Dive Brief:
- A recent report by the Agency for Healthcare Research and Quality showed the rate of mastectomies increased 36% from 2005 to 2013 with 45% of mastectomies in 2013 performed in outpatient surgery centers - up from 22% in 2003.
- The report doesn't specify whether those who opt for outpatient procedures fare better than those who chose inpatient surgery. It also doesn't specify the reasons for the increase in outpatient mastectomies.
- Concerns regarding shorter hospital stays led to 20 states enacting laws 10 years ago to prevent insurers from forcing hospital discharges 48 hours after a mastectomy but attempts at national legislation have failed.
Dive Insight:
The report also found the number of women opting for bilateral mastectomies without a breast cancer diagnosis more than doubled from 2 women per 100,000 in 2005 to 4.4 women per 100,000 in 2013. Also, women who had bilateral mastectomies in 2013 were 10 years younger than those who had a unilateral mastectomy.
This trend is being driven by several factors: Women who have the BRCA gene mutation often choose double mastectomies (as Angelina Jolie did in 2013), and women with breast cancer often choose a double mastectomy for cosmetic reasons or fear of cancer in the other breast.
The National Cancer Institute says women with genetic mutations and those with familial breast cancer could consider a preventative mastectomy, but many surgeons consider that option overly aggressive for women without risk factors. There are no data that show a bilateral mastectomy improves outcome or survival in women who don't have a BRCA mutation.
Even one of the authors of the report, Claudia Steiner, a senior research physician at AHRQ, told Kaiser Health News she was surprised by the rapid increase of mastectomies. Other advocates raised concerns since less invasive procedures, like lumpectomies, can be as effective and the general push towards more outpatient procedures may be behind more women choosing outpatient surgical centers.