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Mastectomy is not for every multitumor breast cancer

Mastectomy was almost the only option for breast cancer patients with multiple tumors. Now they can choose a less invasive surgery.

Increased use of sensitive MRI imaging has enlarged the number of women diagnosed with multiple breast tumors. However, with no guiding studies, mastectomy – complete removal of the breast – has been mostly recommended for such patients.

A new study by American scientists shows: mastectomy is not the only treatment option for women with multiple breast tumors.

About breast cancer

According to the National Cancer Institute, breast cancer is the most common malignant cancer in Ukraine. The number of breast cancer cases is increasing annually. Every year, almost half a million women die from this disease worldwide.

In 2020, more than 2.26 million new cases of breast cancer in women were registered. In Ukraine – 12 824, of which 88 cases in men, the rest women. About 685 thousand died, mostly residents of low-income countries.

Mortality from this cancer is decreasing annually due to early diagnosis and therapy. However, the percentage could be even lower if more women, especially in the menopause, had regular examinations. Read more about breast cancer, early diagnosis and proper self-examination.

Why mastectomy?

According to study author Judy K. Boughey, advances in imaging techniques have led to more frequent detection of additional breast tumors. This has led to more patients undergoing mastectomy who might otherwise have preferred breast-conserving therapy.

There have been no prospective clinical trials evaluating local recurrence after such therapy in patients with multiple ipsilateral breast lesions. The main objective of this study was to evaluate whether lumpectomy followed by radiotherapy is an adequate treatment for patients who had more than one tumor in the same breast.

Study author, W.H. Odell Professor of Individualized Medicine, Judy K. Boughey, MD

Mastectomy is no longer the only treatment option

The study involved 204 women aged 40 and older with two or three tumors in one breast that were separated by normal breast tissue. They were treated with lumpectomy and radiation. The 5-year recurrence rate among the participants was 3.1%, which is similar to the recurrence rate in cases of single-tumor lumpectomy, Boughey said.

This study provides important information for clinicians to discuss with patients who have two or three breast cancers in the same breast. After all, it is a smaller operation with a faster recovery. As a result, patients are more satisfied and cosmetic results are better.

Study author, W.H. Odell Professor of Individualized Medicine, Judy K. Boughey, MD

Resume

Another important finding of the study was that the recurrence rate was lower among patients who had an MRI before surgery. This probably gave surgeons more detailed information about which areas to remove. In the 15 patients who did not have an MRI, the recurrence rate was 22.6%, compared to 1.7% in the 189 patients who had an MRI before surgery.

The study, presented at the San Antonio Breast Cancer Symposium, did not randomly assign patients to lumpectomy or mastectomy, Boogie noted. So it had this limitation. After all, it would be difficult to get patients to sign up for the trial if they couldn’t make that decision.

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