Comparison between two techniques of breast surgery: 20-year follow-up

This study compared breast cancer recurrence rates and overall survival between women treated with breast-conserving surgery versus radical mastectomy. Results showed that in the case of small tumors, breast-conserving surgery is the recommended option.

Most patients with breast cancer have surgery to remove the cancer from the breast. The amount of breast tissue removed during this surgery is variable. During a ‘radical mastectomy’ of the breast, underlying chest muscle and lymph nodes are removed with the whole breast. Breast-conserving surgery (BCS), also known as a ‘lumpectomy’ is a surgery to remove a tumor (lump) and a small part of breast tissue around it. Radiation treatment (‘Radiotherapy’) is often used following lumpectomy to destroy residual cancer cells that may have escaped surgical removal.

This paper, published in 2002 looked at 701 women who took part in a different study conducted between 1973 and 1980.  It looks at how long they survived for and if their cancer spread during a 20 year period after they first had surgery. These women all had a tumor in the breast no larger than 2cm. 349 women had radical mastectomy, and 352 had BCS followed by radiotherapy. 

Results showed that 8.52% of women who had BCS and radiotherapy had a recurrent tumor in the same breast. 2.29% of women who had radical mastectomy experienced local recurrence. There was no difference in the number of women who developed a tumor in the other breast or whose cancer spread to other parts of the body (metastasized) between the two treatments. There was also no difference in the number of deaths between the two treatment groups.

Overall, this study shows that for women with small breast tumors BCS should be the treatment of choice.

This 20-year follow up study has limitations which should be considered.  Diagnosis of cancers and the identification of tumors that have spread to the lymph nodes have greatly improved since 1973 and new radiotherapy regimens are available.

You should carefully consider all treatment options for small breast tumors. Talk to your doctor about the right treatment for you.