Patients with early stage breast cancer who are treated with lumpectomy plus radiation have a better chance of survival compared with those who undergo mastectomy, according to Duke Medicine research.
The study, which appears online Jan. 28, 2013, in the journal CANCER, demonstrates the effectiveness of breast-conserving therapies such as lumpectomy, where only the tumor and surrounding tissue are surgically removed.
"Our findings support the notion that less invasive treatment can provide superior survival to mastectomy in stage I or stage II breast cancer," said E. Shelley Hwang, M.D., MPH, chief of breast surgery at Duke Cancer Institute and the study's lead author.
Using 14 years of data from the California Cancer Registry, a source of long-term outcome data for cancer, the research team found improved survival to be associated with the less invasive treatment in all age groups, as well as those with both hormone-sensitive and hormone-resistant cancers. Women age 50 and older at diagnosis with hormone-sensitive tumors saw the largest benefit of choosing lumpectomy plus radiation: they were 13 percent less likely to die from breast cancer, and 19 percent less likely to die from any cause compared with those undergoing mastectomy.
Prior research has shown that lumpectomy with radiation is as effective as mastectomy in treating early stage breast cancer. As a result, the rate of women electing lumpectomy with radiation has climbed in the past few decades.
However, a recent trend has emerged with some early stage breast cancer patients, often younger women, opting for mastectomy. These women may perceive mastectomy to be more effective at eliminating early stage cancer and therefore reducing the anxiety accompanying long-term surveillance.
"Given the recent interest in mastectomy to treat early stage breast cancers, despite the research supporting lumpectomy, our study sought to further explore outcomes of breast-conserving treatments in the general population comparing outcomes between younger and older women," Hwang said.