In a nutshell
This study evaluated whether treating breast cancer that has not been completely removed with more surgery was more effective than non-surgical options such as chemotherapy. This study found that there was no difference in outcomes between treating with further surgery versus treating with a non-surgical option.
Surgery is a common treatment for breast cancer. This involves a surgeon cutting the tumor out of the breast. Usually, the surgeon will take some healthy tissue from the area around the tumor site. This tissue is tested to see if there are any cancer cells outside of the tumor. If there are cancer cells outside of the tumor in the normal tissue, further treatment is needed. This often involves more surgery to remove more healthy tissue.
Another option is for the patient to have other treatment that does not involve further surgery. This could be chemotherapy, or radiation, or treatment with an anti-cancer drug. However, whether these non-surgical options are more effective compared to further surgery is unclear.
Methods & findings
This study had 6922 patients with breast cancer. All patients had surgery to remove a breast tumor. In 277 patients, cancer cells were found outside the tumor. Of these, 57 patients had further surgery and 220 had non-surgical treatment to kill the cancer cells. These treatments could have been any combination of radiotherapy, chemotherapy, or anti-cancer medicine. Patients were followed-up for an average of 9.9 to 10.4 years.
Of the 57 patients who had a second surgery, 4 had the cancer come back in the same breast. Of the 220 patients who had a non-surgical treatment, 12 had the cancer come back in the same breast.
98.2% of patients treated with a second surgery were still alive 5 years later without the cancer returning. At 10 years, this rate was 92.2%. 97.2% of patients who had a non-surgical treatment were still alive 5 years later without the cancer returning. At 10 years, this rate was 93.9%.
It was found that there was no significant difference between surgery and non-surgical treatments in the risk of the cancer coming back.
The bottom line
The study concluded that in patients with remaining breast cancer after initial surgery, further surgery or non-surgical treatment were equally as effective at preventing the cancer from coming back. The authors suggest that further surgery may not improve recurrence rates for these patients.
The fine print
This study was retrospective. This means it looked back in time to analyze data. More studies are needed to confirm these results.
Talk to your care team if you have questions about further surgery for remaining breast cancer.
Published By :
Breast Cancer Research and Treatment
Apr 23, 2019
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