Mastectomy 'does not guarantee longer survival': Study

Cancer victims who have a breast removed do not always live longer, according to a new study.

Researchers said in patients with breast cancer who also have genetic mutations that make them more susceptible to the disease, women appear to live just as long whether they choose treatment that preserves their breast or have a breast removal, or mastectomy.

The study results were presented today in Barcelona at a European breast cancer conference.

Dr Lori Pierce, a professor of radiation oncology at the University of Michigan, and her colleagues observed 655 breast cancer patients in Australia, Israel, Spain and the United States, all of whom had genetic mutations that gave them a much higher chance of getting the disease.

After 15 years, women who had a breast removed had about a 6% chance of a cancer relapse, compared with 24% of women who kept their breasts.

If the latter group added chemotherapy, their risk dropped to about 12%.

But when it came to survival, there was almost no difference whether the cancer patients had decided to keep their breast or have it removed. Women who kept their breasts had a survival rate of 87% after 15 years, and women who had mastectomies had a survival rate of 89%.

“This will be useful for patients who are bombarded with a lot of information at once,” said Dr Pierce.

“Being diagnosed with breast cancer and finding out (they have a genetic susceptibility) is a lot to process, and women may not want to think about a mastectomy right then.”

“Breast conservation therapy ... with chemotherapy and hormonal therapy is a very reasonable alternative,” she added.

She said the study results probably would not apply to women who have the genetic mutations but have not yet got cancer.

“Their thinking is very different because they’ve often seen multiple family members get diagnosed with breast cancer and they are much more likely to undergo a preventive mastectomy,” she said.

Doctors said her findings should buy some recently diagnosed breast cancer patients a bit of breathing room.

“These are convincing data that show women can keep their breast and not be worse off,” said Dr Alain Fourquet, head of radiation and oncology at the Institut Curie in Paris.

Dr Fourquet said being genetically predisposed to breast cancer may be less important in determining a course of action once women actually get the disease, and that decisions to remove a breast should not be based on genes.

Maria Leadbeater, a clinical nurse specialist at British charity Breast Cancer Care said the findings should change the discussions doctors have with breast cancer patients.

“Surgeons may be able to give more weight to patients’ thoughts and wishes,” she said. “If both options are equally effective, then what the patient wants may become more important.”