Hello bOObs Bloggettes:
I thought I’d write a bit about something I came across in the medical literature a while back that still irks me. If you have breast cancer (BC) and are thinking about getting a surgical treatment for it (or if you’ve already had surgery), please tip toe into this blog. In fact, I’m going to start warning women that I’m about to expose something that might be downright depressing so they are forewarned to skip that reading, if they so desire.
I know some of my blogs aren’t well sugar-coated for folks going through problems with their breasts (I’m one of those women) but I’m a straight-forward writer; I simply want to help those women who are open to listening to a researcher versus only the White Coats in the medical community. Most Coats don’t read the literature themselves as they simply don’t have time. Therefore, they rely on document briefs given to them by a medical association or perhaps their hospital department head and, hence, oftentimes get it flat wrong. This in the end can harm the patient.
Anyway, I digress. Here’s the information in the medical literature regarding BC surgery I wanted to alert you on:
One in 400 women who receive a mastectomy die within 30 days of the surgery.
Astonishing, isn’t it? Most of these deaths, the article said, are due to infection from the surgery. And in fact, I know several women who have had that exact problem, and therefore had to undergo another surgery to clean out the infection. Infection can also occur following a lumpectomy or reconstruction, but I don’t have the figures on how often for those two.
Now here’s where it gets interesting: The literature article gave the statistic on how many women die post-mastectomy…but they put it into a weird percentage and talked about the dreaded statistical “P value” that would not be easily understood by many (including me). So I dusted off my trusty calculator from grad school and dug around in my brain trying to recall algebra (or something of the like). Lo and behold, there it was: One in 400 die within 30 days of surgery.
I couldn’t believe my eyes. So I sent my calculation to a friend who I knew would either confirm my one in 400 or tell me to go back to high school. He quickly confirmed that my analysis was indeed correct.
The other item I couldn’t believe was that, based on blasted statistics, the article’s authors said this: “Morbidity and mortality rates following [breast cancer surgery] in women are low, limiting their value in assessing quality of care.”
The rates “are low”?
When I saw that one in 400 were dying, I didn’t think for one second that that figure was “low”. In fact, I thought it was astoundingly high.
Maybe it’s just me, but if I was going to get a mastectomy, I’d like to know what all the side-effects of the surgery are, including accurate death/mortality figures.
And speaking of these figures, the “one in 400” statistic is only for the first 30 days after surgery. This doesn’t include how many women died on day 31, or day 32, or day 33, etc. You see my point: The final figure is most likely higher than 400. (I’ve come to discover that they use this same statistical trick of only counting problems up to day 30 for other surgery complications, such as strokes following hip replacements, etc. — so beware.)
My guess is that many BC surgeons don’t have a clue that this number of women are dying. Or if they do and they’re not informing their patients of this danger prior to surgery, then shame on them.
Here’s the link to the article in the most highly referenced literature for surgeons, Annals of Surgery (I put title and citation in here in case link doesn’t work):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1877061/
(El-Tamer MB, Ward BM, Schifftner T, Neumayer L, Khuri S, Henderson W. Morbidity and mortality following breast cancer surgery in women: national benchmarks for standards of care. Ann Surg. 2007 May; 245(5):665-71)
The American Cancer Society only says this about mastectomies:
“Like any type of surgery, a mastectomy can have risks and side effects, some of which could affect your quality of life. Because of this, preventive surgery is not usually a good option for women who are at average risk of breast cancer, or for those who are at only slightly increased risk.”
So, no mention of death/mortality risk from the ACS (although I guess you could consider that death actually does affect your “quality of life”, so are they just lumping the two together?)
ACS continues: “A prophylactic mastectomy can lower breast cancer risk by 90% or more, but it doesn’t guarantee that you will not get breast cancer. This is because it’s not possible to remove all breast cells, even with a mastectomy. The breast cells that are left behind might still go on to become cancer.”
So are women told this succinctly when they meet with their surgeons? I have friends who assume that, since they’ve had prophylactic double mastectomies, they are breast cancer-free henceforth. But are they? ACS says maybe not.
bOObs BOTTOM LINE: Do your research before making any decisions and ask you BC surgeon oodles of questions. Raise the above issues with them and see what they say — and then let me know please:)
Blog at you soon, thanks for reading and helping to spread the word! (Please see the “share” links below.) And we’d love to hear comments from you! (see below as well)
Stay healthy,
Megan
Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts
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