Recent research has suggested that more women are choosing to have mastectomy to treat early-stage breast cancer when lumpectomy followed by radiation therapy is a good option. A study wanted to know why this trend was happening and whether mastectomy was appropriate for most of the women opting for it.
Lumpectomy followed by radiation therapy is a good option for many women diagnosed with early-stage breast cancer. Still, there are medical and personal reasons that may make mastectomy a better choice.
Medical reasons include:
- cancer that is large, has spread to lymph nodes, or is in multiple locations in the breast
- unsuccessful lumpectomy
- higher-than-average risk for recurrence or another, new breast cancer diagnosis (these women may choose to have both breasts removed to greatly reduce risk)
Personal reasons include:
- reducing the risk of recurrence or another, new breast cancer diagnosis, even in women without higher-than-average risk
- avoiding radiation therapy
- better cosmetic and reconstructive options
In this study, the researchers looked at the medical records of nearly 2,000 women diagnosed with early-stage breast cancer who had surgery. About 75% of the women had lumpectomy as the initial surgery and 25% had mastectomy. For medical reasons, some women who initially had lumpectomy had mastectomy later. Overall, about 33% of the women ended up having mastectomy. The researchers found that women who chose mastectomy instead of lumpectomy to treat early-stage breast cancer had good reasons for their choice.
The researchers found:
- 13.4% of the women had mastectomy based on their doctors' recommendation
- 8.8% of the women had mastectomy after an unsuccessful lumpectomy (the lumpectomy didn't remove the all the cancer); in many of these cases, their doctors initially recommended mastectomy, but the women requested lumpectomy
- 8.8% of the women chose mastectomy instead of lumpectomy even though their doctors recommended lumpectomy or didn't make a specific recommendation
About 20% of the women got a second opinion on which surgery was best for them. If a woman's doctor initially recommended mastectomy, she was more likely to get a second opinion. Most of the time (88%) the second opinion agreed with the initial recommendation.
It seems that doctors are doing a good job of identifying and recommending a breast cancer surgery that makes sense based on a woman's specific situation. Most of the recommendations for mastectomy were considered appropriate by the researchers -- only 6.2% of the mastectomy recommendations were considered questionable.
If you've been diagnosed with early-stage breast cancer, you and your doctor will discuss a surgical approach that makes the most sense for you and your unique situation. Ask your doctor about the cancer characteristics that are influencing the surgery recommendation. Your surgery decision also should reflect your personal beliefs and preferences. Accurate information about the cancer, as well as a clear understanding of what you want, are essential to developing a treatment plan that makes the most sense for you.