Is removal of the breast still the best treatment for breast cancer?

Recent reports from two studies confirm earlier reports that breast-conserving surgery plus radiation therapy (high-energy x-rays that kill cancer cells) is as effective as mastectomy (removal of the whole breast) as a breast cancer treatment. Breast conserving surgery is removal of the tumor and some surrounding tissue, but not the breast itself.

The recent studies involved women who were treated for relatively small breast tumors (no larger than 1.5 inches in diameter) in the 1970s and 1980s. The women had either breast-conserving surgery or mastectomy. One study was done in the United States and the other in Italy.

The U.S. study involved 1,851 women, who were divided into three groups. One group received a type of breast-conserving surgery called lumpectomy. A second group had lumpectomy plus radiation and a third group had mastectomy. All the women had underarm lymph nodes removed.

After 20 years, survival rates for those treated with lumpectomy were the same as for those treated with mastectomy. In addition, significantly fewer of the women who had lumpectomy plus radiation had cancer return in the same breast, compared with those who had lumpectomy alone.

In the Italian study, 701 women received either a breast-conserving surgery called quadrantectomy (similar to lumpectomy but more extensive) plus radiation or a radical mastectomy (removal of the breast, muscle tissue, and lymph nodes). Again, researchers found that survival rates for the two groups were the same after 20 years.

Both breast-conserving surgery and mastectomy are used to treat breast cancer patients. Women should talk with their doctor about which choice is best for them.

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