A
fter 20 years of monitoring, two studies can say that conservative surgery is as effective as a full breast removal.If these results are used to close the debate across the Atlantic, they appear in France as evidence over the past two decades. Thanks to Dr. Krishna Clough, a specialist of the Institute Curie.
Should we still resort to mastectomy for small tumors ? In his editorial, specialist in breast cancer, Dr. Monica Morrow believes that the two studies published simultaneously in the same issue of The New England Journal of Medicine should convince the most skeptical. But in France, the debate is closed long ago.
Towards surgery less traumatic
Long for women with breast cancer, mastectomy (removal of the breast) remained the mode of surgical care preferred. The belief that a broader operation was necessarily better prevailed in the USA until the years 1970-1980. The two major studies should end the debate across the Atlantic.
The study italienne has tracked 701 women diagnosed between 1973 and 1980 with a tumor less than 2 cm in diameter.
Spread into two groups, they have suffered either a radical mastectomy (removal of the breast) is a quadrantectomie (removal of the breast tumor and a significant part of the fabric around) followed by radiotherapy.
Since 1976, all patients received chemotherapy. After 20 years of monitoring, no differences were found in terms of recidivism on the other hand, metastases, overall survival or death by breast cancer.
The second etude has tracked 1 851 women with breast cancer less than 4 cm. Broken down into three groups, they have suffered either a total mastectomy or a lumpectomy alone (removal of the tumor with the fabric close) or a lumpectomy followed by radiation therapy.
Results after 20 years of follow-up: radiotherapy has reduced the number of local recurrences but no difference between the three groups has been observed in terms of survival without recurrence, metastasis-free survival or overall survival.
These two studies and argue in favour of the lumpectomy combined with radiation therapy.
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