Researchers at the federally-funded Agency for Healthcare Research and Quality found that number of mastectomies skyrocketed in recent years in 13 U.S. states. According to the federal analysis, breast cancer patients opt for more invasive procedures over breast-sparing ones.
Investigators also found that half of patients who undergo the procedure are discharged on the same day. So, cancer patient advocates are concerned that mastectomy, or surgical breast removal to prevent breast cancer tumors from spreading, is often unnecessary. They argue that lumpectomy and mastectomy are equally effective especially in early stages. Plus, because mastectomies are more expensive, patients may be discharged too soon, advocates say.
But in the U.S. there is a shifting trend from less invasive procedures to mastectomies. Federal researchers have found that the number of mastectomies jumped 36 percent from 2005 through 2013. On the other hand, this change was not accompanied by lower incidence of breast cancer in the U.S. population, researchers noted.
Claudia Steiner, one of the senior researchers involved in the AHRQ analysis, was shocked by the rapid growth observed in recent years. Past studies had shown that less invasive surgeries paired with radiotherapy are as effective as mastectomy in curbing cancer growth in early cancers.
Researchers highlighted another shifting trend: patients tend to opt more and more for “drive-by” mastectomies, so they don’t have to spend a night in hospital. In 2013, 45 percent of mastectomies were carried out in outpatient facilities, which represents a 22 percent rise from 2005.
Nevertheless, study authors couldn’t tell the reason behind the trend. Some possible explanations may be tied to patient option or insurance reimbursement problems. Or it could just be linked to a growing trend which favors outpatient surgical centers.
The report didn’t show whether women who had their mastectomies in a hospital and stayed there at least two days had better post-op outcomes. Lisa McGiffert, the head of a patient watchdog group, noted that there’s no evidence on the safety of outpatient facilities since there is little info on those settings.
McGiffert acknowledged that some of these facilities are highly specialized in a set of procedures, which may benefit the patient. Still, it is surprising that nowadays so many women go home immediately after surgery. Two decades ago, concerns that short hospital stays may boost risk of complications prompted states to prevent insurers from forcing patients to go home less than 48 hours after mastectomy.
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