[deborahswope]

#1059151

has anyone else had their endocrinologist recommend breast reduction in conjunction with their Graves disease? I am 58, 4 years past RUI and menopause.

[Kimberly]

#1172540

Hello and welcome – I’m a fellow Graves’ patient, not a doctor, but I haven’t ever heard of this. Did your doc give you a particular reason?

[adenure]

#1172541

First I’ve heard of it- especially since you’re past menopause & RAI. It seems like all the hormonal fluctuations would be more or less calmed down at this point? I don’t know. Did you ever mention to him that you wanted to get that surgery done? Maybe he’s saying it’s safe to do now at this point bc your hormones are stable- beats me.

Alexis

[snelsen]

#1172542

Alexis wrote exactly what I was going to say.
Is this something you have been thinking about for a while, and mentioned it to your endo as you were having your Graves’ treatment? Cause it would not be a good idea to elect surgery when hyper. Maybe it is an offhand comment responding to what you said.
But no, I do not see any relationship between the two. Guess you can specifically as the endo that question.
Shirley

[catstuart7]

#1172543

I’ve never heard of breast reduction in relation to Graves either but I’ve had it recommended to me to reduce cancer risk. Do you have any family history of breast cancer or were you wanting it for cosmetic reasons?

[snelsen]

#1172544

I imagine if breast procedures were recommended to reduce breast cancer risk, it would total bilateral mastectomies, not just reducing the size of the breasts.
Shirley

[catstuart7]

#1172545

snelsen wrote:

I imagine if breast procedures were recommended to reduce breast cancer risk, it would total bilateral mastectomies, not just reducing the size of the breasts.
Shirley

This was recent information from one of the top breast surgeons in my entire region of the country who I was lucky enough to see. She said the reason the risk is reduced is because they take a good bit of glandular tissue which is the part of the breast that is highest risk for developing cancer. Of course if one wants to eliminate risk bilateral mastectomy is the most complete option.

Here’s an article about it:
http://www.medicalnewstoday.com/releases/8858.php

[snelsen]

#1172546

Well, that is an interesting concept. But I am bothered by it. I really don’t want to belabor this too much, but here I go. I just can’t help it!

In the first place, oncologists should be designing the study. Plastic surgeons (and all surgeons) are pretty much the docs who operate, do post op follow up care from the surgery, then they are done with a patient. And they are not oncologists.

From a research view, this study needs to be an evidenced based study over a very long period of time, with a fairly large population, with a control group. It does not state the period of time, which is crucial for anyone to make any statement or conclusion about this. I read the article. It is an “observational study.” The following statement, by the principal investigator, pretty much says this, and even his statement infers knowledge that is not known. And, there is definitely a financial incentive for the plastic surgeons. A whole new population of potential patients, yet undiscovered. There was no due diligence stated, even that this could be a potential conflict of interest.

“While this report is based on observational studies, it’s pretty clear that breast reduction could hold a key to decreasing breast cancer in high-risk patients. Undoubtedly, as we reduce the amount of breast tissue, we also reduce the risk of developing breast cancer,” continued Dr. Young. “Going forward, we expect clinical studies will support our findings that breast reduction is a viable preventative alternative for many women.”

I don’t think “it’s pretty clear.” He does not have evidence to make that statement.
If anyone is considering this, I suggest they also consult with oncology and pathology.
Shirley
Breast cancer x 2 Stage 2, Stage 3B 12 years apart, with different pathology.

[catstuart7]

#1172547

This answers most of your objections:

http://www.ncbi.nlm.nih.gov/pubmed/16328720

“While it has been demonstrated that prophylactic mastectomy reduces breast cancer incidence among women at high risk, many women often consider this disfiguring surgery unacceptable. One alternative approach may be breast reduction surgery. In order to evaluate the long-term incidence of breast cancer following surgical removal of breast tissue, we have extended by 9 years the follow-up period of our earlier retrospective cohort study of Swedish women electing cosmetic breast reduction surgery (n=30,444) between 1965 and 1993, yielding an average of nearly 16 years of follow-up. Cancer incidence through 2002 was ascertained via the Swedish Cancer Registry. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated comparing women who underwent breast reduction surgery with women in the general Swedish population. Breast cancer was observed in 443 women versus 624 expected for a statistically significant reduced SIR of 0.71 (95% CI=0.65-0.78). Analyses by age at surgery, time since surgery or calendar year of surgery revealed similar reductions in risk. Our study of over 30,000 women with long-term follow-up offers further evidence that women undergoing breast reduction surgery have reduced breast cancer risk. As the evidence from large-scale cohort studies accumulates, direct testing of this reduction in risk through clinical trials should be considered.”

[snelsen]

#1172548

Thanks, That is a much better study than the one originally referenced in another post.
Interesting to think about. Tricky to do the clinical trials, but they all are.
As an individual, even knowing that there would be some reduction of risk, but not as much as a bilateral mastectomy, I would chose mastectomy.
However, we are all different, and if a high risk woman chose SOME reduction
versus no action at all, there may well be profit from less breast tissue.
Thank you so much for the further reference.
Shirley

[Author]

Posts