02:14 - Source: CNN
Bold and Breastless: A Survivor's Story

Story highlights

Younger women with breast cancer are more likely to remove healthy breasts, a trend that varies by state, a study finds

"Sometimes, surgery is a blessing. ... It doesn't come complication-free," says a young survivor who shares her story

(CNN) —  

For many, the Fourth of July evokes jovial memories of backyard cookouts and fireworks, but for Amberlea Childs, the summer holiday conjures a haunting memory that changed her life.

Childs was diagnosed with breast cancer a day before July Fourth weekend in 2010.

She was 36, newly engaged, and had a lump the size of a large walnut in her right breast. She visited a radiologist to get it checked.

“He ended up doing five different biopsies, and on the last one, he pulled it out, and he looked at me, and his eyes welled up with water,” Childs said.

“It was definitely that out-of-body experience where you’re kind of watching your own story play out, and as his eyes welled up, he said, ‘I’m not 100% sure, but if I had to bet, I’m 99.9% sure what I just pulled out of your breast was breast cancer,’ ” Childs said.

Later on, once her diagnosis was confirmed, “I needed to have surgery.”

Amberlea Childs, third from the left, in treatment in St. Petersburg, Florida.
PHOTO: Amberlea Childs
Amberlea Childs, third from the left, in treatment in St. Petersburg, Florida.

Childs first opted to have a lumpectomy, in which only the cancerous mass in her breast was removed, but then the disease advanced. She was told that she would need another surgery. This time, she opted for a double mastectomy, in which both of her breasts – even the one without cancer – were removed.

“I wanted to do a mastectomy on that right side, and then from there, you have to then contemplate, ‘Well, should I do a prophylactic mastectomy on the other side that does not have cancer?’ ” Childs said. “Many women have this thought, but I feel for a younger woman – and I identify as a young survivor – you have longer to live, therefore you have a greater chance of recurrence just by the mere fact that you’re going to be alive longer.”

Since her cancer diagnosis, Childs has had nine surgeries to her chest. The double mastectomy was among the earliest.

Amberlea Childs, with her husband Donny, last year.
PHOTO: Amberlea Childs
Amberlea Childs, with her husband Donny, last year.

Now, she is a healthy 43-year-old Milwaukee resident and a breast health advocate with Susan G. Komen of Southeast Wisconsin. While chemotherapy treatments affected Childs’ fertility, she and her husband are preparing to adopt their first child, whom they can’t wait to meet.

“I am feeling wonderful. I can honestly say that my life is healthier, better directed after I’ve had cancer,” she said. “It gave me a different lens to look through life.”

Yet because of her experience, Childs can relate to the 7% of women with breast cancer who are diagnosed before age 40, many of whom face the same decision she did: whether to go under the knife for a lumpectomy or a mastectomy.

’The cancer didn’t develop overnight, so pump the brakes’

Younger women with breast cancer are increasingly opting to undergo double mastectomies, even if they were diagnosed with early-stage cancer in only one breast, known as unilateral breast cancer, according to a study published in the journal JAMA Surgery on Wednesday.

The procedure to remove the healthy breast along with the affected breast is called a contralateral prophylactic mastectomy, or CPM.

In certain states, more than 42% of women 20 to 44 who underwent surgery between 2010 and 2012 opted to remove both breasts with a CPM, the study found. Researchers now are hoping to determine why.

“To be honest, I think it’s very difficult to really pinpoint why the increase,” said Ahmedin Jemal, vice president of surveillance and health services research at the American Cancer Society, who was senior author of the study. However, he offered some ideas.

“One factor that could contribute to the increase is this desire for symmetry,” Jemal said, referencing how the breasts would look more symmetrical after a double mastectomy compared with after having just one breast removed.

“Another factor is probably the Angelina Jolie effect. She was diagnosed with the BRCA-1 cancer gene that mutation that causes breast cancer, and she had a double mastectomy, so that was covered widely in the media,” he said. “For women diagnosed with breast cancer in one breast, there is no evidence to suggest to remove the unaffected breast.”

Last year, the American Society of Breast Surgeons published a consensus statement in the journal Annals of Surgical Oncology recommending against the routine use of removing both breasts in women with unilateral breast cancer – a recommendation that the American Board of Internal Medicine also made.

“CPM should be discouraged for an average-risk woman with unilateral breast cancer. However, patient’s values, goals, and preferences should be included to optimize shared decision making when discussing CPM. The final decision whether or not to proceed with CPM is a result of the balance between benefits and risks of CPM and patient preference,” the statement said.

Even if a CPM procedure is to prevent cancer from developing in the healthy breast, Jemal said, “the maximum is 6% of women will develop breast cancer on the unaffected breast within the next 10 years. It is very small.”

On the other hand, the most common second cancer in breast cancer survivors is another breast cancer, according to the American Cancer Society.

A healthy 55-year-old woman has about a 2.5% chance of developing invasive cancer in a given breast over the next 15 years, whereas a 55-year-old breast cancer survivor has a 10% to 15% chance, according to a paper published in the Journal of the National Cancer Institute in 2010.

About 12.4% of women in the United States will be diagnosed with breast cancer at some point during their lifetime, according to the National Cancer Institute.

“Sometimes, surgery is a blessing, and it can help remove cancer and do great things, but it doesn’t come cost-free, and it doesn’t come complication-free,” Childs, the breast cancer survivor, said.

