New Data Show Mastectomies Increased 36 Percent From 2005 to 2013
Data released today by the Agency for Healthcare Research and Quality (AHRQ) show that while breast cancer rates have remained constant, the rate of women undergoing mastectomies increased 36 percent between 2005 and 2013, including a more than tripling of double mastectomies.
AHRQ’s analysis also shows that both single and double mastectomies are increasingly performed as outpatient procedures. The overall proportion of mastectomies performed in hospital-based ambulatory surgery settings reached 45 percent in 2013.
“This brief highlights changing patterns of care for breast cancer and the need for further evidence about the effects of choices women are making on their health, well-being and safety”,” said AHRQ Director Rick Kronick, Ph.D. “More women are opting for mastectomies, particularly preventive double mastectomies, and more of those surgeries are being done as outpatient procedures.”
The overall rate of mastectomies – combining single and double mastectomies – increased 36 percent, from 66 mastectomies per 100,000 women in 2005 to 90 per 100,000 in 2013. The rise in double mastectomies was particularly steep, with the rate more than tripling from 9 out of 100,000 women to 30 out of 100,000. In 2013, 33 percent of all mastectomies were double mastectomies.
AHRQ’s analysis also shows an increase in double mastectomies for women who don’t have cancer, although the number of women making this choice remains low. Women who are genetically predisposed to breast cancer may elect to have a double mastectomy as a preventive safeguard even though there is no diagnosis of cancer in either breast. According to this new data, the rate of cancer-free women choosing double mastectomies more than doubled from 2005 to 2013, increasing from 2 per 100,000 women to more than 4 per 100,000.
AHRQ’s analysis also shows that in 2013, women who had double mastectomies were approximately 10 years younger than women who had single mastectomies. The average age of women having double mastectomies was 51 years old compared to the average age having single mastectomies, 61 years old.
The vast majority of breast cancers occur only in one breast. Treatment options for women with breast cancer include breast-conserving lumpectomies, single (unilateral) mastectomies, or double (bilateral) mastectomies, which involves removal of the healthy breast along with the unhealthy one. Choosing a mastectomy rather than breast-conserving treatment, or electing to undergo a double mastectomy rather than single mastectomy, may be based on physician advice, fear of cancer recurrence or desire for cosmetic symmetry. The choice may also be influenced by a family history of breast cancer, or mutations in the BRCA1 and BRCA2 gene.
Details of these and other findings are shown in “Trends in Bilateral and Unilateral Mastectomies in Hospital Inpatient and Ambulatory Settings, 2005-2013,” a statistical brief from AHRQ’s Healthcare Cost and Utilization Project (HCUP). The analysis draws upon comprehensive hospital-based discharge data from 13 states, covering more than 25 percent of the U.S. population. HCUP is a family of databases that present the largest collection of longitudinal hospital care data available in the United States. It includes all-payer data on hospital stays from nearly every state in the nation.
AHRQ is part of the U.S. Department of Health and Human Services (HHS). Its mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within HHS and with other partners to make sure that the evidence is understood and used.