Radiation After Lumpectomy Improves Survival, Saves Breasts


Mastectomy or Radiation?

Dr. Jay Brooks, chairman of Ochsner Baton Rouge Hematology/Oncology, said the number of women opting for double mastectomies has drastically increased over the past several years.

After getting a mammogram and seeing an abnormality, he explained, women go for breast MRIs which can make a breast appear unhealthier than it actually is.

"The number of women getting radiation declined, because women got really frightened," he said. Many women worry about spreading to the other breast or coming back, so they opt for breast removal.

"But it could have been treated with lumpectomy and radiation, and they don't have to lose their breasts," he added.

Women with breast cancer often choose to have double mastectomies because they are afraid of the side effects of radiation treatment, radiation can be costly and inconvenient, or removing the tumors may cut away too much breast tissue and they make a cosmetic decision to have their breasts removed.

"There are very few situations in my mind where I think it really is in a woman's best interest to have a mastectomy unless she wants one," said Dr. Marc Lippman, professor and deputy director of the Sylvester Cancer Center at the University of Miami's Miller School of Medicine.

Recurrence of a localized breast tumor is rare, specialists say. If cancer comes back, it will most likely be in another part of the body.

"We talk a lot about breast cancer coming back, and I think most patients think we're just talking about it coming back in the breast, so it makes sense to people that if there's a perception of risk of cancer coming back, removing breasts should reduce that risk," said Blackwell.

But breast removal isn't any more effective in preventing recurrence than having radiation, experts stress.

They hope the study data help women understand that while mastectomies are an effective treatment and women can opt for them if they choose, they can survive early stage breast cancer without sacrificing their breasts.

"If you look at the studies -- six in the world -- comparing mastectomy to breast-conserving surgery and radiation, survival is identical," said Lippman. "Survival not a second worse with lumpectomy and radiation."

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