Our Summary

The research paper discusses Breast Conserving Therapy (BCT), a treatment for breast cancer that aims to control the disease while minimizing damage to the breast. The researchers found that BCT has similar survival rates and recurrence rates as mastectomy (complete removal of the breast). Interestingly, some studies showed even better overall survival rates for women treated with BCT compared to mastectomy, regardless of the type of cancer.

Despite these findings, many women with small breast cancers still opt for mastectomy, and the number of mastectomies being performed has been increasing. The paper suggests that this might be due to lack of awareness about BCT.

The paper also notes that new treatments given before the main treatment (neoadjuvant treatments) have made it possible for more women to undergo BCT. These treatments have been shown to increase the success of BCT without raising the risk of the cancer coming back.

The researchers conclude that patients who are suitable for BCT should be informed that it is the best treatment option for them. This is because, compared to mastectomy, it has similar survival and recurrence rates but fewer complications, a better quality of life, and fewer surgeries if reconstruction is needed. The researchers even suggest that it may no longer be appropriate to offer the choice of mastectomy or BCT to women suitable for BCT.

FAQs

  1. What is Breast Conserving Therapy (BCT) and how does it compare to mastectomy in terms of survival and recurrence rates?
  2. Why do some women with small breast cancers still opt for mastectomy instead of BCT?
  3. How have neoadjuvant treatments impacted the success of BCT and its risk factors?

Doctor’s Tip

A doctor might tell a patient considering a mastectomy that Breast Conserving Therapy (BCT) is a treatment option that can control their breast cancer while minimizing damage to the breast. BCT has similar survival rates and recurrence rates as mastectomy, and some studies have even shown better overall survival rates for women treated with BCT. Additionally, new treatments given before the main treatment have made it possible for more women to undergo BCT successfully. Patients who are suitable for BCT should be informed that it is the best treatment option for them, as it has similar outcomes to mastectomy but with fewer complications, a better quality of life, and potentially fewer surgeries if reconstruction is needed.

Suitable For

Patients who are typically recommended mastectomy include those with large tumors relative to breast size, tumors located in multiple areas of the breast, inflammatory breast cancer, a history of radiation therapy to the affected breast, or a genetic mutation that predisposes them to developing breast cancer. Additionally, some patients may choose mastectomy as a personal preference or due to psychological factors such as fear of cancer recurrence. Ultimately, the decision to undergo mastectomy or BCT should be made in consultation with a healthcare provider, taking into consideration the individual patient’s medical history, tumor characteristics, and personal preferences.

Timeline

Before mastectomy:

  • Diagnosis of breast cancer through imaging tests, biopsies, and consultations with oncologists
  • Discussion of treatment options with healthcare providers, including the possibility of mastectomy
  • Pre-operative appointments and tests to assess overall health and prepare for surgery
  • Decision-making process regarding the type of mastectomy, reconstruction options, and post-operative care

After mastectomy:

  • Surgery to remove the breast tissue, possibly including lymph nodes
  • Recovery period in the hospital and at home, with pain management and monitoring for complications
  • Follow-up appointments with healthcare providers to monitor healing, discuss pathology results, and plan for further treatment if needed
  • Physical therapy and emotional support to cope with changes in body image and function
  • Consideration of reconstruction options, if desired, and additional surgeries for reconstruction
  • Long-term follow-up care to monitor for recurrence, manage side effects of treatment, and support overall health and well-being.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with mastectomy?
  2. How does the recovery process differ between mastectomy and breast conserving therapy?
  3. Are there any long-term effects of mastectomy that I should be aware of?
  4. What are the chances of the cancer coming back after mastectomy compared to breast conserving therapy?
  5. Are there any factors that make me a better candidate for mastectomy over breast conserving therapy?
  6. What are the options for breast reconstruction after mastectomy?
  7. How will mastectomy affect my physical appearance and self-image?
  8. Are there any alternative treatments to mastectomy that I should consider?
  9. How will mastectomy impact my daily activities and quality of life?
  10. Are there any support resources available for patients considering mastectomy?

Reference

Authors: Johns N, Dixon JM. Journal: Eur J Surg Oncol. 2016 Nov;42(11):1636-1641. doi: 10.1016/j.ejso.2016.08.016. Epub 2016 Aug 31. PMID: 27665053