Lumpectomy Found Equal to Mastectomy

After monitoring more than 2,500 breast cancer patients for 20 years, researchers have concluded that women fare just as well with lumpectomy as they do by having the entire breast removed. This may end the continuing debate over the safety of lumpectomy. The study was published in the October 17, 2002, issue of The New England Journal of Medicine.

The research was composed of two studies. One study, involving 1,851 women with tumors up to 4 cm in diameter, was conducted at the University of Pittsburgh (PA, USA; www.upmc.edu). In more than a third of these women, cancer had spread to the lymph nodes. All the women were randomly assigned to have a mastectomy, a lumpectomy, or a lumpectomy followed by radiation. The results showed that there was absolutely no difference among the three groups in the likelihood that the disease would later spread or in the rate of death from cancer or in the rate of death from all causes. Twenty years later, 47% of the women were still alive, regardless of which treatment they had.

The second study, involving 701 women with tumors no larger than 2 cm in diameter, was conducted at the European Institute of Oncology (Milan, Italy; www.ieo.it). Similar results were found.

The overall results also showed that radiation did not improve survival. However, the researchers did find that radiation markedly reduced the chance that another cancer would arise in the same breast. In women who had lumpectomy alone, the risk of having a second cancer in the same breast was 40%, while the risk in women who had lumpectomy followed by radiation was only about 14%. The studies also showed that radiation therapy did not cause cancer over a period of 20 years.

Only 42.6% of women in the studies chose lumpectomy. The choice of mastectomy was found to be influenced by the seriousness of the prognosis: the worse the prognosis, the more likely a woman was to choose mastectomy. In the past, lumpectomy has been viewed by many doctors are not appropriate for women with a bad prognosis. The new studies do not support this view.




Related Links:
Univ. Pittsburgh
European Institute of Oncology