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Study: Mastectomy often not necessary
©Associated Press BOSTON -- Twenty years of followup research on women with breast cancer has offered powerfully reassuring confirmation that cutting out just the lumps can save as many lives as mastectomies. Dr. Monica Morrow, a Northwestern University breast cancer specialist, said the findings should convince "even the most determined skeptics." "It is time to declare the case against breast-conserving therapy closed," she said. Her editorial was published today with two studies in the New England Journal of Medicine. The studies, one Italian and one American, showed similar death rates after 20 years for large groups of women who underwent mastectomies or breast-saving surgery. Mastectomy, or removal of the breast, was the surgery of choice for most of the 20th century. In the 1980s, largely on the strength of early data from these two studies, many doctors began to suspect that in women whose tumors have not spread, mastectomy works no better than cutting out only the diseased tissue. The two landmark studies changed the way many surgeons treated breast cancer. By the end of the 1980s, the less-disfiguring procedure, often called a lumpectomy, was widely accepted on an equal footing with mastectomy for cancer that had not spread. Still, breast-saving surgery is not always offered to women who are potential candidates. The researchers behind the latest findings hope to change that. The researchers at the European Institute of Oncology in Milan, Italy, split 701 women into two groups: One got mastectomies; the other got lumpectomies with radiation treatments. In the end, about a quarter of each group died of breast cancer over 20 years. The American study of 1,851 women, backed by the government and run at the University of Pittsburgh, also found little survival differences between two similar groups. A third group that underwent lumpectomy without radiation also survived as well as others, though they developed recurrent cancer on the same side more often than women who got radiation. Researchers say survival remains unaffected by the kind of surgery because it turned out that breast cancer is fundamentally a systemic disease, not one that simply spreads from an initial site. Systemic treatments, like chemotherapy, have increasingly been used in recent years. In a 1999 survey by the American College of Surgeons, 57 percent of 145,681 operations for breast cancer were lumpectomies, and the rest were mastectomies. The sample included 1,480 hospitals. The lead author at Pittsburgh, Dr. Bernard Fisher, said many women who could have undergone more narrow surgery have chosen mastectomies on the theory that you "get it out, and you're not going to have any trouble." But he said the evidence clearly shows no survival advantage. A shadow spread over the American study in 1994 when a small fraction of data provided by a researcher in Canada was exposed as fake. However, the National Cancer Institute later cleared Fisher of misconduct and determined that the bad data did not change the findings. Study debunks myth over breast cancer, deodorantWASHINGTON -- A new study, prompted by an urban myth spread on the Internet, shows there is no evidence that antiperspirants or deodorants can cause breast cancer. The study, appearing this week in the Journal of the National Cancer Institute, examined the personal hygiene habits of 813 women with breast cancer and 793 women without the disease and found no link between cancer and body odor control cosmetics. Dana Mirick, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, said the rumor started more than 10 years ago, probably from a widely distributed, anonymous e-mail.
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