The number of women who choose mastectomies for early-stage breast cancer is on the rise, but a new study suggests that this may not be the best option for their long-term survival.
When Dutch researchers looked at results for 37, 207 women who were diagnosed with early-stage breast cancer between 2000 and 2004, they found that those who opted for breast-conserving surgery plus radiation had a 10-year survival rate of 76.8 percent. Among the women who had mastectomies, 59.7 percent survived at least 10 years.
After then focusing on the outcomes for a smaller group of those women, they concluded that 83.6 percent who chose the more conservative approach, also known as lumpectomy, were cancer-free after 10 years, compared to 81.5 percent of those who had mastectomies.
While mastectomy — and even double mastectomy — has been on the increase as a therapy for early-stage breast cancer, study author Sabine Siesling says that women and their physicians ought to think carefully about lumpectomy plus radiation.
“If it’s medically feasible and it’s the choice of the patient, then the patient has a better prognosis,” said Siesling, a professor of outcome research and personalized cancer care at the University of Twente in the Netherlands. She said it’s possible that the post-surgery radiation is critical to preventing the cancer’s recurrence and spread, though that was not studied in this research. The study was presented Thursday at the San Antonio Breast Cancer Symposium.
Stage 1 and stage 2 breast cancers for which lumpectomy plus radiation are recommended involve tumors smaller than 5 centimeters that have not spread outside the breast but may have affected as many as three lymph nodes.
Previous research has reached differing conclusions on the two surgical approaches. Some randomized clinical trials, the gold standard of medical research, have determined that survival rates are about equal. The website of the Susan G. Komen foundation, for example, advises that “overall survival with lumpectomy plus radiation therapy is the same as with mastectomy.”
Yet when Duke Cancer Institute researchers looked back at the survival rates for more than 112,000 California women in a 2013 study, they found that rates for women who opted for lumpectomy plus radiation were better than for those who had mastectomies.
(Click here to read the full article, written by Lenny Bernstein, Washington Post)