations in which the breast cancer patient isn't eligible for breast conserving surgery and mastectomy is the higher survival rate option.

The calculus is different for women who have genetic indications for preventative mastectomy (BRCA gene and many more). Preventative double mastectomy can reduce the odds of breast cancer greatly (50-90% depending on what genes). So the risk/benefit calculus favors mastectomy, whereas in patients, absent cancer genes, the risks of major surgery outweigh any benefit.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How keen would you be to cut your penis off?

Um that’s not comparable. At all.

Of course not. All hail the penis and the penis-bearers.