Mastectomies can be used both to treat breast cancer and as a preventative measure by some women, but one breast cancer survivor thinks we need to talk more about their use, and whether they’re always necessary.

Writing for the Guardian, journalist Joanna Moorhead explained that she’d wrestled with the decision over whether to have a mastectomy after being diagnosed with breast cancer, because she was scared that if she went through with the procedure she’d “never again feel whole, or truly confident or comfortable with myself”.

After speaking with her consultant Fiona MacNeill, they agreed that she would have a lumpectomy, rather than opting for a mastectomy.

Joanna explained that since that decision three and a half years ago, she has explored mastectomies as a treatment option to try and better understand why women have them and if they are always the best option.

Dr MacNeill explained that, from a surgeon’s perspective, deciding whether someone needs a mastectomy is what she terms a “technical decision”, which relates to “the volume of the cancer versus the volume of the breast”.

However, she noted that many patients believe that having a mastectomy, or a double mastectomy will mean they won’t get breast cancer again, won’t need more chemotherapy or won’t die from the disease.

“None of these ambitions can be achieved by a double mastectomy,” Dr MacNeill asserted, which is why doctors need to have more conversations with their patients about why they want to have a mastectomy, and evaluate whether it’s the most appropriate course of action.

There is much research going on at the moment looking into different ways of treating breast cancer – last month one group of researchers announced that they had developed a test to identify which women are most at risk of developing secondary tumours from a certain type of breast cancer, which could allow them to spare those at low risk of further chemotherapy.

Joanna hopes that there can be more discussion over the necessity of mastectomies and for women to feel more in control when being treated for breast cancer.

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