Can Breast Cancer Surgery Nurture New Tumors?
Controversial Theory: Tumor Removal Unleashes Cancer Growth Factors in Younger Women
Breast Cancer Screening Paradox continued...
Over time, breast cancer screening shows a benefit for all women. But why the early increase in risk? Could it be due to women with node-positive breast cancer who suffer early relapses after surgery? Retsky suggests that it is.
Looking at data from studies of breast cancer screening, Retsky and colleagues saw about one excess death per 10,000 screened young women in the third year of screening. That, he says, is just what one would expect if his hypothesis is correct.
"It looked like surgery accelerated the disease by two years on average, which is the usual dormancy of this [blood vessel-free] tumor state," Retsky says. "All the data show this."
Even so, Retsky stresses, younger women with breast cancer still need surgery. He strongly advises women to continue to seek breast cancer screening -- and, when a cancer is found, to have it removed.
"We don't have all the answers," Retsky says. "We think our work has pointed out that the mammography paradox is real. We are confident we understand what causes it. We have identified a problem -- a mechanism that is testable. We have not found a solution. But identifying the problem is a major step in the right direction."
Retsky and colleagues report their findings in the current issue of the International Journal of Surgery.
American Cancer Society Says It Isn't So
Don't believe any of this, says Robert A. Smith, PhD, director of cancer screening for the American Cancer Society.
"The data don't add up to Dr. Retsky's conclusion," Smith tells WebMD. "The idea that surgical interruption of the tumor bed will cause death this rapidly just does not make sense."
Smith, a strong proponent of early and regular breast cancer screening, says the apparent screening paradox does not exist.
"You do not expect mammograms to be instantly beneficial," he says. "When you first invite women to screening, you get some with tumors that are already advanced. And not all of the women will respond to the invitation to screening. They may die next year or the year after, and because they were invited, they will be counted as a death in the screening group. So you really can't look at this pattern and make any sense out of it."