Survival better with lumpectomy-not mastectomy-for early breast cancer

According to a recent observational study in JAMA Surgery, women with early-stage invasive breast cancers have higher rates of disease-specific survival when they undergo breast-conserving therapy (BCT) than women who undergo mastectomy.

Researchers from University of Michigan Medical School used the Surveillance, Epidemiology, and End Results database to identify 132,149 patients with early-stage invasive ductal carcinoma, defined as tumor size ≤ 4 cm with ≤3 positive lymph nodes, who had BCT, mastectomy alone, or mastectomy plus radiation between 1998 and 2008.

BCT was used to treat 70% of the patients; 27% of the women were treated with mastectomy alone; and mastectomy plus radiation was used to treat 3%. Based on multivariate analysis, women who underwent BCT had 5-year and 10-year survival rates of 97% (P<0.001) and 94% (P<0.001), respectively.  In women who underwent mastectomy alone, the rates were 94% (P<0.001) and 90% (P<0.001), respectively. And for mastectomy plus radiation, the 5-year and 10-year survival rates were 90% (P<0.001) and 83% (P<0.001), respectively.

The scientists concluded that BCT led to higher breast cancer-specific survival rates in early-stage invasive ductal carcinoma than other common treatment methods. They cautioned that evidence from observational studies is not as strong as from prospective randomized trials.

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