Mastectomy No Better Than Lumpectomy For Some

BOSTON -- Just under 200,000 women will be diagnosed with breast cancer this year.

They not only face worries about their long-term survival, but many also have to cope with losing a part of their bodies.

But two new studies published in this week's New England Journal of Medicine suggest that for women with early stage breast cancer, the latter needn't become a reality.

Hester Hill is an oncology social worker and the perfect person to help women diagnosed with breast cancer decide between a mastectomy or a lumptectomy with radiation. Almost 10 years ago, she was diagnosed with breast cancer herself.

"And my surgeon reminded me, even back in 1993, that for most women there was no difference in survival," Hill said.

The studies, conducted by researchers in Italy and from the University of Pittsburgh, found that women with early stage breast cancer who underwent lumpectomies with radiation had the same survival rate as women who received mastectomies up to 20 years after the procedures were performed.

Doctors like Susan Troyan are pleased by the data, but question why more women don't choose the more cosmetically appealing alternative.

"More than twice as many women are getting mastectomies than absolutely need it," Troyan said. "It really comes down to who they're seeing, how much experience they have in the field, whether or not there's a radiation therapy facility nearby, how old they are."

Even if all the options are presented fairly, some women still choose mastectomies, and experts say that's OK.

"For women who fear radiation or have anxiety about having their breast retained, mastectomy may still be the best treatment," said Dr. Patricia Ganz, of the University of California, Los Angeles.

Given the studies, however, Troyan said that one thing is certain.

"If you've been told that you need a mastectomy for stage one or two breast cancer, get a second opinion," Troyan said.

Troyan said that women should seek a second opinion from a place known for breast conserving therapy. She estimates that about 75 to 80 percent of women with early stage breast cancer can be treated just as well with lumpectomies and radiation as with mastectomies.