Lumpectomy not advised if breast cancer returns

NEW YORK (Reuters Health) - A mastectomy is prudent when breast cancer returns after a lumpectomy, because survival rates are better than with another lumpectomy, according to a new report.

“We were surprised to find that so many women in our study — almost a quarter of them — had received another lumpectomy rather than a mastectomy,” Dr. Steven L. Chen, from the University of California Davis Cancer Center in Sacramento, said in a statement.

“It’s likely,” he added, “that patients are asking for lumpectomies when their cancer is diagnosed a second time, and their doctors are simply complying with that request. Whatever the reason, that decision can shorten life spans.”

The study, in the American Journal of Surgery, involved 747 women who had a same-breast cancer recurrence after undergoing breast conservation therapy. Twenty-four percent of these patients underwent a second lumpectomy.

The 5-year survival rate was 67 percent for women who had a lumpectomy compared with 78 percent for those who had a mastectomy. An analysis confirmed that lumpectomy reduced the odds of survival by 50 percent.

“As therapy for breast cancer becomes more targeted and researchers come closer to identifying those factors that make some breast cancers more aggressive than others, we may have the option of recommending second, and even third lumpectomies in select cases in the future,” study co-author Dr. Steven Martinez commented.

“Until then,” he added, “mastectomy remains the best option for women experiencing a same-breast recurrence of their breast cancer.”

SOURCE: American Journal of Surgery, October 2008.


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