It's Always Biology
This is an interesting article from The American Society of Breast Surgeons about the safety of lumpectomy vs mastectomy for women with locally advanced breast cancers. Their bottom line is that the risk of a local recurrence depends on the biology of the specific tumor, not on the choice of surgical treatment. This seems completely obvious and brimming with common sense. We already know that, although other factors matter, the most important variable in continuing good health is how responsive a particular cancer is to treatments. There are breast cancers that respond (that is, shrink or disappear) to virtually all chemotherapy agents, and there are others that seem impervious to everything. The treatment resistant ones are the real dangers, and there is often no way to know in advance. To be reassuring: the overwhelming majority of breast cancers do respond to chemotherapy, and oncologists have some strategies to deal with those that don't.
Here is the beginning of the article and then a link to read more:
Women with High Risk Locally Advanced Cancers can be Safely
Treated with Lumpectomy
Abstract: Biology, Not choice of Mastectomy versus Lumpectomy, Dictates Recurrence in High-Risk Breast Cancer
May 4, 2012, Phoenix--Women with high-risk tumors can be safely treated with lumpectomy if their tumors respond well to chemotherapy prior to surgery (neoadjuvant chemotherapy), suggests a new study presented this week at the American Society of Breast Surgeons (ASBrS) Annual Meeting. The study examined cancer recurrence in areas near the original tumor site (local recurrence) in high-risk women who received multidisciplinary cancer therapies. It found that tumor biological characteristics,
reflected in part by response to neoadjuvant chemotherapy, and not choice of mastectomy or breast conserving lumpectomy was the major determinant of cancer returning locally.
"Traditionally, the choice of surgical treatment was thought to have the greatest impact on local recurrence, especially in women with significant tumor remaining after pre-surgical chemotherapy," explains Dr. Elizabeth Cureton, Breast Surgical Oncology Fellow, University of California, San Francisco Medical Center. "But this was not the case. In fact, the study found that tumor characteristics such as gene expression, advanced stage, and the poor response to neoadjuvant therapy itself were the major predictors of cancer recurrence."