Mastectomy is the most recommended surgery for the treatment of breast cancer. It consists of the complete removal of the breast and greatly affects the self-esteem of patients, but it is considered the safest way to prevent tumor recurrence.
However, according to research conducted by the Alliance for Oncology Clinical Trials and the Mayo Clinic Cancer Center in the United States, patients with multiple tumors in one breast may be able to avoid a mastectomy as long as the tumors are removed while preserving a sufficient amount of breast tissue.
For the case studies, breast conservation therapy consisted of a partial mastectomy followed by radiotherapy to the entire breast. The study was published in the medical journal Journal of Clinical Oncology.
“I am excited about the findings as they will empower patients and the multidisciplinary care teams that care for them. They will be able to think about this option for women who want to preserve the breast,” says oncologist Judy Boughey, lead author of the paper.
The doctor points out that the method is not indicated for all cases and that patients may prefer or need a complete mastectomy. However, it reinforces the value of the finding. “Being able to offer an option to more patients diagnosed with breast cancer is a major step forward,” says the author, WH Odell Professor of Individualized Medicine.
Participants
In the study conducted by the Mayo Clinic, researchers looked after 204 patients over the age of 40 who had 2 or 3 different areas of breast cancer in the same breast.
All patients had preoperative mammography and/or ultrasound, and all but 15 had magnetic resonance imaging of the breasts. They had partial mastectomies to remove the tumors, followed by radiation therapy to the entire breast with high doses of radiation to the sites where the lumps had been removed.
The women were followed for five years to look for post-breast cancer events. The data obtained during the observation point out that, in a mean follow-up of 66.4 months, only six patients had breast tumors again.
Choice
The result, according to the study, is excellent and is similar to the recurrence rate for patients with a single breast tumor who received breast conservation therapy.
Historically, women with multiple tumors in one breast have been advised to have a mastectomy.
A complementary finding indicates that the rate of tumor recurrence was lower in patients who had preoperative magnetic resonance imaging than in patients who did not have preoperative magnetic resonance imaging.
“For patients with two or three tumors in one breast who wish to conserve the breast, it is important to consider magnetic resonance imaging prior to surgery to ensure the disease has not metastasized. However, other factors such as breast size can also influence whether breast conservation therapy is a suitable option,” says Judy.
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