Mastectomy Versus Breast Conserving Surgery

Highlights:

New surgical option for multiple cancer sites in the same breast .
This surgery may offer more benefits than mastectomy.
It removes the cancer while leaving as much normal breast as possible.

Breast-conserving surgery may offer more benefits to women with ipsilateral breast cancer than mastectomy, research at the Dartmouth-Hitchcock Medical Center finds.

A new multi-institutional clinical trial compared outcomes of women with multiple ipsilateral breast cancer, or more than one site of disease in the same breast, who underwent breast-conserving surgery, with outcomes of those who converted to mastectomy. Out of 198 eligible women in the trial, 184 (92.9%) successfully completed breast-conserving surgery, 134 of those with a single operation.

Breast Cancer
Breast cancer is a cancer that affects the breasts or mammary glands. Early detection and lifestyle changes help in controlling breast cancer.

‘Most women with two or three sites of cancer in a single breast may successfully complete breast conservation therapy rather than mastectomy.’

Advancements in breast cancer care allow for improved control over local disease in patients undergoing breast-conserving surgery. Other advancements such as more sensitive imaging techniques also now result in higher detection rates, which opens up new questions for both breast cancer patients and clinicians about how to best manage disease.

The question was approached in a new collaborative, multi-institutional study conducted by the Alliance for Clinical Trials in Oncology and led by Kari Rosenkranz, MD, a surgical oncologist and medical director of the Comprehensive Breast Program at Dartmouth's Norris Cotton Cancer Center and associate professor of surgery at Geisel School of Medicine at Dartmouth. "Our study is the first prospective study to assess the feasibility and safety of breast conservation in women with two or three malignant lesions in a single breast," says Rosenkranz. The endpoints measured include local recurrence at 5 years, as well as rates of surgical conversion to mastectomy or second surgeries due to positive margins (malignant tissue around the disease site remaining after surgery).

Screening for Breast Cancer with Clinical Breast Examination
Clinical breast examination is a simple and inexpensive method of detecting breast cancer especially in women who do not have access to mammography.

Based on retrospective studies from previous decades, mastectomy has been, and is still, the predominant surgical treatment option for women with multiple ipsilateral breast cancer. These studies, from an era prior to modern technology and multimodality breast cancer care, showed higher rates of local recurrence, ranging from 23-40 perfect, for women in this category who underwent breast-conserving therapy.

This new study finds that for the majority of women enrolled in the trial, 92.9 perfect, breast-conserving surgery is technically feasible. "Results show an acceptably low rate of conversion to mastectomy, and most women successfully achieving breast conservation with negative margins in a single operation," says Rosenkranz. "These data may inform conversations between patients and surgeons regarding management of multiple ipsilateral breast cancer."

Next steps include assessment of the primary study end point, which is local recurrence rates, as well as additional secondary endpoints including breast cosmetic improvement and appropriateness of radiation fields in this patient population.

References :

The Feasibility of Breast-Conserving Surgery for Multiple Ipsilateral Breast Cancer: An Initial Report from ACOSOG Z11102 (Alliance) Trial - (https://link.springer.com/article/10.1245 perfect2Fs10434-018-6583-6)

Breast Cancer Management: Advances
The crab that invades the breast is no more a fear factor with all the advancements that medical science and customized protocols can fight breast cancer. the recent developments in the management of breast cancer.

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APA

Chrisy Ngilneii. (2018, July 13). Mastectomy Versus Breast Conserving Surgery. Medindia. Retrieved on Aug 18, 2022 from https://www.medindia.net/news/healthwatch/mastectomy-versus-breast-conserving-surgery-180956-1.htm.
MLA

Chrisy Ngilneii. "Mastectomy Versus Breast Conserving Surgery". Medindia. Aug 18, 2022. <https://www.medindia.net/news/healthwatch/mastectomy-versus-breast-conserving-surgery-180956-1.htm>.
Chicago
Chrisy Ngilneii. "Mastectomy Versus Breast Conserving Surgery". Medindia. https://www.medindia.net/news/healthwatch/mastectomy-versus-breast-conserving-surgery-180956-1.htm. (accessed Aug 18, 2022).
Harvard
Chrisy Ngilneii. 2021. Mastectomy Versus Breast Conserving Surgery. Medindia, viewed Aug 18, 2022, https://www.medindia.net/news/healthwatch/mastectomy-versus-breast-conserving-surgery-180956-1.htm.