TODAY   |  November 28, 2012

Cancer study: Most don’t need double mastectomy

A new study by the University of Michigan Comprehensive Cancer Center found that most women diagnosed with cancer in one breast have a very low risk of it occurring in the other breast, and therefore don’t necessarily need a double mastectomy. NBC’s Dr. Nancy Snyderman reports.

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>>> is the best way it treat it? a new study suggests most women who have a double mastectomy actually don't need it. dr. nancy snyderman is nbc's chief medical editor. nancy, good morning to you.

>> hey, savannah. this is an important study that comes from the university of michigan comprehensive cancer center , and it is small, but still clearly shows that most women who are diagnosed with cancer in one breast have a very low risk of having cancer in their other healthy breast. it's not a decision e news host giuliana rancic made lightly.

>> at the end it came down to choosing to live and not looking over my shoulder.

>> reporter: but after consulting with her doctors and family she decided it was right for her, announcing her decision here on "today."

>> and i'm going to go ahead and move forward with a double mastectomy.

>> reporter: thousands of women with breast cancer face the same question every year. what form of therapy should i choose? for a growing number of women the answer has been to have both breasts removed.

>> for me it was important to get the cancer out.

>> reporter: but a new study by the university of michigan finds that for the overwhelming majority of women who have had both breasts removed, the risk of cancer developing in the healthy breast is very low.

>> for most women over the 20 years after a breast cancer diagnosis, their risk of getting a new second cancer is in the range of about 5% or 6%, very, very small.

>> reporter: actress christina app applegate had the surgery and sharon osbourne had the surgery after learning she had a high-risk gene but using the double mastectomy as a preventive measure may be unnecessary.

>> many people are doing the procedure without the understanding of what the risk is for the other side.

>> reporter: study suggests that fear of recurrence is one of the biggest factors driving the decision to have preventive surgery. 90% reported being very worried cancer would develop in their other breast. doctors say the science suggests for most women that fear is unfounded.

>> the idea that by doing bigger surgery you're being safer and helping ensure a better outcome just simply true.

>> there are some notable exceptions. women with a very strong family history of breast cancer , at least two or more immediate relatives, and those who carry very strong genetic mutations, for those women , yes, having a double mastectomy may be advisable, but those are the individuals who must make those decisions talking to their doctors and fear, we found, is the overriding reason people are having those, not the individual family decisions.

>> let me pick up on that. let me be devil's advocate. no woman wants to do a double mastectomy but if she feels she should is there any harm?

>> it's a major surgery. having a breast removed is not a simple operation. you also leave some breast tissue behind. place a bet that there's a 70% chance of you not ever having trouble or 90% chance, would you go ahead and have major surgery, the answer is no. we've let the fear of cancer override the statistical chances of getting cancer , that's a bad equation.

>> have doctors been routinely recommending these double mastectomies?

>> i think not, but doctors haven't been standing up to patients and say you must listen to me on this one, let's not go forward. i think they haven't been frankly honest enough.

>> dr. nancy snyderman , thank you very much.