A 47-Year-Old Woman With Ductal Carcinoma In Situ of the Breast

To the Editor. —Dr Morrow's 1 discussion of a 47-year-old woman with DCIS of the left breast who was treated with a left mastectomy was excellent. The patient opted for a prophylactic right mastectomy to allay her fear of cancer in that breast and her fear of death. Prophylactic mastectomy is an option available to women, but we feel strongly that a patient's decision should rely on facts rather than fear. Surveillance of the contralateral breast is equivalent to mastectomy in terms of survival in this patient's situation. 2,3 No data are available to prove or suggest that prophylactic mastectomy improves overall survival or survival free of breast cancer in women with DCIS or early invasive breast cancer. 3 A woman should not be led to believe that sacrificing her breast(s) will ensure her survival with or without breast cancer. The chance of finding invasive carcinoma in addition to the