For some cancer patients, removing a breast doesn’t always mean living longer

Losing breast not always best for cancer patients

BARCELONA, Spain — For some women, having a breast removed once they’re diagnosed with cancer doesn’t always mean they’ll live longer, a new study says.

Researchers said that in women with breast cancer who also have genetic mutations that make them more susceptible to the disease, women appear to live just as long whether they choose treatment that preserves their breast or have a breast removal, or mastectomy.

The study results were presented in Barcelona at a European breast cancer conference on Friday.

Dr. Lori Pierce, a professor of radiation oncology at the University of Michigan, and her colleagues observed 655 breast cancer patients in Australia, Israel, Spain and the United States, all of whom had genetic mutations that gave them a much higher chance of getting the disease. After 15 years, women who had a breast removed had about a 6 percent chance of a cancer relapse, compared with 24 percent of women who kept their breasts. If the latter group added chemotherapy, their risk dropped to about 12 percent.

But when it came to survival, there was almost no difference whether the cancer patients had decided to keep their breast or have it removed. Women who kept their breasts had a survival rate of 87 percent after 15 years, and women who had mastectomies had a survival rate of 89 percent.

“This will be useful for patients who are bombarded with a lot of information at once,” said Pierce. “Being diagnosed with breast cancer and finding out (they have a genetic susceptibility) is a lot to process, and women may not want to think about a mastectomy right then,” she said. “Breast conservation therapy…with chemotherapy and hormonal therapy is a very reasonable alternative.”

She said the study results probably wouldn’t apply to women who have the genetic mutations but haven’t yet gotten cancer. “Their thinking is very different because they’ve often seen multiple family members die and they are much more likely to undergo a preventive mastectomy,” she said.

Doctors said Pierce’s findings should buy some recently diagnosed breast cancer patients a bit of breathing room.

“These are convincing data that show women can keep their breast and not be worse off,” said Dr. Alain Fourquet, head of radiation and oncology at the Institut Curie in Paris. Fourquet is the chair of the European breast cancer conference and was not linked to Pierce’s study.

Fourquet said that being genetically predisposed to breast cancer may be less important in determining a course of action once women actually get the disease, and that decisions to remove a breast should not be based on genes.

Maria Leadbeater, a clinical nurse specialist at Breast Cancer Care, a British charity, said the findings should change the discussions doctors have with breast cancer patients.

“Surgeons may be able to give more weight to patients’ thoughts and wishes,” she said. “If both options are equally effective, then what the patient wants may become more important.”