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Study Finds Breast Cancer Recurrence Best Treated with Mastectomy (dateline Nov. 21, 2008)


Many women undergo a lumpectomy after a breast cancer diagnosis. The procedure preserves a portion of the breast by only removing the breast tumor and a small amount of surrounding breast tissue. However, new research finds that women who experience a recurrence of breast cancer are likely to undergo a second lumpectomy instead of a mastectomy-removal of the entire breast. Their research finds that a mastectomy after a breast cancer recurrence can increase the chances of survival.

To conduct their study, researchers from the University of California-Davis Cancer Center studied 747 patients who previously received a lumpectomy and had been diagnosed with cancer for a second time between 1988 and 2004. They found that women who had mastectomies had a 78 percent survival rate after five years, while those who had second lumpectomies had a 67 percent survival rate.

Survival rates after ten years were also higher among women who underwent mastectomies after their breast cancer recurrence. The 10-year survival rates were 62 percent for those who had mastectomies and 57 percent for those who had second lumpectomies. In all, the researchers report that 24 percent of women with a breast cancer recurrence in the same breast had second lumpectomies.

We were surprised to find that so many women in our study - almost a quarter of them - had received another lumpectomy rather than a mastectomy," said lead researcher Steven Chen of the University of California-Davis Cancer Center in a UC Davis news release. "It's likely that patients are asking for lumpectomies when their cancer is diagnosed a second time, and their doctors are simply complying with that request. Whatever the reason, that decision can shorten life spans," said Dr. Chen.

According to Dr. Chen's statement, a mastectomy is the accepted treatment for a second cancer because whole breast radiation, which typically accompanies a lumpectomy, is not usually recommended twice in a woman's lifetime.

"As therapy for breast cancer becomes more targeted and researchers come closer to identifying those factors that make some breast cancers more aggressive than others, we may have the option of recommending second and even third lumpectomies in select cases in the future. Until then, mastectomy remains the best option for women experiencing a same-breast recurrence of their breast cancer," ssaid Dr. Chen in the UC Davis statement.

Additional Resources and References

  • The study referenced in this article, "The survival impact of the choice of surgical procedure after ipsilateral breast cancer recurrence," appeared in the October issue of The American Journal of Surgery, http://www.sciencedirect.com/science/journal/00029610
  • The October 1, 2008 UC Davis news release, "Second lumpectomy for breast cancer reduces survival rates," was published on the Cancer Center's website at http://www.ucdmc.ucdavis.edu/cancer/