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Breast-Conserving Surgery is Viable Option for Women with Large Tumors (dateline July 21, 2000)

Several studies have shown that women with small breast tumors have an equal chance of surviving breast cancer regardless of whether they have a mastectomy (breast removal) or breast-conserving surgery (lumpectomy).  Now researchers have found that the same may be true for women with larger breast tumors (2.1 centimeters to 5 centimeters).  In a study published in the Journal of the National Cancer Institute, researchers found that women with Stage II breast cancer could be treated effectively with lumpectomy and radiation instead of mastectomy. 

In the study, researchers followed 868 women who had either mastectomy or lumpectomy and radiation for an average of 10 years.  Most of the women in the study (80%) had Stage II breast cancer; breast tumors between 2.1 centimeters (cm) and 5.0 cm.  The results of the study showed equal survival rates among the two groups of women, regardless of which type of breast cancer surgery they had.  Approximately two-thirds of the women in both groups were alive after 10 years.

Most women who have breast tumors over 2 cm are recommended for mastectomy (breast removal).  However, the results of this study show that lumpectomy (followed by radiation) is as effective as mastectomy for many Stage II breast cancer patients, and could spare many women their breasts.  Researcher Harry Bartelink, MD, PhD, called the results of the study “remarkable and reassuring.”  

However, the study did find that the risk of local breast cancer recurrence (return) was significantly higher among the women who received breast-conserving therapy instead of mastectomy.  Approximately 20% of women in the lumpectomy group developed breast cancer again within 10 years while only 12% of the women in the mastectomy group experience a recurrence within 10 years.   While local breast cancer recurrence was higher among women in the lumpectomy group, women who received breast-conserving surgery were no more likely to have their cancer spread ( metastasize) to other regions of the body. 

Future research will likely investigate which women who receive lumpectomies are most likely to experience a cancer recurrence, based on characteristics of their tumors, etc.  Though the study does show equal survival in Stage II breast cancer patients regardless of which type of surgery they have, some women may be more or less suited for mastectomy or lumpectomy, based on their individual situations. 

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