The study reviewed here is reassuring if you're under 40 and diagnosed with early breast cancer and are considering lumpectomy instead of mastectomy. In younger women, breast cancer is generally harder to treat and more likely to spread or come back after treatment. So doctors tend to recommend more aggressive surgery, which means removing the whole breast (mastectomy) instead of only removing the cancer and surrounding tissue (lumpectomy).
In this study, women younger than 40 who chose lumpectomy instead of mastectomy had about the same risk of the cancer coming back in the same breast (local recurrence) as women over 40 who also chose lumpectomy. Five years after surgery, 9% of the women who choose lumpectomy had a local recurrence. By 10 years after surgery, 18% had a local recurrence. This means that among women followed for 10 years, more than 80% did not have the cancer come back.
Doctors also tend to recommend mastectomy instead of lumpectomy in younger women because there is a risk of younger women developing a new, second breast cancer in the same breast if the whole breast isn't removed. This study showed that only 7% of the younger women developed a new breast cancer in the same breast (not a recurrence of the original cancer).
While lumpectomy can be a good option for some younger women diagnosed with early breast cancer, there are two very important details of this research to keep in mind:
Regardless of your age, if you've been diagnosed with early breast cancer and are considering surgery, only you and your doctor can decide which type of surgery is best for you. Whether you choose lumpectomy or mastectomy, your doctor will probably also recommend radiation therapy and chemotherapy. Together, you can decide on a treatment plan that is right for YOU.
NEW YORK (Reuters Health) - Breast cancer tends to be more aggressive when it occurs in younger women, and doctors often advise radical surgery. Now, however, a study shows that breast-conserving treatment, commonly known as lumpectomy, is safe for women younger than 40.
Acceptable outcomes, "almost comparable to the rates observed among patients older than 40 years, can be obtained if high-quality surgery and radiotherapy are combined with chemotherapy," Dr. Adri C. Voogd from Maastricht University in the Netherlands told Reuters Health.
Voogd and colleagues evaluated the outcomes of 758 women 40 years of age or younger who underwent this course of treatment between 1988 and 2002.
Ninety-five women developed a local recurrence of breast cancer during follow-up, the researchers report in the medical journal Cancer, and an additional 17 women had recurrences diagnosed after the cancer was found to have spread to other sites in the body.
"Of the local recurrences that were identified in our study, the large majority occurred at or near the site of the primary tumor, and only 7% developed elsewhere in the breast," the researchers explain. "This suggests that, at least in young women, most local recurrences are not new primary tumors, but are more likely to be true recurrences, originating from residual tumor tissue."
The team calculates that local recurrence rates were 9% at 5 years and 18% after 10 years.
"With our findings, we hope to have taken away some of the fears and make breast conservation a more acceptable treatment option for young women with breast cancer," Voogd said.
SOURCE: Cancer, May 15, 2007.
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