When it comes to breast cancer surgery, is less really more?
The study, published in a recent issue of the journal Cancer, found that women, especially those over 50 with early-stage breast cancer, respond just as well to a minimally invasive lumpectomy—a procedure that removes only the identified tumor and some surrounding tissue.
Researchers found that women who had the lumpectomy and radiation therapy were 13 percent more likely to survive. And, in women over 50, the chances of survival increased by 19 percent. Additionally, the team discovered that women who had a mastectomy had a higher risk of dying from other causes, such as heart disease.
However, cancer physicians say the study results, though impressive, must be taken with caution.
“This is a report of outcomes, not a clinical trial,” says Dr. Ann Mauer, chief of oncology at Advocate Illinois Masonic Medical Center. “The conclusions are interesting and reassuring, but not necessarily conclusive. This is one study on data from one state. Until further study is completed, the conclusions can’t be accepted as final truth.”
Dr. Mauer says earlier research comparing breast conservation therapy had concluded that the two procedures are similarly effective, so more research is needed to confirm the study’s conclusions.
“From the study alone, we can’t conclude that lumpectomy is superior to mastectomy,” she says. “The apparent difference may have occurred because there were differences in the two groups of women that researchers were not able to take into account as part of the study.”
For example, Dr. Mauer says there may have been differences in patient access to health care or patient health, which may have affected the choice of treatment. She notes the researchers did not have data on information about several important factors, such as the patients’ tumor-to-breast ratio and measures of tumor aggressiveness. Because the study did not examine that level of detail, these factors could very well have affected the results.
“When I meet with patients who have early-stage breast cancer, we discuss both options,” Dr. Mauer says. “The majority of my patients—more than 80 percent—are candidates for lumpectomy. However, lumpectomy is not appropriate for all women with breast cancer.”
According to Dr. Mauer, the less-invasive procedure may or may not be recommended for women with large tumors or multiple tumors in the same breast, those who have had previous chest radiation or those who have certain genetic mutations.
“This study provides reassurance to patients opting for a more conservative approach. I urge anyone concerned to speak to their surgeon, so they can make an informed decision. Every health choice is personal.”
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