“Breast conserving therapy (BCT, breast conserving surgery combined with radiation therapy) is superior to mastectomy in certain types of breast cancer patients, according to results from the largest study to date, to be presented to the European Cancer Congress 2017 today (Monday).
“Professor Sabine Siesling, from the Netherlands Comprehensive Cancer Organisation (IKNL) and University of Twente and Mirelle Lagendijk, MD, from the Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands, and colleagues from other hospitals, studied survival nationwide in nearly 130,000 breast cancerpatients, divided into two groups: those diagnosed between 1999-2005 and those diagnosed between 2006-2012. The patients selected from the Netherlands Cancer Registry had no metastases (spread of the cancer to organs other than the lymph nodes close to the tumour). To obtain information on cause of death, data were linked to the cause of death register.”
“Young women with early breast cancer face a difficult choice about whether to opt for a mastectomy or breast conserving therapy (BCT). This is because there is little evidence as to whether the greater risk of a return of the disease at the site of the original tumour after BCT is linked to a greater risk of the cancer spreading to other parts of the body, leading to higher death rates.
“Now, new research presented at the ESTRO 35 conference today (Saturday) has shown women aged younger than 45 years, who had early stage breast cancer that had not spread to the lymph nodes and who opted for BCT with radiation therapy, had a 13% higher risk of developing a local recurrence of their disease over a 20-year period than women who had a mastectomy and no radiation therapy. Furthermore, local recurrence doubled the risk of the cancer spreading elsewhere in the body (metastasis) and the risk of death was approximately two-thirds higher for BCT patients compared to mastectomy patients.”
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“The number of women in the US undergoing breast-conserving therapy following a diagnosis of early-stage breast cancer has risen during the past 2 decades, according to a new study published in JAMA Surgery, though the authors reveal there are still barriers preventing women from receiving the treatment.
“After skin cancer, breast cancer is the most common cancer among American women, estimated to affect around 1 in 8 at some point in their lives.
“The majority of women diagnosed with breast cancer undergo some form of surgery, particularly if the cancer is diagnosed in the early stages. The surgical options available include mastectomy and breast-conserving therapy (BCT), or lumpectomy.
“While mastectomy involves full or partial removal of the breast tissue, BCT involves only the removal of the part of the breast containing the cancer.
“There are pros and cons with each procedure. With a mastectomy, a woman may lose an entire breast, while women who undergo BCT may be able to retain the majority of their breast tissue – making it a preferable option for many. However, women who have BCT often need to undergo radiation therapy for around 5-6 weeks following the surgery to ensure any remaining cancer cells are destroyed.”
Editor’s note: Women with early-stage breast cancer have surgery to remove their tumors. They can choose between a mastectomy to remove the entire breast or a lumpectomy to remove the diseased part of the breast (breast conserving therapy, or BCT). Until now, it was thought that a mastectomy and BCT had similar results in terms of long-term survival for a patient. But a new study shows that BCT offers better survival for women who are PR-positive or ER-positive. Further studies are needed to figure out why. The researchers speculate it may have to do with the radiation treatment usually given just after BCT to keep the cancer from returning. Unfortunately, there appear to be socioeconomic barriers to receiving BCT instead of a mastectomy.
“When factoring in what is now known about breast cancer biology and heterogeneity, breast conserving therapy (BCT) may offer a greater survival benefit over mastectomy to women with early stage, hormone-receptor positive disease, according to research from The University of Texas MD Anderson Cancer Center.
“The study findings defy the conventional belief that the two treatment interventions offer equal survival, and show the need to revisit some standards of breast cancer practice in the modern era.
“The research was presented at the 2014 Breast Cancer Symposium by Catherine Parker, MD, formerly a fellow at MD Anderson, now at the University of Alabama Birmingham.”