Mastectomy or Lumpectomy?
Long Term Survival Is The Same

Finding a lump through breast self exams or mammograms leads to a series of decisions. First comes the biopsy, then the diagnosis. If the lump turns out to be early breast cancer there are two options for surgery.

The mastectomy removes most of the breast tissue in the affected breast and lymph nodes that may have cancer cells.

The lumpectomy removes only the lump, any tissue surrounding the tumor that may have cancer cells, and any lymph nodes that may be involved.

Removing less of the breast tissue usually means faster healing with less complications. The lumpectomy is also cosmetically less drastic. Decideing which surgery is best can be a difficult decision for breast cancer patients and their health care team. A recent finding may make this decision a little easier.

In a study presented at the American Society for Therapeutic Radiology and Oncology’s Annual Meeting in New Orleans in October 2002 and updated in the August 2003 issue of Cancer Online, breast cancer patients who underwent lumpectomies fared just as well as patients who had mastectomies.

In the original study, 247 patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary dissection and radiation therapy.

The patients who underwent randomization and have now been followed for a median 18.4 years showed an overall survival rate of 58 percent for patients assigned to mastectomy and 54 percent for patients assigned to lumpectomy plus radiation.

There was no statistically significant difference in survival between the two groups. Disease- free survival at 18 years was 67 percent for the patients assigned to mastectomy and 63 percent for those assigned to lumpectomy plus radiation.

"These findings contribute to the growing body of research that suggests that lumpectomy can be just as effective as mastectomy in treating breast cancer,” said Matthew M. Poggi, M.D., of the Radiation Oncology Branch of the National Cancer Institute and lead author of the study. “This is valuable information for women to have when they are considering the many treatment options that exist.”

There were more recurrences in women who had the lumpectomy. These were normally treated by a mastectomy, but did not change the survival statistics.

The outcome of this study suggests that lumpectomies can be as safe as the more drastic mastectomy. but closer follow up during the years after the surgery is necessary.

Sources: The American Society for Therapeutic Radiology and Oncology, Inc.,

Cancer Online Journal [Abstract]

July 28, 2003