A new study from Duke University researchers shows that early stage breast cancer patients may actually fare better if they don't undergo surgery to have their breasts removed, and instead undergo a less-invasive treatment.
Specifically, the researchers found that women with stage I or II breast cancer who undergo radiation in addition to a lumpectomy -- which is when the breast is mainly conserved, and only the tumor and some of the surrounding breast tissue is removed -- are more likely to survive than women who have their full breasts removed.
"Our findings are observational but do suggest the possibility that women who were treated with less invasive surgery had improved survival compared to those treated with mastectomy for stage I or stage II breast cancer," study researcher Dr. E. Shelley Hwang, M.D., MPH, the chief of breast surgery at Duke Cancer Institute, said in a statement.
The study, published in the journal Cancer, included 112,154 women with early stage breast cancer (stage I or II) who were in the California Cancer Registry. The women were diagnosed with cancer between 1990 and 2004; 50,383 of them had undergone a mastectomy for their cancers without radiation, while 61,771 underwent lumpectomy plus radiation. Everyone was followed for an average of 9.2 years.
Researchers found that women who underwent the lumpectomy plus radiation generally had better survival rates over the study period, compared with those who underwent the mastectomy. The benefit was greatest in women ages 50 and older, who had hormone-sensitive tumors -- compared with those who underwent mastectomy, they had a 13 percent lower risk of dying of breast cancer over the study period, and a 19 percent lower risk of dying from any cause.
However, researchers noted that a possible reason why women who only underwent the lumpectomy had better survival rates is because they were healthier to begin with.
Still, "our study supports that even patients we thought might benefit less from localized treatment, like younger patients with hormone-resistant disease, can remain confident in lumpectomy as an equivalent and possibly better treatment option," Hwang said in the statement.
According to the Mayo Clinic, the efficacy of lumpectomy and mastectomy are about the same, though some people may not be able to undergo -- or may choose not to undergo -- lumpectomy.
Whether mastectomy rates are increasing or decreasing is not completely clear, though a 2010 study in the Journal of Clinical Oncology showed that rates are not increasing even though other studies had suggested an increase in mastectomy rates, Reuters reported. That study included 230,000 breast cancer patients who were diagnosed sometime between 2000 and 2006.
However, the researchers of that study did note that there was a slight increase in the number of mastectomies being performed between 2005 and 2006, Reuters reported:
While this increase wasn't statistically significant, meaning it could have been due to chance, it could also signal a future rise in mastectomy rates.
Similarly, a 2012 study in The Breast Journal also suggested that the rate of mastectomy was declining up until 2005. That study included 21,869 women with earlier-stage breast cancer who were diagnosed between 1998 and 2007 and participated in the Kentucky Cancer Registry. However, the researchers did find that the mastectomy rate is "now increasing across all age groups, especially for women < 50 years and ≥70 years," they wrote in the study.
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