Some early breast cancer patients benefit more from breast conservation than from mastectomyJanuary 29, 2017
Amsterdam, The Netherlands: Breast conserving therapy (BCT, breast conserving surgery combined with radiation therapy) is superior to mastectomy in certain types of breast cancer patients, according to results from the largest study to date, to be presented to the European Cancer Congress 2017  today (Monday).
Professor Sabine Siesling, from the Netherlands Comprehensive Cancer Organisation (IKNL) and University of Twente and Mirelle Lagendijk, MD, from the Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands, and colleagues from other hospitals, studied survival nationwide in nearly 130,000 breast cancer patients, divided into two groups: those diagnosed between 1999-2005 and those diagnosed between 2006-2012. The patients selected from the Netherlands Cancer Registry had no metastases (spread of the cancer to organs other than the lymph nodes close to the tumour). To obtain information on cause of death, data were linked to the cause of death register.
Although randomised trials initiated in the 1980s have shown equal survival outcomes for BCT and mastectomy, trials often exclude elderly patients or patients with existing disease other than breast cancer (comorbidity). Studies with large, population-based groups, including comorbidity and those who are elderly, can add to the knowledge based on these trials and provide outcome that is more widely applicable and reflect daily practice. Several recent population-based studies showed a survival advantage for BCT. However, these studies tended to lack long-term follow-up, evaluated limited patient numbers, had differences in medication after surgery between both groups and lacked the data on cause of death that are needed to evaluate breast cancer-specific survival. All this could have led to the introduction of confounding factors such as severity of disease or death due to other causes, the researchers say.
In the current study, a number of prognostic factors such as age, stage, comorbidity, hormonal receptor and HER2 status , and differences in systemic treatments (medication after surgery) were included and considered as possible explanations for the previously reported survival differences between BCT and mastectomy. This enabled the identification of possible prognostic factors that might, in future, predict which patients could benefit most from BCT.
"We looked at two different groups in order to allow us to compare long-term outcomes in a more historical versus a more recent cohort, evaluating patients that had been able to benefit from more sophisticated diagnostics and therapies. A considerably superior survival, both specific to breast cancer and from any cause of death, was found for BCT in the early stage T1-2N0-1M0  cancers in both time cohorts," says Prof Siesling.
To identify patients who could possibly benefit most from BCT, both time cohorts were divided into subgroups. Evaluation of T1-2N0-1M0 cancers, which are at a stage when metastasis to distant organs has not yet occurred, in both groups showed a considerable advantage for BCT in patients with increasing age, those with comorbidity, and those who did not receive chemotherapy.
"Although this study is based on retrospective data with much detailed data, and residual confounding factors cannot be ruled out completely, we believe that this information will have potential to greatly improve shared treatment decision-making for future breast cancer patients in those aged over 50 years and those with comorbidity," says Prof Siesling.
"However, we would like to emphasise that these results do not mean that mastectomy is a bad choice. For patients for whom radiotherapy is not suitable or feasible due to social circumstances, for whom the risk of late side effects of radiotherapy is high, or who have the prospect of a poor aesthetic outcome following BCT, a mastectomy may still be the preferable treatment option. Our study showed that BCT is at least as good as mastectomy and that some patients might benefit more than others from BCT in the future," Prof Siesling will conclude.
 The European Cancer Congress is the only truly multidisciplinary oncology congress in the world. It is organised by the European CanCer Organisation (ECCO), a not-for-profit federation of 25 member societies, representing over 80,000 professionals working in cancer.
 The HER2 receptor can play a role in the development of cancer. Patients who are positive for HER2 can take drugs that block the chemical signals telling cancer cells to grow.
 The TNM (tumour, node, metastasis) is a system used to describe the stage of the cancer, i.e. how a tumour looks and behaves.
ECCO-the European CanCer Organisation
Related Breast Cancer Articles:
A new article published by JAMA Oncology compares outcomes for combined mammography and MRI or ultrasonography screenings for new breast cancers in women who have previously undergone breast conservation surgery and radiotherapy for breast cancer initially diagnosed at 50 or younger.
A Clinical Breast Cancer study demonstrates Videssa Breast can inform better next steps after abnormal mammogram results and potentially reduce biopsies up to 67 percent.
The proportion of women in the United States undergoing surgery for early-stage breast cancer who have preventive mastectomy to remove the unaffected breast increased significantly in recent years, particularly among younger women, and varied substantially across states.
Breast cancer patients with dense breast tissue have almost a two-fold increased risk of developing disease in the contralateral breast, according to new research from The University of Texas MD Anderson Cancer.
Breast conserving therapy (BCT) is better than mastectomy for patients with some types of early breast cancer, according to results from the largest study to date, presented at ECC2017.
An annual mammogram is recommended after treatment for breast cancer, but nearly one-third of women diagnosed with breast cancer aren't receiving this follow-up exam, according to new findings presented at the 2016 Annual Clinical Congress of the American College of Surgeons.
Even though dense breast tissue is a risk factor for breast cancer, very low mammographic breast density is associated with a worse prognosis in breast cancer patients.
Young women with early breast cancer face a difficult choice about whether to opt for a mastectomy or breast conserving therapy (BCT).
In a study appearing in the April 26 issue of JAMA, Elizabeth A.
Five years after breast-conserving surgery, radiotherapy focused around the tumor bed is as good at preventing recurrence as irradiating the whole breast, with fewer side effects, researchers from the UK have found in the large IMPORT LOW trial.
