- Recent research suggests lumpectomy with radiotherapy may be more effective
- Women undergoing lumpectomy showed better survival rates and fewer complications
- Findings challenge the notion of mastectomy as the most effective option
It is frequently believed that a mastectomy is the most effective method of preventing the recurrence of breast cancer.
However, the most recent research indicates that women may survive longer if only the tumour is removed rather than the entire breast.
The survival rates of patients who underwent a lumpectomy, which involves the removal of only malignant tissue in conjunction with radiotherapy, were superior to those who underwent a mastectomy, which involves the removal of the entire breast.
Additionally, they exhibited a diminished likelihood of complications.
The results, which UK scientists obtained, have the potential to decrease the number of women who undergo mastectomies on the NHS in favour of less aggressive treatments.
Every year, approximately 15,000 women in the United Kingdom undergo the procedure.
The surgery can have a significant impact on the mental health and sexual lives of women, even if they undergo breast reconstruction, in addition to increasing the risk of complications (such as infection and disfigurement).
Furthermore, there is some evidence that the malignancy may occasionally recur. Following a mastectomy, this typically occurs in the brain, bones, liver, or lungs. One hypothesis posits that this is due to the substantial influence of the major surgery on the body, which may suppress the immune system and enable any aberrant tumour cells that remain to increase.
Breast cancer is the most prevalent form of the disease in the United Kingdom, with over 55,000 new cases reported annually.
Treatment typically commences with a lumpectomy, which is subsequently followed by radiotherapy or chemotherapy. Alternatively, a mastectomy is performed to eliminate one or both breasts, which is occasionally followed by radiotherapy or chemotherapy.
But in the most recent study, researchers from Bristol Medical School and Liverpool University Hospitals discovered that women who underwent a lumpectomy and radiotherapy lived longer than those who had one or both breasts removed. This was true regardless of whether they also received radiotherapy.
It also discovered that lumpectomy and radiotherapy resulted in superior survival rates for women under the age of 50 compared to mastectomy.
The British Journal of Surgery Open published the research, which utilized data from 35 studies involving over 900,000 women over a 23-year period.
The findings are consistent with those of a more extensive investigation, which was published in the Annals of Surgical Oncology in 2022 and involved 1.5 million patients with early-stage breast cancer.
Additionally, researchers at Tufts University School of Medicine in the United States discovered that individuals who underwent a lumpectomy in conjunction with radiotherapy, as opposed to a mastectomy, experienced extended survival times in this study.
Improvements in radiotherapy, hormone treatments, and immunotherapy (which enhances the immune system to eliminate cancer cells) may be crucial, according to the UK team, as they enable the precise targeting of tumours. However, the reasons for this still need to be clarified.
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Professor Kefah Mokbel, the supervisor of breast surgery at the London Breast Institute, expressed his enthusiasm for the discoveries at the Princess Grace Hospital in London.
He informed Good Health that it could result in a 50% reduction in the number of NHS mastectomies in the future.
Professor Mokbel disputed the widespread belief that mastectomy induces “peace of mind.”
“By preserving the breasts, we not only maintain the quality of life but also have the potential to improve the quantity of life for patients.”
He stated that local recurrences are typically treated with another lumpectomy, and it is common for the cancer to recur in the breast.
However, the cancer may settle in a different location if the breast has been removed, which can complicate the treatment process and impact the outcome.
Nevertheless, the professor stated that mastectomy may still be the preferred treatment for certain patients, including those with large or multiple tumours.
