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Lumpectomy more effective than mastectomy early on

Monday January 28, 2013
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Lumpectomy plus radiation for early breast cancer may provide patients with a better chance of survival than mastectomy, according to an analysis.

Scheduled for publication in Cancer, a peer-reviewed journal of the American Cancer Society, the results provide confidence in the efficacy of breast-conserving treatments even among patients with aggressive early disease, according to the authors.

Lumpectomy combined with radiation is a good treatment choice for women with early breast cancer, according to background information for the study. However, over the past 10 years, a growing number of women have been choosing mastectomy even for very small cancers. This trend has been most pronounced in certain populations, such as women who are young and those living in urban areas with high socioeconomic status, because of the perception that outcomes may be better with mastectomy than with lumpectomy.

Shelley Hwang MD, MPH, of the Duke Cancer Institute, and her colleagues investigated whether some populations of women may have better outcomes after mastectomy compared with lumpectomy and radiation. The researchers obtained information regarding all women who were diagnosed with stage I or II breast cancer in California between 1990 and 2004 and who were treated with either mastectomy or lumpectomy plus radiation. The investigators followed 112,154 cases through 2009 and looked for patterns among different age groups and across different breast cancer types.

In the first three years after surgery, women who underwent mastectomy had a higher risk of dying from heart disease and other diseases than women who underwent lumpectomy, possibly indicating that the latter group was generally healthier, according to Hwang.

Over the entire study period, women were more likely to survive breast cancer after undergoing lumpectomy plus radiation than mastectomy. This was true among all age groups and cancer types, with the biggest benefit seen in women older than 50 with hormone-sensitive breast cancer. These women had a 14% decreased risk of dying from breast cancer during the study, compared with their counterparts who underwent mastectomy.

"The findings in this study should reassure women that among all age groups and tumor types, lumpectomy continues to be an excellent choice for women with small early breast cancers," Hwang said.

The study abstract is available at http://onlinelibrary.wiley.com/doi/10.1002/cncr.27795/abstract.


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