Cancer Resources > Cancer News > 2002 > October

Long-term breast cancer survival similar after conservation therapy or mastectomy

Emma Hitt, PhD

Last Updated: 2002-10-07 15:53:34 -0400 (Reuters Health)

NEW ORLEANS (Reuters Health) - The longest follow-up study to date of the treatment of early-stage breast cancer suggests that breast-conservation therapy and mastectomy result in similar overall and disease-free survival.

The findings were presented here on Monday at the 44th annual meeting of the American Society for Therapeutic Radiology and Oncology, in New Orleans.

Dr. Matthew M. Poggi, with the National Cancer Institute, Bethesda, Maryland, and colleagues randomized 247 patients with clinical stage I and II breast cancer to undergo modified radical mastectomy or breast conservation therapy involving lumpectomy, axillary dissection, and radiation. The patients have been followed for a median of 18.4 years

The researchers found that the overall survival was 58% for patients assigned to mastectomy and 54% for patients assigned to lumpectomy plus radiation (p = 0.67).

Similarly, disease-free survival at 18 years was 67% for the patients assigned to mastectomy and 63% for those assigned to lumpectomy plus radiation (p = 0.64), after recurrences successfully salvaged by mastectomy were excluded from analysis.

Distant disease-free survival was also similar; 69% for mastectomy and 68% for breast conservation (p = 0.82).

According to Dr. Poggi, other studies have shown similar findings but "what our study showed of note was that, even with very long-term follow-up, this finding is still valid."

As he told Reuters Health, "In fact, breast cancer differs from many other malignancies in that we now have very good, long-term data by which to measure outcomes and help guide treatment."

In practice, negative surgical margins are generally required for a patient to be considered for breast conservation, Dr. Poggi said "but this was not required for our study, suggesting that for the appropriate early-stage breast cancer patient, there is no decrement to survival by choosing breast conservation."

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