More Women Having Double Mastectomy But Survival No Better Than Breast Conserving Surgery Plus Radiation

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349798

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INTRO: Women diagnosed with cancer in one breast can choose several treatments, including removing the cancerous breast, removing both breasts or having breast conserving surgery combined with radiation. A new study examined the use of these different options for women in California and whether there were any differences in the survival rates for these women. Catherine Dolf has more in this week’s JAMA Report. B-ROLL Breast cancer surgery Super: JAMA File @ :02 DURING RECENT YEARS MORE AND MORE WOMEN HAVE BEEN CHOOSING A DOUBLE MASTECTOMY TO TREAT CANCER DIAGNOSED IN JUST ONE BREAST. SOT/FULL Scarlett L. Gomez, Ph.D., - Cancer Prevention Institute of California Super@ :06 Runs:07 “The use of double mastectomy indeed increased steadily over time from the period of 1988 to 2011.” SOT/FULL Allison W. Kurian, M.D., M.Sc., - Stanford University School of Medicine Super@:17 Runs:07 (Video covering 1st part of bite: breast cancer surgery) “What we don’t know is what happens to those women afterward and whether they gain any benefit in terms of survival.” B-ROLL Dr. Kurian and Dr. Gomez walking, standing looking at graph Graphic: EARLY STAGE CANCER IN ONE BREAST SINGLE MASTECTOMY DOUBLE MASTECTOMY BREAST CONSERVING SURGERY WITH RADIATION DR. ALLISON KURIAN (KER-EE-ANN) FROM STANFORD UNIVERSITY SCHOOL OF MEDICINE AND DR. SCARLETT GOMEZ FROM THE CANCER PREVENTION INSTITUTE OF CALIFORNIA AND CO-AUTHORS STUDIED A DATABASE OF WOMEN DIAGNOSED WITH BREAST CANCER IN CALIFORNIA DURING THE PAST DECADE. THEY EXAMINED RECORDS OF WOMEN WITH EARLY STAGE CANCER DIAGNOSED IN JUST ONE BREAST, WHO UNDERWENT A SINGLE MASTECTOMY, DOUBLE MASTECTOMY OR BREAST CONSERVING SURGERY WITH RADIATION. SOT/FULL Allison W. Kurian, M.D., M.Sc., - Stanford University School of Medicine Super@ :42 Runs:06 “We ended up studying more than 189,000 women for at least seven years each.” SOT/FULL Scarlett L. Gomez, Ph.D., - Cancer Prevention Institute of California Super@:51 Runs:07 (Video covering 1st part of bite: Dr. Kurian examining a patient) “We were able to study the experiences of women from many different racial, ethnic groups and socioeconomic backgrounds.” SOT/FULL Voice of: Allison W. Kurian, M.D., M.Sc., - Stanford University School of Medicine Super@ :54 Runs:07 (Video covering bite: breast cancer surgery) “The rates of double mastectomy to treat a one-sided breast cancer have increased at a rate of 14 percent a year.” SOT/FULL Scarlett L. Gomez, Ph.D., - Cancer Prevention Institute of California Super@1:06 Runs:11 (Video covering 1st part of bite: breast cancer surgery) “Women under age 40 were using double mastectomy at a much higher rate. In 2011 nearly a third of women in that age group were having double mastectomy.” GXF FULL JAMA COVER THE STUDY APPEARS IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. SOT/FULL Scarlett L. Gomez, Ph.D., - Cancer Prevention Institute of California Super@1:15 Runs:09 (Video covering 2nd half of bite: breast cancer surgery) “Women who had double mastectomy did not seem to have any better survival than women who had the other two surgical procedures.” SOT/FULL Allison W. Kurian, M.D., M.Sc., - Stanford University School of Medicine Super@ 1:25 Runs:06 (Video covering 1st part of bite: breast cancer surgery) “The women that had the single mastectomy did have worse survival than the other groups of women.” B-ROLL Graphic: DOUBLE MASTECTOMY NON-HISPANIC, WHITE WOMEN HIGHER SOCIOECONOMIC STATUS PRIVATE INSURANCE SINGLE MASTECTOMY MINORITIES LOWER SOCIOECONOMIC STATUS PUBLIC INSURANCE THE RESEARCHERS FOUND THAT WOMEN HAVING DOUBLE MASTECTOMY TENDED TO BE NON-HISPANIC WHITES WITH A HIGHER SOCIOECONOMIC STATUS AND PRIVATE INSURANCE. IN CONTRAST, THOSE HAVING SINGLE MASTECTOMY WERE MORE LIKELY MINORITIES, WITH LOWER SOCIOECONMIC STATUS AND PUBLIC INSURANCE. SOT/FULL Allison W. Kurian, M.D., M.Sc., - Stanford University School of Medicine Super@ 1:44 Runs:11 (Video covering end of bite: patient talking with Dr. Kurian) “We really need to improve on our strategies for communicating this kind of information to a patient who’s making choices on how to treat her early breast cancer.” B-ROLL Patient talking with Dr. Kurian CATHERINE DOLF, THE JAMA REPORT. TAG: DOUBLE MASTECTOMY ALSO HAS A HIGHER COMPLICATION RATE THAN SINGLE MASTECTOMY OR BREAST CONSERVING SURGERY WITH RADIATION. Please see the complete study for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. TO CONTACT: Dr. Allison Kurian call: MA Malone at (650) 723-6912 OR Dr. Scarlett Gomez call: Jana Cuiper at (510) 608-5160 doi.10.1001/jama.2014.10707 ADDITIONAL SOUNDBITES: Allison W. Kurian, M.D., M.Sc., - Stanford University School of Medicine QUOTE 1 Runs:22 “Although the rate of double mastectomy has increased substantially throughout the state of California over the last decade, women are not actually gaining any better survival because of this surgery and this is a surgery which has a higher complication rate so it is somewhat concerning to see that there is no associated survival benefit in our study.” Scarlett L. Gomez, Ph.D., - Cancer Prevention Institute of California QUOTE 2 Runs:28 “The women who were having the double mastectomy tended to be non-Hispanic white women, of higher socioeconomic status, they tended to have private insurance and they were more often seen at cancer centers. In contrast, the women who had the single mastectomy were more likely to be minorities that is non-white women, they were more likely to be from lower socioeconomic status backgrounds and they were more likely to have public insurance.
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