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    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.



    To get weekly advice for today's Ob/Gyn, subscribe to the Contemporary Ob/Gyn Special Delivery.

    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.


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