Understanding the Cost of Mammograms and a Double-Mastectomy

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Getting an annual mammogram is the first step in defeating breast cancer, but what if someone ends up being one of the 1-in-8 who is diagnosed? It’s important to know about treatment options and be aware of care trends.

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Doctors are concerned by a growing trend in breast cancer treatment: Recent years have seen an explosion in double mastectomies, surgeries which involve removing both breasts even if only one of the breasts is cancerous. In 1998, only 2% of women who were having a mastectomy chose a contralateral prophylactic mastectomy (CPM), in which the healthy breast is removed as a preventive measure. In 2011, 11% of women having a mastectomy opted for CPM.

The increase in CPM procedures is worrying because unless a woman has a mutation in the BRCA1 or BRCA2 genes, which are responsible for suppressing tumors, removing both breasts does not improve her chances of survival. Moreover, the results of a recent study suggest that CPM offers only a negligible boost to a woman’s quality of life.

Why are double mastectomies on the rise?
It’s difficult to pinpoint a single reason why more women are choosing CPM. Some women choose this option to alleviate the anxiety that comes with a breast cancer diagnosis. They might not be convinced that a single mastectomy (or a lumpectomy) will really eliminate all the cancer cells. Perhaps they watched a loved one endure multiple cancer surgeries and want to reduce the risk of enduring a similar ordeal themselves. Other women might be under the impression that having reconstructive surgery on both breasts simultaneously will result in a more natural look.

What are the possible downsides to a double mastectomy?
While CPM does significantly lower the risk of developing cancer in the healthy breast, it doesn’t increase a woman’s survival odds. For this reason, women should be sure to discuss the pros and cons of the procedure with their medical team. If the patient is feeling stressed or anxious about the possibility of a future cancer diagnosis, her doctor should be able to explain the actual probability of developing contralateral breast cancer, and also help her explore other reasons why she might be considering the more extensive surgery.
As for the aesthetic motivations for choosing CPM, new plastic surgery techniques allow surgeons to reconstruct the breast that has been removed so that it fairly closely matches the healthy one. When a woman has bilateral breast reconstruction, she sometimes loses all feeling in her chest. In the aforementioned study, researchers found only a tiny difference in terms of “sexual confidence and feelings of attractiveness” between women who had CPM and women who only had one breast removed. It should be noted that women who had reconstructive surgery, whether they had single or double mastectomies, scored higher in measures of overall well-being.

Cost as a factor
As discussed in this article, a range of factors, personal as well practical, influence women’s decisions regarding breast cancer surgery. Unfortunately, as with any major health-care decision, the question of how to pay for treatment often adds to the stress of the diagnosis. Though almost every state in the U.S. mandates that insurance companies cover breast cancer screening tests, treatment-related expenses range widely depending on one’s coverage. The important thing is that women not be afraid to discuss all their options with their medical team and insurance provider, and avail themselves of the online resources dedicated to helping patients save money on healthcare, after all price transparency is key to overcoming healthcare system challenges. The costs related to a double-mastectomy go beyond just the price your wallet pays though, so it’s important to keep all components in mind.

David Noble is a blogger and social media manager for Treato.com, the web’s leading site for consumer health insights.