Breast cancer

Whether opting for mastectomy or lumpectomy, doctors say survival rates are similar in early stage

The impulse to opt for a mastectomy or even double mastectomy after receiving a breast cancer diagnosis is understandable: You’ve just been told you have cancer, and you want it out. You might also think that by removing as much breast tissue as possible, you’re improving your chances of beating the disease.

That isn’t necessarily true. The National Institutes of Health came out in 1990 with a consensus statement endorsing lumpectomies, also called breast conservation surgery, for treatment of early-stage breast cancer.

“There’s a belief that removal of the entire breast or removal of the opposite breast will improve the woman’s chances of survival, and it’s been shown repeatedly that that does not happen,” says Southern California-based breast cancer surgeon Dennis Holmes. He spoke recently at the American Society of Breast Surgeons’ annual meeting in Las Vegas.

Mastectomies, however, are still being performed on women with early-stage breast cancer, for whom a lumpectomy plus radiation could be equally as effective. Though mastectomy rates dropped in the years following the NIH’S statement, the past decade has seen another uptick, possibly fueled in part by Angelina Jolie’s highly publicized preventative double mastectomy four years ago. Preventative mastectomies are only necessary for people carrying the BRCA gene, which Jolie had learned she carried.

CANCER

The decision between a mastectomy and lumpectomy “is certainly a partner decision,” says Las Vegas-based surgeon Annabel Barber, though patients have the final say.

“My job is to dispel their fears with facts,” Barber says. “And then if that’s what they still want to do that’s fine, I’m happy — I mean, it’s these people’s bodies that they’ve got to live with the rest of their lives.”

Though there are surgeons who do default to mastectomy — for many years, that was the modus operandi — many within the breast cancer treatment community are hoping to stymie the trend.

Less surgery, shorter recovery

In addition to the equally promising long-term prognosis, there are other reasons for suitable candidates