Long-term survival similar with mastectomy or breast-conserving therapy

In women with early breast carcinoma, mastectomy and breast-conserving therapy are associated with similar long-term survival rates, according to a report in the August 15th issue of Cancer.

Dr. Matthew M. Poggi of the National Cancer Institute in Bethesda, Maryland, and colleagues prospectively followed 237 women with early breast cancer for a median of 18.4 years. The subjects were randomized to mastectomy or breast conservation therapy.Modified radical mastectomies were performed in 116 women, and breast conservation therapy, consisting of lumpectomy, axillary lymph node dissection, and radiation therapy, was administered to 121 women.At follow-up, “there was no detectable difference in overall survival or disease-free survival in patients with early-stage breast carcinoma who were treated for mastectomy compared with those treated with breast-conservation therapy,” the authors report. Specifically, overall survival was 58% with mastectomy and 54% with breast conservation therapy.Some of the women in the breast conservation arm eventually required mastectomy for what the researchers referred to as “in-breast” events. After censoring such events in patients who were successfully salvaged by mastectomy, there was no significant difference in estimated 20-year disease-free survival between the groups.The investigators point out, however, that in the women who did not undergo mastectomy, in-breast events continued to occur throughout the entire study. “Therefore,” they caution, “diligent surveillance is warranted” after breast-conserving therapy.(Source: Cancer 2003;98:000-000: Reuters Health: July 25, 2003: Oncolink)