Two new studies have discredited the common belief that mastectomy should be the standard treatment for breast cancer in women under 40. In fact, say both teams of researchers, the practice of lumpectomy in which just the cancerous tumor and a small amount of surrounding tissue is removed carries no higher risk of recurrence or mortality than a mastectomy.
The findings, presented at the Multidisciplinary Breast Cancer Symposium in San Francisco, are welcome news, considering that there has been a growing trend toward mastectomy in younger women, precisely because of the belief that breast cancer in those under 40 tends to be more aggressive. Thus, the thinking was that the chance of recurrence would be higher if only a lumpectomy were performed. However, the study conducted by researchers at Massachusetts General Hospital found nearly identical recurrence rates in a group of 628 women who had either a mastectomy or lumpectomy: about 7.4 percent after six years. Similar results came from the study of 14,760 women by researchers at the M.D. Anderson Cancer Center in Houston, in which long-term survival rates for both groups were above 85 percent.
With this knowledge, women should be able to make a more informed decision about their treatment, the researchers observed. The choice between a lumpectomy and mastectomy should also be guided by screening for a particular gene mutation that of the BRCA1 or 2 genes which confers a greater risk of developing cancer.
In a younger woman with breast cancer, says ACHS's Dr. Gilbert Ross, I d probably want to refer her for genetic screening, since the BRCA1 and BRCA2 genes occur more commonly in younger cancer patients. Then we can put the knowledge from these most recent studies to use.
