Lumpectomy Still Good Choice for Women
But New Breast Cancers Can Develop That May Require Breast Removal
July 14, 2003 -- For women with early-stage breast cancer, lumpectomy still seems the best treatment choice. However, women should be checked regularly for signs of new cancers, researchers say.
Their study appears in the August issue of Cancer, published online today.
Lumpectomy, which involves surgical removal of the cancer, some surrounding tissue and usually some of the lymph nodes in the underarm, has increasingly gained acceptance as an effective alternative to mastectomy in treating early-stage breast cancer. Lumpectomy preserves as much of the breast anatomy as possible and is followed by radiation therapy to reduce the chance of recurrence.
However, questions remain about the long-term effect of radiation therapy on surrounding normal tissue when compared with mastectomy, writes lead researcher Matthew M. Poggi, MD, a researcher at the National Cancer Institute (NCI).
In fact, other studies have indicated that though survival rates for these procedures are similar, women who opt for lumpectomy have higher rates of recurrence, with some cancers developing 20 years or more later, writes Poggi. However, those cancers have been treated successfully.
His current study supports those findings.
Survival Rate Still Excellent
In it, he describes the results of an NCI study conducted between 1979 and 1987. The study involved women diagnosed with early-stage breast cancer -- cancer that has not spread beyond the breast.
Of the 237 women, one-half underwent modified radical mastectomy and one-half had lumpectomy and radiation therapy. All the women were followed for an average of 18 years.
"There were no detectable differences" in overall survival rates among the women, reports Poggi. The data:
- 63% of women who had lumpectomy were still disease free 18 years later, compared with 67% of women who had mastectomy.
- In the lumpectomy group, 22% developed breast cancer in the treated breast during the follow-up period or up to 20 years after treatment; 59% of those women were treated successfully with mastectomy.
- Women in both groups had similar overall survival rates 18 years later, with 59% of the mastectomy patients and 54% of the lumpectomy patients still living.
Get Checked Regularly
This study helps allay concerns that cancer from radiation treatments could develop many years afterward, Poggi writes. However, 20 years may not be sufficient to follow up on that possibility.
Bottom line: Although there was no overall difference in survival, women who choose lumpectomy should be monitored closely for any recurrences, he says.