Lumpectomy for breast cancer recurrence may reduce survival

NEW YORK (Reuters Health) - When a cancer returns in a breast previously treated with breast-conserving therapy, the use of lumpectomy rather than mastectomy is associated with decreased survival, according to a report in the American Journal of Surgery for October.

"We were surprised to find that so many women in our study-almost a quarter of them-had received another lumpectomy rather than a mastectomy," lead author Dr. Steven L. Chen, from the University of California Davis Cancer Center in Sacramento, said in a statement.

"It's likely," he added, "that patients are asking for lumpectomies when their cancer is diagnosed a second time, and their doctors are simply complying with that request. Whatever the reason, that decision can shorten life spans."

The study featured 747 women drawn from the Surveillance, Epidemiology, and End Results (SEER) database (1988-2004) who had experienced an ipsilateral breast cancer recurrence after undergoing breast conservation therapy. Twenty-four percent of these patients underwent a second lumpectomy.

The 5-year survival rate for patients who underwent lumpectomy was 67% compared with 78% for those treated with mastectomy. Multivariate analysis confirmed that lumpectomy reduced the odds of survival by 50% (p = 0.003).

"As therapy for breast cancer becomes more targeted and researchers come closer to identifying those factors that make some breast cancers more aggressive than others, we may have the option of recommending second, and even third lumpectomies in select cases in the future," study co-author Dr. Steven Martinez comments.

"Until then," he added, "mastectomy remains the best option for women experiencing a same-breast recurrence of their breast cancer."

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