Lumpectomy As Effective As Mastectomy For Early-Stage Breast Cancer, Study ConfirmsLumpectomy Followed By Radiation Treatment< July 16, 2003 >Women with breast cancer who choose lumpectomy followed by radiation live as long as those who choose mastectomy, if their cancer is diagnosed earlier than later, concludes a new report in the medical journal Cancer. The study reported this week marks the third time in less than a year that a major, long-term study has found that a woman need not lose her entire breast to ensure cancer survival, as long as the cancer is diagnosed early. "Our study, one of only six worldwide and one of just two US trials ever to look at this question in a prospective, randomized fashion, confirmed that there was no detectable survival difference between women with early-stage breast cancer treated with mastectomy or breast conservation therapy (lumpectomy) which included radiation," says lead study author Dr. Matthew Poggi, a radiation oncologist at the National Cancer Institute (NCI) of the National Institutes of Health (NIH). Even when a cancer did recur in the breast treated with lumpectomy requiring a follow-up mastectomy, Dr. Poggi says, "There was not any detectable difference in disease-free survival." Breast cancer is the most common cancer among women, excluding non-melanoma skin cancer. Currently, approximately 3 million women in the US are living with the disease, including 2 million who have already been diagnosed, and another 1 million who do not yet know they have the disease. Lumpectomy involves removing the tumor, evaluating the auxiliary lymph nodes for signs of cancer, and following the surgery with radiation therapy for several weeks or months. A mastectomy is surgery which removes the cancerous breast, and it may also involve removal of several lymph nodes. Early Detection and SurvivalFor breast surgeon Dr. Kimberly Van Zee, the findings are not only an encouraging endorsement of the safety and efficacy of breast conservation therapy, but they underscore the importance of regular mammograms and early detection. "The increase in survival rates for breast cancer directly correlate with advances in mammography," says Dr. Van Zee, a breast surgeon at Memorial Sloan-Kettering Cancer Center in New York City. "And I think this study offers important evidence that finding a breast cancer early can not only help save your life, it can also save your breast." Before mammography, Dr. Van Zee points out, most breast cancers were found at such a late stage that breast conservation therapy was impossible. "But today, the widespread use of screening mammography, plus improvements in the quality of that screening, means the average size of diagnosed tumors has progressively decreased over the last two decades," she says. "And that is what has made breast conservation therapy possible." In addition to bolstering confidence in breast conservation therapy, the study also offers new evidence that radiation therapy - almost always administered following lumpectomy - does not result in an increased risk of either cancer in the healthy breast or heart disease, as once thought, Dr. Van Zee says. "If it did have these effects, it would have been reflected in the death rate - and it was not," says Dr. Van Zee. Long-Term Study Shows Similar ResultsThe study involved a comparison of diagnosis, treatment, and survival data on 237 breast cancer patients. All were originally part of a NCI randomized trial comparing mastectomy to breast conservation therapy that began some 22 years ago. Over the following two decades, the women's health was carefully monitored for not only cancer recurrences, but also cancer-related and overall survival rates. Dr. Poggi's team then analyzed the data and compared the two groups of women. In addition, disease-free survival between the two groups was similar as well - 67 percent in the mastectomy group, 63 percent in the breast conservation group. Although 22 percent of the women who chose breast conservation therapy did develop cancer again in the treated breast, 59 percent of those women were able to successfully thwart the cancer's spread with mastectomy. Their survival rates were then equal, once again, to the women who initially chose mastectomy. "What this showed us is that even if your cancer recurs, your survival won't be affected," says Dr. Van Zee. However, she emphasizes this also means the need for vigilant and diligent breast exams for any woman who has had breast cancer. As hopeful as these study results may be, Dr. Poggi says that keeping a breast is still a decision many women with breast cancer are hesitant to make. "As a radiation oncologist, I often find myself in the position of explaining to a patient that a more aggressive surgical procedure does not necessarily mean that their chances of 'beating the cancer' are improved," Dr. Poggi says. Dr. Van Zee adds, "I think women should always be told all their treatment options. But, hopefully, these three studies combined will give those that choose breast conservation therapy confidence in their choice so they don't have to spend their healthy time worrying if they made the right decision." Always consult your physician for more information. |
For more information on health and wellness, please visit health information modules on this Web site. Surgery in Breast Cancer TreatmentSurgery to remove as much of the cancer as possible is the primary treatment for breast cancer. Today, women have many surgical options and choices. The type of surgery performed depends upon:
There are several types of breast surgery. A physician can explain the benefits and risks of each type, in addition to answering any questions or concerns prior to surgery. Questions to ask your physician before surgery:
Always consult your physician for more information. Online Resources(Our Organization is not responsible for the content of Internet sites.) Centers for Disease Control and Prevention (CDC) National Alliance of Breast Cancer Organizations National Breast Cancer Coalition National Cancer Institute (NCI) National Institutes of Health (NIH) |
