Value of Breast Surgery At Early Cancer Stage Questioned
Tumor-removal surgeries such as a mastectomy, double mastectomy or lumpectomy are often prescribed for women during a very early stage of breast cancer known as stage 0. But, according to research published in JAMA Oncology, those procedures ultimately may have little effect on the final outcome of the disease.
Those conclusions were based on the most extensive collection of data ever analyzed on the condition, known as ductal carcinoma in situ, or D.C.I.S--100,000 women followed for 20 years. The findings are likely to raise questions about women having surgery for premalignant conditionss that are unlikely to develop into life-threatening cancers.
The researchers hoped to see if D.C.I.S. cancer was a precursor to cancer or just a risk factor, and whether or not treatment of the early cancer makes a difference. A majority of the 100,000 women were shown to use lumpectomies as treatment, and nearly all the rest had mastectomies. However the chance of dying no matter which treatment was given was 3.3 percent -- the same as is for an undiagnosed woman’s chance of dying from breast cancer.
The data did show that women younger than 40, black women, and women who find molecular markers on abnormal cells during later stages of cancer are at higher risk. In addition those who received removal surgeries for D.C.I.S. should have been protected from the deadly stages of cancer, but either the risk was unchanged, or the women who died of breast cancer contracted the disease without ever having it in their breast.
Even though more clinical trials are needed to determine how necessary the surgeries may be, the team says that at least identifying groups of women who are at higher risk can help define who should be targeted for treatment.