At the 22nd annual San Antonio Breast Cancer Symposium, researchers presented the results of a 10 year study that revealed no difference in long-term survival among women with ductal carcinoma in situ (DCIS) who chose mastectomy over lumpectomy or vice versa. The study followed 839 women with DCIS, a Stage 0 breast cancer confined to the milk ducts, for an average of 10.3 years after treatment by mastectomy (removed of the affected breast), lumpectomy (removal of a breast lump), or lumpectomy plus radiation therapy. Although the number of breast cancer recurrences was higher among women who were treated with lumpectomy, a near 100% survival rate among DCIS patients regardless of treatment indicates that women with DCIS are at very little risk of dying from cancer recurrence.
In the past, most physicians have recommended that women with DCIS have mastectomy. However, in recent years, breast-conserving therapy (lumpectomy followed by at least six weeks of radiation therapy) has become a popular surgical option because it allows women to preserve their breast(s). Researchers at the symposium revealed that women who undergo lumpectomy plus radiation (termed breast-conserving therapy), have a 10% chance of breast cancer recurrence within 12 years of breast surgery compared to a 1% chance of recurrence among women treated with mastectomy.
Among the 839 DCIS patients studied, the following experienced a recurrence of invasive breast cancer:
- 2 of the 316 women treated with mastectomy
- 22 of the 223 women treated with lumpectomy
- 19 of 300 women treated with lumpectomy plus radiation
However, the study also showed that the mortality rates were low and almost identical regardless of lumpectomy or mastectomy. Women with DCIS who were treated with breast-conserving therapy had a 1.0% chance of dying from breast cancer within 12 years compared with a 0% chance among women who had mastectomy.
DCIS is the most common form of non-invasive breast cancer among women. The key to breast cancer survival is early detection and treatment. Women whose breast cancer is confined to the milk ducts and has not spread into the fatty breast tissue or to other regions of the body have a near 100% survival rate when the cancer is surgically removed-either by breast-conserving therapy or mastectomy.
Women with DCIS should weigh the advantages and disadvantages of both surgical procedures with their cancer treatment team to determine which treatment is best for them. Lumpectomy may preserve the physical appearance of the breast but usually requires six to seven weeks of radiation therapy. Mastectomy may reduce local recurrence of breast cancer but additional decisions about breast reconstruction are introduced. Also, some women may be better candidates for mastectomy than lumpectomy or vice versa depending on their individual medical situation.
- This article references the December 15, 1999 WedMD report by Charles Bankhead, "Long-Term Survival for DCIS Approaches 100% Irrespective of Treatment Survival, Not Local Recurrence, Should Be Primary Outcome Measure."
- The December 15, 1999 Doctor’s Guide report by Robert Carlson, "Outlook Good for Women With Early Breast Cancer," is available at http://www.pslgroup.com/dg/150b3a.asp
- Imaginis.net provides detailed information on DCIS, lumpectomy, and mastectomy at http://www.imaginis.com/breasthealth/dcis.asp, http://www.imaginis.com/breasthealth/lumpectomy.asp, and http://www.imaginis.com/breasthealth/mastectomy.asp respectively.
