Do Women Live Longer With Lumpectomies or Mastectomies?

Early breast cancer survival rates higher among women who have lumpectomies and radiation

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) There’s been a growing trend in America among women with early (stage I or II) breast cancers. Instead of having only the tumor removed with a lumpectomy, women are choosing to have the entire breast removed (mastectomy) for even small cancers. 

That choice may not be the best one.

A large study has uncovered that women who have lumpectomies plus radiation to treat early breast cancers tend to live longer than women who have mastectomies.

Researchers found this to be the case even with aggressive early-stage cancers.

"Learn the pros and cons of each type of cancer surgery."

A study involving more than 112,000 women was led by Shelley Hwang MD, MPH, of the Duke Cancer Institute. She and her colleagues wanted to know which type of surgery had better outcomes for women with early breast cancer – mastectomies or lumpectomies plus radiation.

Over the last decade, more women have been choosing to have mastectomies instead of lumpectomies due to the perception that removing the diseased breast results in better long-term outcomes. This choice has been particularly popular among young urban women of higher socioeconomic means.

To explore the facts, researchers gathered and analyzed information on all women who were diagnosed with and underwent surgery for stage l or ll breast cancer in California between 1990 and 2004. A total of 112,154 women were followed through 2009. Researchers searched for patterns among different age groups of women who were treated for different types of breast cancer.

Over the entire period, women who had lumpectomies, followed by radiation, were more likely to survive breast cancer than were women who’d had mastectomies.

While these patterns were true for women of all ages, women over the age of 50 who had hormone-sensitive (estrogen receptor positive, ER+) benefited the most, according to this study.

These women who’d chosen the less radical surgery had a 14 percent lower risk of dying from breast cancer than did their sisters who had an entire breast removed.

Researchers also found that women who had mastectomies were at higher risk of dying from heart disease in the first three years after surgery than did women who’d had lumpectomies. Dr. Hwang suggests this may be because the women who’d had lumpectomies were generally in better health.

"The findings in this study should reassure women that among all age groups and tumor types, lumpectomy continues to be an excellent choice for women with small early breast cancers," said Dr. Hwang in a statement announcing the results of this study.

The study was published January 28 in CANCER, a peer-reviewed journal of the American Cancer Society.

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Review Date: 
January 27, 2013
Last Updated:
August 19, 2013