‘Angelina Jolie op is given to women it cannot help’

Angelina Jolie spoke publicly about her mastectomy; she is pictured here at the Annual Critics’ Choice Movie Awards

Surgeons are encouraging women with breast cancer to have double mastectomies that do little or nothing to improve survival chances, a leading doctor has warned.

Dr Fiona MacNeill, a surgeon at London’s Royal Marsden Hospital, said medics were ‘driving the removal’ of the second – healthy – breast sometimes just to give patients ‘peace of mind’.

The warning comes after a US study showed the opinion of a patient’s surgeon has a strong effect on whether she has a double mastectomy after being diagnosed with cancer in a single breast.

Among patients of surgeons who most favoured the operation – officially called a contralateral risk reducing mastectomy (CRRM) – 34 per cent went ahead.

But among patients of surgeons most strongly against, only four per cent had it, according to the research published in the journal JAMA Surgery.

Dr MacNeill said previous research has shown that, for women diagnosed with cancer in one breast, a double mastectomy ‘does not significantly reduce risk or improve survival’.

That is because the risk of cancer occurring in the other breast is low. By contrast, ‘their bigger risk is their original cancer returning elsewhere in their body’.

Dr MacNeill said: ‘So many of these ladies are having both their breasts removed thinking it’s going to be a longer-term benefit for them but the reality is it’s not.

‘They’re probably putting themselves at more harm in terms of excessive surgery and the complications from surgery.’

She added: ‘One of my concerns is that it’s surgeons themselves who are driving this removal of healthy breast.’ The reasons most frequently cited by surgeons for performing this type of double mastectomy included to ‘give patients peace of mind’ and to ‘avoid patient conflict’.

Breast cancer core biopsy - ductal carcinoma in situ (DCIS) detected by screening mammography: Tumor cells are confined to the mammary ducts

Breast cancer core biopsy – ductal carcinoma in situ (DCIS) detected by screening mammography: Tumor cells are confined to the mammary ducts

Women themselves could also want double mastectomies to achieve better symmetry after surgery, which is easier to achieve with two identical implants rather than trying to match a reconstructed breast to a natural one.

But Dr MacNeill warned reconstructed breasts lacked sensation, and that having a double mastectomy was likely to ‘impact on your femininity, your image and your ultimate sexuality’.

The number of double mastectomies carried out in Britain has surged since actress Angelina Jolie, now 42, had the procedure in 2013. NHS figures show a leap from 234 in 2010 to 484 in 2016.

However, Jolie had the operation to stop cancer developing in the first place, rather than to stop it recurring. She took the decision after finding out she carried the BRCA1 gene, which substantially raises the risk of both breast and ovarian cancer.

Breast cancer has stalked my family for generations: Dr Ellie Cannon, Page 68


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