Double MastectomyMost women with breast cancer choose mastectomy, the surgery to remove the entire breast. In certain cases both the breasts are removed (a double mastectomy), often as preventive surgery in women at very high risk for breast cancer. The number of women opting for preventive mastectomy or contralateral prophylactic mastectomy has increased markedly in recent years, with influence from celebrities such as Angelina Jolie and Christina Applegate considering the procedure to prevent cancer risks.

However, a new research recently published in the Journal of the American Medical Association finds that many breast cancer patients who have their second breast removed as a precaution don’t actually need double mastectomy. While fear of cancer return appears to drive the decision to undergo the additional surgery, the fact is that relatively few women have a clinically significant risk of developing cancer in both breasts.

The team studied 1,447 women who had been treated for the condition and who had not had it come back in the following four years. Eight percent of the women had a double mastectomy, and 18 percent had considered having unilateral procedure.

Women with a family history of breast or ovarian cancer or with a positive genetic test for mutations in the BRCA1 or BRCA2 genes may be advised to consider having both breasts removed, as they are at high risk of a new cancer developing in the other breast. But the study funded by grants to the University of Michigan from the National Institutes of Health, reports that more than two-thirds, that is 68.9 percent of the women who had both breasts removed had no major genetic or family risk factors.

The study also reported that "Surgeons are for the most part trying to discourage patients from having this procedure and patients are the ones requesting it".

Plastic surgery specialists and oncologists performing mastectomy use relevant diagnosis codes to bill the procedure. Current ICD codes for this breast surgery include:

ICD-9-PCS

85.41 Unilateral simple mastectomy
85.42 Bilateral simple mastectomy
85.43 Unilateral extended simple mastectomy
85.44 Bilateral extended simple mastectomy

ICD-10-PCS

0HTT0ZZ Resection of Right Breast, Open Approach
0HTU0ZZ Resection of Left Breast, Open Approach
0HTV0ZZ Resection of Bilateral Breast, Open Approach
07T50ZZ Resection of Right Axillary Lymphatic, Open Approach
07T60ZZ Resection of Left Axillary Lymphatic, Open Approach