PORTLAND, Ore. - March 17, 2006 - Most women with cancer in one breast who decide to have the unaffected breast removed along with the diseased breast don't regret the decision and have a quality of life equal to patients who didn't have a preventive mastectomy, according to a survey of breast cancer survivors. The study is reported today in the Journal of Clinical Oncology.

"Women who develop cancer in one breast face a very difficult decision," says Emily Harris, PhD, senior investigator at Kaiser Permanente's Center for Health Research in Portland and a co-author of the study. "One choice they can make is having surgery to remove both breasts. Making this choice involves weighing the answers to two important questions - how much will this surgery improve my chances of staying cancer-free and how will the surgery affect my quality of life?"

Women with cancer in one breast have a three to five times higher risk of developing cancer in the other breast than women without breast cancer, and the risk may be higher in women with a family history of breast cancer. Several studies have shown that preventive removal of the unaffected breast reduces the risk of cancer and may improve survival. In an earlier study involving this same group of women, the researchers found that women who had the mastectomy had a 97 percent lower risk of developing cancer in the other breast than women who had only the affected breast removed. Until this study, however, there has been little information on the psychological and social outcomes of the mastectomy.

This new study, based on a survey that took about 10 to 15 minutes to complete, was designed to measure contentment with quality of life, body image, sexual satisfaction, breast cancer concern, depression and health perception. It involved 519 women with cancer in one breast who chose to have preventive mastectomy in addition to regular cancer treatment, and 61 breast cancer survivors who had only the affected breast treated. All women had been diagnosed from 1979 to 1999.

Results showed that a large majority of women (86.5 percent) who had the procedure were satisfied with their decision. The majority of all women (75 percent) reported "very much" or "quite a bit" of contentment with quality of life, regardless of whether they had undergone the preventive mastectomy. While less contentment with quality of life was not associated with the preventive mastectomy, it was linked with poor general health perception, symptoms of depression, body image issues and feeling the need to avoid thoughts about breast cancer.

The survey results also revealed that while concerns about breast cancer were common among all the women, they were less common in women who had the preventive mastectomy. Nearly 75 percent of women who didn't have the preventive mastectomy reported concerns about breast cancer, compared to half of women who had the mastectomy.

"Our research suggests that preventive mastectomy prevents future breast cancer and that women's psychosocial outcomes are driven more strongly by issues related to aging and surviving breast cancer than by their preventive mastectomy," says Ann Geiger, PhD, lead author, from Wake Forest University School of Medicine in North Carolina. "Nevertheless, it is important to remember that preventive mastectomy is a major surgical procedure likely appropriate for a very small percentage of women with breast cancer. We encourage women with breast cancer to carefully consider their treatment options in consultation with their physicians, family and friends."

The study was conducted by six health care systems that participate in the National Cancer Institute-funded Cancer Research Network, whose goal is to conduct research that transforms cancer care and prevention. The six sites were Kaiser Permanente's Northwest, Northern California and Southern California regions, Group Health Cooperative (Seattle), Harvard Pilgrim Health Care (Boston), and HealthPartners (Minneapolis).

Kaiser Permanente's Center for Health Research, founded in 1964, is a not-for-profit research institution whose mission is advancing knowledge to improve health.

Kaiser Permanente is the nation's leading integrated health care organization. Founded in 1945, it serves more than 8.4 million people nationwide, including more than 485,000 in Oregon and Southwest Washington.

Jim Gersbach - 503-813-4820 or
Terry Fitzpatrick - 503-335-6602