High-risk women act fast

Christina Applegate's choice to have a double mastectomy puts her in the company of a growing number of women who are taking aggressive steps to avoid dying of breast cancer.

Studies show more patients are choosing mastectomies, even though women are just as likely to survive if they have smaller, breast-conserving surgeries.

Doctors say part of the trend has been spurred by technology: scans that can detect smaller, earlier cancers; sophisticated genetic tests that can warn women of their inherited risks; even new techniques in plastic surgery that make such radical surgery more appealing. But experts say some women are opting for mastectomy because their fear of cancer looms larger than concerns about their appearance.

Applegate, 36, was at high risk for breast cancer, both because her mother had the disease and because she carries a rare genetic mutation in a gene called BRCA-1, which increases the risk ...