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Lumpectomy may be Better than Mastectomy

Posted 9/15/2014

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  If you are a regular reader of this blog, you know that I have written often about the dubious benefit of bilateral vs. single mastectomies for most women. This is a new and nice twist on that topic: a study suggesting that wide excision/lumpectomy may actually provide a small survival benefit over mastectomy for women with early stage ER positive breast cancer.

  The commonly quoted statistics are that mastectomy and wide excision/lumpectomy are equally effective for most women. Since the studies giving those results were all done decades ago, researchers looked at the national Cancer Database to identify records of 16,646 women who were treated in 2004 and 2005. Their findings have been a surprise and were presented at the recent Breast Cnacer meetings in California. As we know more and more about the biology of different tumors, it is more and more possible to make specific and clear and personal recommendations. One size does not fit all.

  This is from and includes links to the originial study:

Lumpectomy Plus Radiation May Offer Survival Benefits Over Mastectomy for Early-Stage, Hormone-
Receptor-Positive Disease

Many studies done in the 1970s showed that lumpectomy plus radiation to treat women diagnosed with early-stage breast cancer offered the same survival rates as mastectomy. Based on these studies, the U.S. National Institutes of Health released a statement in 1990 saying that lumpectomy plus radiation was preferred over mastectomy to treat early-stage breast cancer.
These studies were done about 40 years ago, before we knew as much as we do now about all the characteristics of breast cancer. So researchers wanted to know if considering the hormone-receptor status of a breast cancer would affect survival rates for lumpectomy plus radiation versus mastectomy. So they decided to do a new study.
The results suggest that women diagnosed with hormone-receptor-positive early-stage breast cancer who have
lumpectomy followed by radiation have slightly better survival rates than women who have mastectomy alone or
lumpectomy alone.
The study was presented on Sept. 4, 2014 at the 2014 ASCO Breast Conference. Read the abstract of “Effect of
hormone receptor status on local treatment and overall survival for early-stage breast cancer.”


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