By Alexandra Sifferlin
September 2, 2014

New research shows that double mastectomies are increasingly used to treat cancer in a single breast, and it doesn’t always result in fewer deaths.

In a new paper published in the journal JAMA, a team of researchers looked at data from a cancer registry in California and found that double mastectomies for early-stage breast cancer increased significantly from 1998 to 2011. When the researchers compared the mortality rates of 189,734 patients who underwent either double/bilateral mastectomies, unilateral mastectomies or breast conserving surgery plus radiation, they found that double mastectomies were not associated with a lower risk of death compared to surgery plus radiation. Unilateral mastectomy had the highest mortality rate.

The researchers also found that double mastectomies increased the most among women who were under age 40 when they were diagnosed. Though the researchers can’t confirm, they suspect that the numbers may be due to the women’s relatively high likelihood of carrying genetic mutations like BRCA1 and BRCA2, as well as the greater likelihood that they have younger children and therefore want to extend their lives for as long as possible. The researchers call this “an emotional rather than evidence-based decision.”

“The increase in bilateral mastectomy use despite the absence of supporting evidence has puzzled clinicians and health policy makers,” the study authors write. “Although fear of cancer recurrence may prompt the decision for bilateral mastectomy, such fear usually exceeds the estimated risk.”

Given the rising numbers and growing concern about over-treatment, the researchers say physicians should really stop and consider how to respond to a patient’s request for double mastectomy, given that it’s an incredibly invasive procedure.

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