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Some Early Breast Cancer Patients Benefit More From Breast Conservation Than From Mastectomy

Breast conserving therapy (BCT, breast conserving surgery combined with radiation therapy) is superior to mastectomy in certain types of breast cancer patients, according to results from the largest study to date, presented to the European Cancer Congress 2017.

Professor Sabine Siesling, from the Netherlands Comprehensive Cancer Organisation (IKNL) and University of Twente and Mirelle Lagendijk, MD, from the Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands, and colleagues from other hospitals, studied survival nationwide in nearly 130,000 breast cancer patients, divided into two groups: those diagnosed between 1999-2005 and those diagnosed between 2006-2012. The patients selected from the Netherlands Cancer Registry had no metastases (spread of the cancer to organs other than the lymph nodes close to the tumor). To obtain information on cause of death, data were linked to the cause of death register.

Although randomized trials initiated in the 1980s have shown equal survival outcomes for BCT and mastectomy, trials often exclude elderly patients or patients with existing disease other than breast cancer (comorbidity). Studies with large, population-based groups, including comorbidity and those who are elderly, can add to the knowledge based on these trials and provide outcome that is more widely applicable and reflect daily practice. Several recent population-based studies showed a survival advantage for BCT. However, these studies tended to lack long-term follow-up, evaluated limited patient numbers, had differences in medication after surgery between both groups and lacked the data on cause of death that are needed to evaluate breast cancer-specific survival. All this could have led to the introduction of confounding factors such as severity of disease or death due to other causes, the researchers say.

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