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Title: Second Lumpectomy for Breast Cancer Reduces Survival Rates
URL: http://www.pslgroup.com/dg/22E03A.htm
Doctor's Guide
October 2, 2008

SACRAMENTO, Calif -- October 2, 2008 -- A number of women with breast cancer who were candidates for lumpectomy but whose cancer recurred in the same breast are being treated with a second lumpectomy rather than a mastectomy, defying current treatment recommendations and cutting the number of years those women survive in half. The study appears in the October issue of the American Journal of Surgery.

"We were surprised to find that so many women in our study -- almost a quarter of them -- had received another lumpectomy rather than a mastectomy," said lead author Steven Chen, MD, University of California Davis Cancer Center, Sacramento, California.

"It's likely that patients are asking for lumpectomies when their cancer is diagnosed a second time, and their doctors are simply complying with that request. Whatever the reason, that decision can shorten life spans."

Dr. Chen and study coauthor, Steve Martinez, MD, University of California Davis Cancer Center, gathered data from the National Cancer Institute's Surveillance, Epidemiology and End Results database, which includes information on all cancers diagnosed in selected regions throughout the nation.

Their study included 747 patients who previously received breast-conservation therapy and were diagnosed with cancer a second time in the same breast between 1988 and 2004.

The authors found that women who had mastectomies had a 78% survival rate after 5 years, while those who had second lumpectomies had a 67% survival rate. The 10-year survival rates were 62% for those who had mastectomies and 57% for those who had second lumpectomies. In all, 24% of women with recurrent breast cancer in the same breast had second lumpectomies.

The researchers went on to calculate the risk of dying for mastectomy patients compared with lumpectomy patients. They found that, after adjusting for factors that affect survival, there will be half as many survivors at any given time in the lumpectomy group versus the mastectomy group.

"As therapy for breast cancer becomes more targeted and researchers come closer to identifying those factors that make some breast cancers more aggressive than others, we may have the option of recommending second and even third lumpectomies in select cases in the future," said Dr. Martinez.

"Until then, mastectomy remains the best option for women experiencing a same-breast recurrence of their breast cancer."

SOURCE: University of California Davis - Health System

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