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Mastectomy linked to lower survival rates

28th January 2013

Researchers in the United States say women who have a lumpectomy followed by radiation treatment have a higher chance of surviving breast cancer than those who have a breast completely removed.

breastcancer

A new analysis of existing data in the journal Cancer shows doctors should have confidence in limited surgery options that preserve the breast, as it is apparently not just a cosmetic decision.

In the past decade, there has been an increase in the number of women who opt for mastectomies because they hope that more radical surgery will lessen the likelihood of a recurrence.

Researchers led by Shelley Hwang of the Duke Cancer Institute said they were unable to determine why mastectomies were associated with a lower survival rate.

However, their findings showed that even women who have aggressive, early breast cancers have a higher rate of survival with a lumpectomy and radiation therapy.

Hwang said the study's findings should reassure women among all age groups and with all types of tumour that lumpectomy was a good choice, if the breast cancer is relatively small and caught at an early stage.

The analysis came after Hwang and her team looked at more than 112,000 cases of stage I and stage II breast cancer. The women were all diagnosed in California sometime between 1990 and 2004.

They had opted either for a mastectomy or lumpectomy plus radiation therapy. Follow-up data from 2009 was also available.

After analysing patterns of treatment and survival across different age groups and types of tumour, they found women who had had a mastectomy were more likely to die from heart disease or other diseases during the first three years following surgery, compared with those who had a lumpectomy and radiation treatment.

The lumpectomy option was associated with a higher rate of survival, regardless of the woman's age or the type of tumour she had.

However, in women over 50 with hormone-sensitive breast cancers, the effects were very marked. Those who had lumpectomy plus radiation were 14% less likely to die during the follow-up period than those who had mastectomies.

The findings did not provide any reason for the associations found by Hwang and her team, however, and further research would be needed to investigate causal factors.

Hwang's study comes just a few days after the publication of a Canadian study which suggests that a simple blood test could predict the likelihood of a recurrence of breast cancer.


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