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Certain breast cancer patients may benefit more from having breast-conserving therapy (BCT), also known as a ‘lumpectomy’, instead of a mastectomy, a large-scale study has revealed.
Women with early-stage breast cancer have higher survival rates if they have ‘breast-conserving’ surgery to remove the tumour alongside radiotherapy, instead of removal of the entire breast.
The Dutch study, which assessed 130,000 breast cancer patients, found that for certain women - those over 50 and with other health issues - survival rates increased by up to a third if they took the non-mastectomy treatment plan.
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According to the NHS, surgery is usually the first type of treatment offered to breast cancer patients, followed by chemotherapy of radiotherapy or, in some cases, hormone or biological treatments.
Doctors will discuss the best treatment plan with each patient.
Breast cancer is the most common cancer in the UK, with one in eight women diagnosed at some point in her lifetime.
Study lead author Professor Sabine Siesling, of the Netherlands Comprehensive Cancer Organisation, said: “A considerably superior survival, both specific to breast cancer and from any cause of death, was found for breast-conserving therapy in the early stage.
“We believe this information will have potential to greatly improve shared treatment decision-making for future breast cancer patients. However, we would like to emphasise that these results do not mean that mastectomy is a bad choice.
“For patients for whom radiotherapy is not suitable or feasible… for whom the risk of side effects of radiotherapy is high, or who have the prospect of a poor aesthetic outcome following breast conserving therapy, a mastectomy may still be the preferable treatment option...
“Our study showed that BCT is at least as good as mastectomy and that some patients might benefit more than others from BCT in the future.”
Rachel Rawson, Clinical Nurse Specialist at Breast Cancer Care, says: “This fascinating study has the potential to change which surgery may be offered to women over 50 with breast cancer. It suggests for some patients, taking out the cancer without removing the whole breast may offer a better chance of survival.
“However, that’s not the whole picture - radiotherapy given alongside the surgery can be gruelling. And for some women a mastectomy will always be the best option.
“We speak to thousands of women on our Helpline overwhelmed by decisions about surgery. An open conversation is crucial to help women make the right surgery choice for them, so they can confidently move forward after breast cancer.”
The study, which was the largest ever to be conducted, is to be presented at the European Cancer Congress 2017 in Amsterdam.
Breast Cancer Signs And Treatment
What Are The Symptoms?(01 of10)
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"A new painless, firm breast lump with irregular margins is a potential symptom of breast cancer," says Dr. Sandhya Pruthi, a breast cancer researcher at the Mayo Clinic. "The cancer diagnosis is confirmed following a biopsy of the lump." She notes that usually, women who are newly diagnosed with breast cancer are healthy and don't feel sick at all. (credit:LarsZahnerPhotography via Getty Images)
Other Symptoms(02 of10)
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Another potential symptom/sign of breast cancer, Pruthi notes, is a new onset of persistent redness on the skin overtop the breast with an orange peel appearance. This would also need a biopsy to confirm a diagnosis of breast cancer. (credit:Image Source via Getty Images)
Metastatic Cancer Symptoms(03 of10)
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"If the cancer is very advanced (metastatic) then the symptoms may also include weight loss, bone pain, headaches, nausea and persistent cough," Pruthi says. (credit:pamela burley via Getty Images)
What Are The Risk Factors?(04 of10)
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Some commonly associated risk factors, Pruthi says, are menstruation before age 11, menstruation after age 54, a first pregnancy after age 35 and a family history of relatives diagnosed with breast or ovarian cancer. (credit:AP Photo/M. Spencer Green)
Are There Any Lifestyle Risk Factors?(05 of10)
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"There is evidence in the literature that obesity after menopause, lack of regular exercise, consuming greater than more or more alcoholic beverages daily, and a high fat diet can all be associated with a higher breast cancer risk," Pruthi notes. But, she points out, "women need to know that any woman can get breast cancer even in the absence of any of these risk factors." (credit:Adrian Samson via Getty Images)
Can I Eat Anything To Prevent It?(06 of10)
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There are no specific types of diets, Pruthi says, but rather women are encouraged to eat fruits, vegetables, fibre, and minimize their alcohol and fat intake, as well as get regular exercise. (credit:lola1960 via Getty Images)
How Do Doctors Determine Treatment?(07 of10)
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"The most current treatment of breast cancer has taken on a individualized approach and is dependent on the biology or aggressive features of the breast cancer," Pruthi explains. "Breast cancer is a heterogeneous disease and this means that are many sub-types and different degrees of aggressiveness. So staging, which typically takes into account common prognostic features such as tumour size and if lymph nodes are involved, are no longer the only factors doctors use to determine treatment options." (credit:Christopher Futcher via Getty Images)
So What Do They Look At?(08 of10)
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"Today the biology of the tumour is also characterized by molecular markers (also known as predictive markers) such as if the estrogen or progesterone receptor is positive or negative and if the HER 2 protein is positive or negative," she says. "This helps decide who will benefit from a specific chemotherapy regimen, hormonal medications known as antiestrogens or who may need both chemotherapy and hormonal treatment." (credit:BluePlanetEarth via Getty Images)
What About Preventative Mastectomies?(09 of10)
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"Preventive mastectomy is an option for women at very high risk for developing breast cancer because they are BRCA 1 or 2 gene positive or if someone has hereditary predisposition to getting breast cancer but chooses not to have the genetic testing done," Pruthi says. "It is prudent that women who are considering this surgery know their family history in detail. Based on the moderate or strong family history, your doctor would recommend you meet with a genetic counselor to go over the family pedigree and help decide who should test for the breast cancer gene, when to test and how to interpret the genetic test results before proceeding with this preventive surgery." (credit:Jesús Jaime Mota via Getty Images)
Are Other Preventative Treatments Available?(10 of10)
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"High risk women who have had precancerous breast biopsies or strong family history may also be eligible to take preventive medications such as tamoxifen, raloxifene or exemestane to reduce breast cancer risk," Pruthi adds. (credit:art-4-art via Getty Images)