Related Breast Cancer Reading:
Chicken Soup for the Soul: Hope & Healing for Your Breast Cancer Journey: Surviving and Thriving During and After Your Diagnosis and Treatment
by Dr. Julie Silver (Author)
Chicken Soup for the Soul: Hope & Healing for Your Breast Cancer Journey will encourage comfort and encourage breast cancer patients and survivors with its inspiring stories and helpful medical information.
A support group from breast cancer diagnosis through treatment to rehabilitation and recovery, this book combines inspiring Chicken Soup for the Soul stories written just for this book and accessible leading-edge medical information from Dr. Julie Silver of Harvard Medical School. Patients and survivors will find comfort, strength and hope. View Details
Breast Cancer Smoothies: 100 Delicious, Research-Based Recipes for Prevention and Recovery
by Daniella Chace (Author)
The statistics are staggering. Breast cancer is the most common type of cancer among women--About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime. Second only to heart disease by a mere one percent, every ounce of prevention and every window of opportunity for healing is critical. In order to reduce the risk of developing this common disease, you need a targeted plan to protect yourself from common breast toxins and to strengthen your immune defenses.
In her delightful new book, Daniella breaks down the complex topic of... View Details
Heal Breast Cancer Naturally: 7 Essential Steps to Beating Breast Cancer
by Dr. Veronique Desaulniers (Author)
One out of eight women will be diagnosed with Breast Cancer. One out of 3 women will experience some form of cancer in their life time.
I was one of those statistics even though I was living a healthy lifestyle that consisted of organic foods, regular exercise, massage, Chiropractic care and colonics. How could somebody like me develop Breast Cancer?
That very question led to thousands of hours of research, study, soul-searching and prayer. It all came together as The 7 Essentials – 7 basic steps that are necessary for preventing and healing cancer, or any dis-ease for... View Details
The Breast Cancer Survival Manual, Sixth Edition: A Step-by-Step Guide for Women with Newly Diagnosed Breast Cancer
by John Link M.D. (Author), James Waisman M.D. (Author), Nancy Link R.N. (Author)
One of the most comprehensive and bestselling books on breast cancer treatment and survival, completely revised and updated
The sixth edition of Breast Cancer Survival Manual provides essential updates on treatment and care, enhancing the basic information that has made this the most trusted guide for women diagnosed with breast cancer for the past two decades. This edition includes the most current advice on:
· The new genomic classification of breast cancer and its importance in treatment planning
· Cancer gene testing, which determines if a woman will benefit... View Details
Dr. Susan Love's Breast Book (A Merloyd Lawrence Book)
by Susan M. Love (Author), Karen Lindsey (Contributor), Elizabeth Love (Contributor)
"The Bible for women with breast cancer" --New York Times
For more than two decades, readers faced with a diagnosis of breast cancer have relied on Dr. Susan Love's Breast Book to guide them through the frightening thicket of research and opinion to find the best options for their particular situations. This sixth edition explains advances in targeted treatments, hormonal therapies, safer chemotherapy, and immunologic approaches as well as new forms of surgery and radiation. There is extensive guidance for the many women now living for years with metastatic breast... View Details
Dear Friend: Letters of Encouragement, Humor, and Love for Women with Breast Cancer
by Gina L Mulligan (Author)
This beautiful collection of handwritten letters offers strength, encouragement, and comfort to women living with breast cancer. Written by compassionate strangers—many of whom have gone through their own health battles—these heartfelt letters were gathered by Girls Love Mail, an organization that provides support to people diagnosed with breast cancer as seen on NBC Nightly News. Presented in an elegant package with metallic endpapers, and a ribbon marker, and brimming with warm messages of empathy, inspiration, and humor, Dear Friend delivers words of wisdom when they're needed... View Details
The Whole-Food Guide for Breast Cancer Survivors: A Nutritional Approach to Preventing Recurrence (The New Harbinger Whole-Body Healing Series)
by Edward Bauman MEd PhD (Author), Helayne Waldman MS EdD (Author), Donald I. Abrams MD (Foreword)
If you’re a breast cancer survivor, chances are you have renewed your commitment to maintaining your good health and taking care of your body. As one of the best preventative measures known to doctors and nutritionists today, a robust, cancer-fighting diet is vital to your personal plan for breast cancer prevention.
The Whole-Food Guide for Breast Cancer Survivors is an essential guide for every woman seeking to understand the effect of nutritional deficiencies and environmental factors on her overall health and wellness. Based on Edward Bauman’s groundbreaking Eating for... View Details
The Mayo Clinic Breast Cancer Book
by the breast-health experts at Mayo Clinic Cancer Ce (Author)
From the breast health experts at Mayo Clinic comes a guide to the many aspects of breast cancer—from prevention, to care and coping, to survival, to living with hope.
The Mayo Clinic Breast Cancer Book is the trusted resource for anyone wanting reliable information about this dreaded disease. Mayo Clinic set out to provide comprehensive and up-to-date facts in easy-to-understand language. They've succeeded in this handbook for those who've been diagnosed, or for those who want to give sensitive and helpful support to someone with breast cancer. The Mayo Clinic Breast... View Details
Just Get Me Through This! - Revised and Updated: A Practical Guide to Coping with Breast Cancer
by Deborah A. Cohen (Author), Robert M. Gelfand M.D. (Author)
You Can Get Through This
Your doctor told you it was breast cancer. So now what?! You'll need plenty of essential advice--the kind that only comes from someone who's been there.
In Just Get Me Through This! Deborah A. Cohen and Robert M. Gelfand, M.D. help you deal with all the ups and downs of the breast cancer experience. From the shock of diagnosis to getting through treatment to getting on with your life, they pack it with plenty of straight talk and practical tips. This newly updated edition also includes advice from two prominent breast cancer... View Details