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Two studies that followed breast cancer survivors for 20 years found that the type of surgery they had—lumpectomy or mastectomy—did not effect their chances of surviving the disease. Though preliminary data have suggested that chances of survival with the breast-conserving surgical option (lumpectomy) were equal to removing the entire breast (mastectomy some physicians still believed that taking out more breast tissue was better and therefore did not present the lumpectomy procedure as a valid option to their patients. According to the researchers, these new studies should assure women and physicians that lumpectomy is a safe, viable option for most patients with small breast cancers. For over a decade, the National Institutes of Health has recommended that women with early stage breast cancers be offered the option of either lumpectomy (followed by radiation) or mastectomy. Yet despite this recommendation, studies have found that surgical options often depend on the physician’s own preference, geographical region, and the medical center setting, with community hospitals performing more mastectomies on small cancers than academic centers. The two newly released studies should dismiss any lingering doubts about the lumpectomy procedure. The first study was conducted by Umberto Veronesi, MD from the European Institute of Oncology and colleagues from Milan, Italy. The researchers followed 701 women with breast cancers measuring less than two centimeters in diameter. All of the women had either lumpectomy followed by radiation therapy or mastectomy. Additionally, some of the women had lymph nodes removed and received chemotherapy. In another study, begun in 1976, Bernard Fisher, MD and colleagues from the National Surgical Adjuvant Breast and Bowel Project at the University of Pittsburgh, analyzed data from women who underwent mastectomy, lumpectomy, or lumpectomy with radiation. The aim of the study was to assess treatment options for women with invasive breast cancer. Both of the studies found that women who underwent lumpectomy were just as likely to survive breast cancer as the mastectomy patients. The researchers of the second study concluded that radiation therapy following lumpectomy continues to be an "appropriate treatment option" for women with breast cancer so long as a margin of normal breast tissue is removed around the breast cancer tumor and that the cosmetic results of the surgery are acceptable. "The long-term survival rate among women who undergo breast-conserving surgery is the same as that among women who undergo radical mastectomy. Breast-conserving surgery is therefore the treatment of choice for women with relatively small breast cancers," conclude Dr. Veronesi and his colleagues from the Italian study. Women with breast cancer should weigh the advantages and disadvantages of both lumpectomy and mastectomy with their cancer treatment team to determine which treatment is best for them. Lumpectomy may preserve the physical appearance of the breast but usually requires six to seven weeks of radiation therapy. Mastectomy may reduce the chances of a local recurrence of breast cancer but additional decisions about breast reconstruction are introduced. Also, some women may be better candidates for mastectomy than lumpectomy or vice versa depending on their individual medical situation.
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