E. Shelley Hwang, M.D., MPH, chief of breast surgery at Duke Cancer Institute, and colleagues published new research in the Jan. 28, 2013 issue of the journal CANCER that indicates patients with early stage breast cancer who are treated with lumpectomy plus radiation have a better chance of survival compared with those who undergo mastectomy.
The researchers used 14 years of data from the California Cancer Registry, a source of long-term outcome data for cancer, and found improved survival to be associated with the less invasive treatment in all age groups, as well as those with both hormone-sensitive and hormone-resistant cancers. Women age 50 and older at diagnosis with hormone-sensitive tumors saw the largest benefit of choosing lumpectomy plus radiation: they were 13 percent less likely to die from breast cancer, and 19 percent less likely to die from any cause compared with those undergoing mastectomy.
The team analyzed data from 112,154 women diagnosed with stage I or stage II breast cancer between 1990 and 2004, including 61,771 who received lumpectomy and radiation and 50,383 who had mastectomy without radiation. They looked at age and other demographic factors, along with tumor type and size to decipher whether each treatment had better outcomes for certain groups of women. Patients were followed on average for 9.2 years.
The researchers evaluated whether illnesses other than breast cancer, such as heart and respiratory disease, may have influenced whether women chose lumpectomy or mastectomy. Within three years of diagnosis, breast cancer patients who underwent lumpectomy and radiation had higher survival rates than those who chose mastectomy when all other illnesses were evaluated. This suggests that women choosing lumpectomy may have been generally healthier.
The researchers note that more women have opted for less invasive treatments for breast cancer in the last decade but a growing trend in younger women has been opting for mastectomy based on the perception that mastectomy is more effective at eliminating early stage cancer and reducing the anxiety associated with long-term surveillance.
The research was reviewed at the Eureka Alert website the date of publication.