A new study published Jan. 28 in Cancer, the peer-reviewed journal of the American Cancer Society, indicates that women opting for breast-conservation surgery (lumpectomy) and radiation may in fact have a better chance of surviving breast cancer than women who choose to have a mastectomy. Does this seem counterintuitive? Read on.
That’s the first emotion most of us feel when hearing the words, “You have cancer.”
We imagine cancer cells proliferating madly, eating away healthy tissue, spreading throughout our bodies, and finally killing us.
In reality, it doesn’t work like that. Most types of breast cancer grow very slowly; the lump you felt in your breast last week probably began as a small cellular aberration up to 8 years ago. So today’s cancer diagnosis is actually old news; and as such, shouldn’t force you into a hurried decision about treatment.
Which, unfortunately, is exactly what most women make: an emotional decision, based not on data but on fear. Many women feel that removing one (or both) breasts entirely gives them a better chance of surviving than simply removing the tumor, and delivering radiation to the removal site.
Yes, it’s true that having a mastectomy reduces your chance of a recurrence of cancer in the same breast – by about 90%. And having a completely healthy breast removed, which some women choose to do when confronted with cancer in just one breast, reduces the risk of cancer in that healthy breast by the same 90%.
But mastectomy doesn’t remove all of your breast tissue; and thus it doesn’t completely eliminate your risk of breast cancer.
According to a growing number of studies stretching back 5 years or more, mastectomy also doesn’t lessen your risk of dying, compared to the much less aggressive lumpectomy/radiation regimen. And the latest study, cited above, is the first to actually suggest that women opting for lumpectomy/radiation enjoy BETTER overall survival rates than women choosing mastectomy – single, or double.
Admittedly, there are issues with this newest study, carried out by researchers at the Duke Cancer Institute in Durham, NC. Cancer scientists cite “unmeasured variables” that could have contributed to the results.
For instance, in the Duke study, carried out over 30 years, many more women in the early years of the study had a mastectomy; and back then, chemotherapy simply wasn’t as effective as it was later on. Perhaps it’s lower-quality chemo, rather than mastectomy, contributing to a higher death rate.
In addition, women sometimes choose mastectomy simply because they’re unable to access radiation. Perhaps radiation interferes with their work schedule; or they can’t afford the daily drive to treatment. Some point out that this might correlate with lower quality of health care overall, due either to distance from treatment, or socioeconomic factors.