More than 200,000 women are diagnosed with early-stage breast cancer annually.
These women are then faced with a multitude of treatment decisions, one of which is to have a mastectomy or lumpectomy.
A mastectomy is a surgery to remove all breast tissue from the breast as a way to treat or prevent breast cancer. A lumpectomy is a breast conserving surgery where only the tumor and some surrounding tissue is removed.
Most women who are diagnosed with a stage 1 or 2 breast tumor that is not highly aggressive are offered both surgical options and left to decide which is best for their particular situation.
Evidence indicates that breast cancer patients who have mastectomies face the same survival odds as those who have lumpectomies along with breast radiation. For the past few decades, oncologists have been encouraging women with early-stage breast cancer to opt for the less radical surgery.
An expert panel convened by the National Cancer Institute declared in 1990 that lumpectomy with radiation was “preferable” to mastectomy for women with stage 1 or 2 breast cancer. This declaration helped drive down mastectomy rates for these patients from 100% in the 1980s to less than 40% today.
However, experts have recently noticed an increase in mastectomies. A 2014 study found that the percentage of those with early-stage breast cancer increased from 34% in 1998 to 38% in 2011.
Experts are unable to explain the reasons for the increase.
Several developments over the years may have contributed. Improvements in breast reconstruction following mastectomy provide patients with more natural looking results than in past decades. In addition, more breast cancer patients are also getting insurance coverage for the procedure, thanks to a 1998 federal law mandating coverage.
It is important that oncologists move away from forcing women to make this decision on their own. This needs to be a shared decision-making process, which entails a more in-depth discussion of the pros and cons of both surgeries.