Sparing the Breast Doesn't Spoil Your Chances
July 18, 2000 -- Sparing the breast doesn't necessarily spoil
your chances of survival, according to a new study on breast cancer
For many women with breast cancer, the choice between
lumpectomy and mastectomy is difficult and confusing. Lumpectomy, or the
removal of the "lump" of cancer, is considered a safe and acceptable
option for small breast tumors, those that are roughly 2 cm or less in
diameter. A 2 cm tumor is equivalent to about three-quarters of an inch. Women
with tumors larger than 2 cm often are advised that it might be safer in the
long term to have a mastectomy, which is complete removal of the breast
However, a new European study shows that even after more than
10 years, women who'd had tumors larger than 2 cm and had had a lumpectomy or a
mastectomy were still alive in similar proportions regardless of which
procedure they'd chosen. Some women in the study had tumors as large as 5 cm,
which is about 2 inches.
"I would say 5 cm is certainly the maximum, but [for tumors
less than 5 cm] if you are treated with mastectomy or breast-conserving
therapy, the results are equal for at least 13.4 years," says Harry
Bartelink, MD, PhD, an author of the study, which was published in a recent
issue of the Journal of the National Cancer Institute.
The study, which began in 1980, included 420 British, Dutch,
Belgian, and South African women who had mastectomies and 448 women from those
same countries who had breast-conserving lumpectomy. Tumors ranged in size from
2 cm to 5 cm.
After more than 10 years, 66% of women who had mastectomy and
65% who had lumpectomy were still alive and well, reports Bartelink, who is
with the Netherlands Cancer Institute in Amsterdam. He says survival rates for
women in the study were similar whether their tumor was 2 cm or 5 cm.
The one major difference between the two groups was the rate of
"local" cancer recurrence in or near the site of the original tumor.
Approximately 12% of women who had a mastectomy had the cancer come back in or
near the original tumor's site, compared with 20% of women who had a
lumpectomy. Bartelink says the 20% rate is higher than would be expected if the
study was done today, because techniques have improved since the early 1980s,
when the women in the study were treated.
He tells WebMD that keeping track of what happens to these
patients a decade or more after their breast cancer is important because it
provides more proof that lumpectomy is safe.
This study adds to a large body of medical data showing that
lumpectomy is not associated with higher rates of death than mastectomy,
according to Stephen B. Edge, MD, who reviewed the study for WebMD.