“There is going to be time that’s needed to heal and recover, and if you’re not willing to give yourself that time, maybe you should weigh that into your decision if it was lumpectomy versus mastectomy, but I think, do the homework. Don’t rush into something so quickly. Take the time, get that extra opinion, meet with one more plastic surgeon,” she said.

“This is the best piece of advice I’ve been told and I always share with other women: The cancer didn’t develop overnight, so pump the brakes and take more time to make the best informed decision for you.”

Differences in mastectomies, by age

The new study included data on 1.2 million women 20 and older in the United States who were diagnosed with early-stage invasive unilateral breast cancer between 2004 and 2012. The data came from the North American Association of Central Cancer Registries.

The researchers took a close look at which patients in the data underwent a lumpectomy; a unilateral mastectomy, in which only the breast with cancer is removed; or a contralateral prophylactic mastectomy.

02:13 - Source: CNN
Why losing weight might protect you from Covid-19
PHOTO: CNN
Now playing
02:13
Why losing weight might protect you from Covid-19
A selection of fruit ready to eat are displayed at a fruit and vegetable shop on April 12, 2016 in Lille, northern France. / AFP / DENIS CHARLET        (Photo credit should read DENIS CHARLET/AFP/Getty Images)
PHOTO: DENIS CHARLET/AFP/AFP/Getty Images
A selection of fruit ready to eat are displayed at a fruit and vegetable shop on April 12, 2016 in Lille, northern France. / AFP / DENIS CHARLET (Photo credit should read DENIS CHARLET/AFP/Getty Images)
Now playing
01:27
New diet can save lives and the planet, study says
this is your brain on pain health orig_00001025.jpg
PHOTO: CNN
this is your brain on pain health orig_00001025.jpg
Now playing
01:39
This is your brain on pain
Now playing
01:42
Here's why you can't stop eating pizza, ice cream and chocolate chip cookies
Now playing
01:10
Trouble sleeping? This may be why
PHOTO: CNN
Now playing
02:40
The reality of wine's health benefits
PHOTO: shutterstock
Now playing
01:49
These foods aren't as healthy as you think
Americans are still too fat according to a new study from JAMA. Two in three of Americans are registering as overweight or obese.
PHOTO: Shutterstock
Americans are still too fat according to a new study from JAMA. Two in three of Americans are registering as overweight or obese.
Now playing
01:15
What is obesity?
PHOTO: CNN
Now playing
01:17
Why your BMI matters
LONDON - MAY 16:  In this photo illustration a cigarette is seen burning on May 16, 2007 in London. Businesses and shops are gearing up for the introduction of the smoking ban on July 1 in England after similar bans have been introduced in Ireland, Scotland and Wales.  (Photo Illustration by Bruno Vincent/Getty Images)
PHOTO: Bruno Vincent/Getty Images Europe/Getty Images
LONDON - MAY 16: In this photo illustration a cigarette is seen burning on May 16, 2007 in London. Businesses and shops are gearing up for the introduction of the smoking ban on July 1 in England after similar bans have been introduced in Ireland, Scotland and Wales. (Photo Illustration by Bruno Vincent/Getty Images)
Now playing
01:07
What tobacco does to your health (2017)
PHOTO: Photo Illustration/Thinkstock
Now playing
01:12
World blood pressure rises (2016)
Woman pointing to area on mammogram x-ray, close-up
PHOTO: Getty Images/File
Woman pointing to area on mammogram x-ray, close-up
Now playing
01:19
Breast cancer: Know the facts
A surgeon sitting in front of screens of a Focal One device performs a robot-assisted prostate tumorectomy using ultrasound imaging on April 10, 2014 at the Edouard Herriot hospital in Lyon, center France. Focal One is the first robotic HIFU (high intensity focused ultrasound) device dedicated to the focal approach for prostate cancer therapy. According to EDAP TMS SA, a leader in therapeutic ultrasound, it combines the three essential components to efficiently perform a focal treatment: state-of-the-art imaging to localized tumors with the use of magnetic resonance imaging (MRI) combined with real-time ultrasound, utmost precision of robotic HIFU treatment focused only on identified targeted cancer areas, and immediate feedback on treatment efficacy utilizing Contrast-Enhanced Ultrasound Imaging. AFP PHOTO / JEFF PACHOUD        (Photo credit should read JEFF PACHOUD/AFP/Getty Images)
PHOTO: JEFF PACHOUD/AFP/AFP/Getty Images
A surgeon sitting in front of screens of a Focal One device performs a robot-assisted prostate tumorectomy using ultrasound imaging on April 10, 2014 at the Edouard Herriot hospital in Lyon, center France. Focal One is the first robotic HIFU (high intensity focused ultrasound) device dedicated to the focal approach for prostate cancer therapy. According to EDAP TMS SA, a leader in therapeutic ultrasound, it combines the three essential components to efficiently perform a focal treatment: state-of-the-art imaging to localized tumors with the use of magnetic resonance imaging (MRI) combined with real-time ultrasound, utmost precision of robotic HIFU treatment focused only on identified targeted cancer areas, and immediate feedback on treatment efficacy utilizing Contrast-Enhanced Ultrasound Imaging. AFP PHOTO / JEFF PACHOUD (Photo credit should read JEFF PACHOUD/AFP/Getty Images)
Now playing
01:21
What is prostate cancer?
PHOTO: Argosy
Now playing
00:53
What is Parkinson's disease?
Now playing
01:38
How Alzheimer's destroys the brain