The percentage of women who choose to have both breasts removed during treatment for breast cancer has risen, a new study reported.

About 8,000 to 10,000 patients a year may be requesting a double mastectomy, an increase from fewer than 2 percent of patients in 1998 to about 5 percent in 2003, according to the study.

Authored primarily by Dr. Todd M. Tuttle, the chief of surgical oncology at the University of Minnesota Medical School, the study was published in the Journal of Clinical Oncology online this October.

"My first reaction was surprise," said Dr. Julie R. Gralow, associate professor of medical oncology at the University of Washington. "I thought we had made more progress with less surgery. Removing the opposite breast would not increase survival. Most women will never get another breast cancer, so we try to put things in perspective here."

As a preventative measure, a contralateral prophylactic mastectomy, or double mastectomy, has rarely shown an impact on survivability of breast cancers. The procedure, however, may possibly impact survivability in young women with a strong familial genetic disposition toward an occurrence in the second breast.

The study found that patients with a genetic mutation that can increase chances for a recurrence of cancer opt more often for a double mastectomy.

Younger women, Caucasian women and those who have had lobular histology (cancer that began in the milk-producing glands of the breast) also chose the procedure more often. Patients who had one breast with cancer removed were also more likely. According to the study, the double mastectomy rate for these patients increased from slightly more than 4 percent in 1998 to 11 percent in 2003.

Women with stage one of breast cancer — in general the lower the stage number the less the cancer has spread — also chose a double mastectomy more often than women with more advanced stages of cancer.

These patients may choose the double mastectomy procedure because they are young and have aggressive cancers, and out of a fear of future recurrence in the second breast.

Gralow described seeing a string of patients in their early '30s and late '40s who had chosen full mastectomies.

"These young women — generally quite young — cheerfully reviewed their risks and benefits and this is how they're managing their risk and they are very happy with their educated decision," he said.

Improvements in reconstructive surgery may also be why more women are choosing double mastectomies. Cosmetic outcomes have improved dramatically, she said, adding, "[Improvements in reconstruction] may be partly why more women are choosing double mastectomies. They say, 'Well, if I'm doing one side, why not the other?'"

"If [a double mastectomy] was the only way to prevent it from spreading, then yes." Aisling Underwood said about getting a double mastectomy.

Underwood is a student whose sorority is working for breast cancer awareness and whose grandmother succumbed to cancer. Fellow student and sorority member Mona Atallah agreed.

"If it was the 100 percent cure, then I would go for it," she said.

For those considering the procedure, the American Cancer Society said different procedures, including mastectomies, are appropriate under certain circumstances and strongly advises patients to take their time to explore the different treatment options available to them.

[Reach reporter Erin Unger at news@thedaily.washington.edu.]