A new study published in the Jan. 28 online journal Cancer presents women faced with treatment decisions for early-stage breast cancer with evidence that lumpectomy may offer a better survival rate than mastectomy.
In the study, early-stage breast cancer patients who were treated with lumpectomy — where only the tumor and surrounding tissue are surgically removed — and radiation were 19 percent less likely to die from any cause as compared with women who had opted for mastectomy.
“Our findings are observational but do suggest the possibility that women who were treated with less invasive surgery had improved survival compared to those treated with mastectomy for stage I or stage II breast cancer,” said Shelley Hwang, MD, MPH, the study’s lead author and chief of breast surgery at Duke Cancer Institute, Durham, N.C., in a news release.
Hwang and her team analyzed the data from 112,154 women diagnosed with stage I or stage II breast cancer between 1990 and 2004. Among the study group, 61,771 underwent lumpectomy and radiation, and 50,383 had mastectomy without radiation.
Patients in the study were followed on average for 9.2 years. Researchers evaluated whether illnesses other than breast cancer – heart and respiratory disease, for example – may have influenced whether women chose lumpectomy or mastectomy.
Study results showed that within three years of diagnosis, women of all ages with both hormone-sensitive and hormone-resistant cancers who underwent lumpectomy and radiation had higher survival rates than those who chose mastectomy when all other illnesses where evaluated. Researchers suggest this means that women choosing lumpectomy may have been healthier in general.
The study also suggests that women 50 and older who were diagnosed with hormone-sensitive tumors saw the largest benefit when choosing lumpectomy plus radiation. This group was 13 percent less likely to die from breast cancer and 19 percent less likely to die from any cause when compared with those undergoing mastectomy.
Many women think “they may do better the more surgery they do,” Hwang told MyHealthNewsDaily. “They need to be aware that lumpectomy gives them excellent long-term outcomes.”
However, researchers caution that lumpectomy is not for everyone. It is not recommended for women with large tumors or multiple tumors in the same breast. In addition, those who have had previous chest radiation, or those who have certain genetic mutations, such as BRCA1, are not good candidates for lumpectomy.
Hwang believes the study does arm women with valuable information. But, “I don’t want women who chose mastectomy to think they did the wrong thing,” Hwang told HealthDay. “At the end of the day, personal preference trumps everything else. I fully support the patient’s options to choose the best treatment for themselves.”
The American Cancer Society provides additional information about treatment options.