Not All Large Breast Tumors Warrant Mastectomy, Study Says

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A combination of breast conservation surgery and radiation is as effective as breast removal for some women with large, localized invasive breast tumors, a new study contends.

Breast-conserving lumpectomy is usually limited to women with small tumors, the researchers said.

“For decades, breast cancers have been felt to be amenable to lumpectomy with radiation only if the tumors were 5 centimeters [nearly 2 inches], or smaller. This is because the prospective trials that compared [lumpectomy and mastectomy] didn’t enroll patients whose tumors were larger than 5 centimeters,” lead investigator Dr. Richard Bleicher, of the department of surgical oncology at Fox Chase Cancer Center in Philadelphia, explained in a Fox Chase news release.

“Since there are no clinical trials evaluating breast conservation therapy versus mastectomy for tumors over 5 centimeters,” breast conservation is still not recommended for that scenario in current guidelines, he added.

Bleicher and his colleagues analyzed data from nearly 5,700 women who had nonmetastatic breast tumors larger than 5 centimeters who had surgery between 1992 and 2009. Nonmetastatic means the tumors had not spread elsewhere in the body.

Of those women, nearly 16 percent had breast conserving lumpectomy and radiation rather than breast removal.

Over a median follow-up of seven years, overall survival and breast-cancer specific survival rates were similar for both groups of women, according to the study published online Oct. 19 in the journal Cancer.

“This study, the largest of its kind, demonstrates that women who are felt to be amenable to [tissue removal] by their surgeons can have a lumpectomy and radiotherapy to the breast, and have an equivalent outcome as mastectomy,” Bleicher said.

The researchers said previous studies have shown a link between breast conservation and higher quality of life because of better body image and greater satisfaction with treatment.

“Many surgeons may not do breast conservation for patients with large tumors, even when their breast size is generous enough to accommodate such a large tumor removal,” Bleicher said. “We now have data demonstrating that breast conservation appears safe and should remain an option when the surgeon feels that the patient’s breast size can accommodate the [tissue removal].”

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

Source: HealthDay

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