Aside from being well known, these women (and many others) in the public eye have something else in common: all of them openly shared information about their breast cancer diagnoses and subsequent mastectomies. Do these media reports impact other women’s decisions about mastectomy?
The actions of celebrities can be highly influential. Our celebrity obsession fuels fashion styles, social causes, and charitable activities. It can also impact health trends, often shaping how we value body images, and how we make medical decisions. Colonoscopy rates shot up after Katie Couric’s televised colonoscopy on the Today Show in 2000, for example.
To try and determine whether media reports of celebrity mastectomies influence other women’s decisions (click on February 2016 in the Archives menu to the right to see “Mastectomy Rates Continue to Rise”), two University of Michigan physicians analyzed 727 articles published between 2000 to 2012 about celebrity breast cancer diagnoses and treatment. They determined that:
- articles were more likely to mention specific surgical treatment when bilateral mastectomy was involved: 45% discussed bilateral mastectomy; 26% mentioned unilateral mastectomy.
- most articles (60%) that mentioned celebrities’ double mastectomies failed to discuss the individual’s family history, genetic risk or why double mastectomy was the choice.
Celebrity influence can be a positive vehicle for change, raising general awareness about neglected issues. Michael J. Fox has definitely taught us a lot about Parkinson’s disease, and more of us are aware of the importance of healthy blood sugar levels since Tom Hanks announced that he is diabetic. Unbalanced or incomplete media reporting, however, can give the wrong impression, and in the case of breast cancer, may be one reason why mastectomies more than tripled between 2005 and 2013.
The problem isn’t that celebrities are coming forward and sharing their experiences. That’s a good thing, because it helps to increase awareness about breast cancer and related issues like genetic testing that women need to know about. The downside is not the story, but that the media often highlights mastectomy as an end result, rather than an option. Too often, stories about women having their breasts removed are misleading; they don’t provide appropriate story background—why an individual chose mastectomy or what other alternatives were dismissed—or the proper prospective: that risk varies between individuals, and that mastectomy is not always the only or best choice.
While bilateral mastectomy is the most effective way to reduce extraordinary risk of breast cancer due to family history or an inherited genetic mutation, roughly 90% of women diagnosed don’t have that dangerous hereditary factor or the same risk for initial diagnosis or recurrence. For most women, bilateral mastectomies are medically unnecessary and don’t improve survival.
More women are making up their minds based solely on what they read, rather than seeking to understand their own risk, what options are available, and overall, weighing the risks and benefits of all options before making a decision. “Patients are not coming in asking what their options are for treatment. They are coming in saying they want a bilateral mastectomy,” said Sabel.
Mastectomy is highly personal decision, and beyond survival, women have other reasons for choosing mastectomy over lumpectomy and radiation, or removing a healthy breast at the same time as a diseased breast, even when their risk of a future diagnosis or recurrence is low. Hopefully, however, women make that decision after understanding and carefully considering the risks and benefits associated with each choice, rather than something they read.
Source: Michael S. Sabel, Sonya Dal Cin. “Trends in Media Reports of Celebrities’ Breast Cancer Treatment Decisions.” Annals of Surgical Oncology, 2016; DOI: 10.1245/s10434-016-5202-7