A mastectomy is often seen as the surest way to prevent breast cancer from returning.
But recent research shows that women live longer if only the tumor is removed instead of the entire breast.
Survival rates were better in patients who had a lumpectomy – which removes only cancerous tissue – plus radiotherapy, than in those who had a mastectomy (complete breast removal).
They also had a lower risk of complications.
The findings from British scientists could reduce the number of women undergoing mastectomy on the NHS in favor of less aggressive treatment.
A mastectomy is often seen as the surest way to prevent breast cancer from returning and around 15,000 women in Britain undergo the operation every year
Breast cancer is the most common form of the disease in Britain, with more than 55,000 new cases every year
About 15,000 women in Britain undergo the operation every year.
In addition to a higher risk of complications (such as infections and scarring), the surgery can also have a serious effect on women’s sex lives and mental health, even if they undergo breast reconstruction.
In addition, there are indications that the cancer can sometimes return. After a mastectomy, this usually happens in the lungs, liver, bones or brain. One theory is that this is because the major surgery has a significant impact on the body, suppressing the immune system and allowing any remaining tumor cells to multiply.
Breast cancer is the most common form of the disease in Britain, with more than 55,000 new cases every year.
Treatment usually begins with a lumpectomy, followed by radiotherapy or chemotherapy, or a mastectomy to remove one or both breasts, sometimes also followed by radiotherapy or chemotherapy.
But in the latest study, researchers from Bristol Medical School and Liverpool University Hospitals found that women who had a lumpectomy and radiotherapy lived longer overall than those who had one or both breasts removed. This was regardless of whether they had also received radiotherapy.
It also found that lumpectomy and radiotherapy led to better survival rates than mastectomy in women under 50.
The study, published in the British Journal of Surgery Open, used data from 35 studies involving more than 900,000 women over a period of 23 years.
The results are consistent with those from a larger study involving 1.5 million patients with early-stage breast cancer, published in the Annals of Surgical Oncology in 2022.
In this study, researchers from Tufts University School of Medicine in the US also found longer survival times in those who had a lumpectomy combined with radiotherapy, rather than a mastectomy.
The British team said the reasons are not clear, but improvements in radiotherapy, hormone treatments and immunotherapy (which boost the immune system to kill cancer cells) could be crucial as they allow tumors to be targeted precisely.
The new findings were welcomed by Professor Kefah Mokbel, chairman of breast surgery at the London Breast Institute, at the Princess Grace Hospital in London.
He told Good Health that this could lead to the number of NHS mastectomies halving in the future.
“The common perception of ‘peace of mind’ associated with mastectomy is unfounded,” says Professor Mokbel.
“By preserving breasts, we not only preserve quality of life, but we may also improve the quantity of life for patients.”
He said if the cancer returns, it is usually in the breast, and local recurrences can normally be treated with another lumpectomy.
But if the breast is removed, the cancer lodges elsewhere, which can make treatment more difficult and affect the outcome.
However, the professor said mastectomy may still be preferable for some patients, such as those with large or multiple tumors.
Statins reduce the risk of dying from breast cancer by 15 percent, according to American research published in the journal Cancer.
It showed that although the cholesterol-lowering pills did not reduce the risk of the cancer coming back, they did reduce the risk of dying from it if the cancer came back.
Animal studies show that statins may hinder the growth of tumor cells by lowering the cholesterol needed to make estrogen, which stimulates the growth of some breast tumors.