30 January 2013

A recent study in the journal Cancer compared patients with early stage breast cancer who underwent lumpectomy with radiation to patients who underwent mastectomy, and found that the patients who underwent lumpectomy had a better overall survival.

It is important to realize that this is an “observational study”, meaning the researchers went back to older data and analyzed the results – in the case of this study, they reported on patients treated between 1990-2004. There are many factors that were not accounted for, most importantly the specific subtype of cancer. It is not clear if the patients who underwent mastectomy had more aggressive tumors, which might in part explain the difference in survival rates.

Randomized clinical trials have demonstrated that the long-term survival is equivalent for patients undergoing a lumpectomy with radiation or mastectomy – in other words – you will not live any longer if the breast is removed. This is important to remember as more women are requesting mastectomy, and even removal of the healthy breast. While there are limitations to this current study, it at least reinforces the point that more surgery is not necessarily better.

The following interview discussed some of the history of breast cancer surgery as well as a discussion of the journal study: