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Breast Conserving Therapy Provides At Least Equal, If Not Superior Results Compared to Mastectomy

Surgery that consists of a lumpectomy, followed by radiation therapy, provides equivalent, if not superior, survival compared to a mastectomy among women with early breast cancer. These results were recently published in the JAMA Surgery.

Early breast cancer, or cancer that has not spread outside the breast to distant sites in the body, can be treated with either a lumpectomy (removal of the cancer plus a margin of healthy tissue) followed by radiation or a mastectomy (complete removal of the breast).

Several trials and studies have been conducted that have indicated equivalent survival between a lumpectomy plus radiation compared to a mastectomy for early breast cancer. However, researchers continue to evaluate survival and other outcomes between the two types of treatment.

Researchers recently evaluated data from the Surveillance, Epidemiology, and End Results (SEER) database that included 132,149 patients with early breast cancer who had been treated between 1998 and 2008. The data included women with breast cancer that had a cancer size of 4 centimeters or less with 3 or less lymph nodes that had cancer. Women were treated with breast conservation therapy (BCT – lumpectomy plus radiation), mastectomy only, or mastectomy followed by radiation.

70% of patients underwent BCT; 27% underwent a mastectomy only, and 3% underwent a mastectomy and radiation.
At 5 years, patients who did not die from breast cancer occurred in 97% of those treated with BCT, 94% of those treated with a mastectomy only, and 90% of those treated with mastectomy plus radiation therapy.
The researchers concluded that breast-cancer survival (patients who did not die from breast cancer) was superior among women with early breast cancer who received BCT compared to those who received mastectomy. They stated that “Further investigation is warranted to understand what may be contributing to this effect.” Patients diagnosed with early breast cancer may wish to speak with their physician regarding their individual risks and benefits of all treatment options available to them.

Reference: Agarwal S, Pappas L, Neumayer L, et al. Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer. Journal of the American Medical Association (JAMA) Surgery. Early on-line publication January 15, 2014. doi:10.1001/jamasurg.2013.3049. Available at: http://archsurg.jamanetwork.com/article.aspx?articleid=1813803