Our Summary

This research compares two main types of surgery for early-stage breast cancer - a modified radical mastectomy (MRM), which is a more traditional method, and oncoplastic breast-conserving surgery (OBCS), a newer technique that aims to conserve as much of the breast as possible.

The study found that while the OBCS procedure took longer, patients had less bleeding during the operation, less fluid draining after the surgery, and spent less time in the hospital. They were also more satisfied and had a better quality of life after surgery, without an increased risk of complications or the cancer coming back.

The researchers also found that whether the cancer had spread to the lymph nodes and the specific type of cancer were important factors in predicting disease-free survival (DFS) - the length of time after treatment that a patient lives without any signs of the disease. They developed a risk model based on these factors, which was effective in predicting whether the cancer would come back.

In summary, the study suggests that OBCS can improve patient satisfaction and doesn’t increase the risk of complications or the cancer coming back. The risk model they created could also be useful in helping to personalize treatment plans for patients.

FAQs

  1. How does oncoplastic breast-conserving surgery (OBCS) differ from a modified radical mastectomy (MRM) in terms of patient outcomes?
  2. What factors did the study identify as important in predicting disease-free survival (DFS) after breast cancer treatment?
  3. How might the risk model developed in this study be used in patient treatment plans?

Doctor’s Tip

A doctor might advise a patient considering radical mastectomy to discuss the option of oncoplastic breast-conserving surgery with their healthcare team. This newer technique may offer benefits such as less bleeding, shorter hospital stays, and improved quality of life compared to traditional methods. Additionally, understanding the factors that can affect disease-free survival, such as lymph node involvement and cancer type, can help in creating a personalized treatment plan. It’s important for patients to have open conversations with their healthcare providers to make informed decisions about their care.

Suitable For

Typically, patients with early-stage breast cancer who are candidates for surgery are recommended radical mastectomy. This includes patients with larger tumors or tumors that have spread to the lymph nodes. However, this study suggests that oncoplastic breast-conserving surgery may be a viable alternative for some patients, particularly those with smaller tumors and no lymph node involvement. It is important for patients to discuss their individual situation with their healthcare provider to determine the best treatment option for them.

Timeline

  • Before radical mastectomy:
  1. Patient is diagnosed with early-stage breast cancer and consults with their medical team about treatment options.
  2. Patient undergoes pre-operative tests and evaluations to determine the extent of the cancer and plan for surgery.
  3. Patient decides on a treatment plan, which may include a radical mastectomy.
  4. Patient undergoes the radical mastectomy surgery, which involves the removal of the entire breast, underlying chest muscles, and lymph nodes in the armpit.
  5. Patient recovers in the hospital for a few days after surgery.
  • After radical mastectomy:
  1. Patient experiences pain and discomfort in the chest and arm area, and may need pain medication to manage it.
  2. Patient may have drains placed to remove excess fluid from the surgical site.
  3. Patient undergoes physical therapy to regain strength and mobility in the affected arm and chest muscles.
  4. Patient may experience emotional and psychological challenges related to body image and self-esteem.
  5. Patient may undergo additional treatments such as chemotherapy or radiation therapy to reduce the risk of cancer recurrence.
  6. Patient follows up with their medical team for regular check-ups and monitoring of their health.
  7. Patient may consider breast reconstruction surgery to restore the appearance of the breast.
  8. Patient adjusts to life after surgery and focuses on physical and emotional healing.

What to Ask Your Doctor

  1. What are the differences between a modified radical mastectomy and oncoplastic breast-conserving surgery?

  2. What are the potential benefits and risks of each type of surgery?

  3. How long is the recovery time for each type of surgery?

  4. Will I need additional treatments such as radiation therapy or chemotherapy after the surgery?

  5. How will the surgery affect my appearance and body image?

  6. What is the likelihood of the cancer coming back after each type of surgery?

  7. How will the surgery impact my quality of life after treatment?

  8. Are there any long-term side effects or complications associated with each type of surgery?

  9. Will I need to have reconstruction surgery after a radical mastectomy?

  10. Can you explain the risk model developed in the study and how it may impact my personalized treatment plan?

Reference

Authors: Xu Y, Cao J, Gong K, Li S, Liu Y, Xiong F, Pan Y, Chen M, Gong J, Luo N, Yuan S. Journal: Am J Cancer Res. 2023 Sep 15;13(9):4259-4268. eCollection 2023. PMID: 37818068