An increasing number of American women choose mastectomy instead of lumpectomy when they suffer from early stage cancer. Full breast removal is a radical option during the early stages of the disease. Medical researchers suggest that lumpectomy (tumor removal) provides similar results while being a safer procedure.
A team of researchers looked at a large dataset on the matter covering the 1998-2011 period. In the 1980s, researchers found that lumpectomy is a reliable alternative to mastectomy if the disease is rapidly detected. Since the 1990s, the procedure was adopted at increasing rates.
But the study led by Kristy L. Kummerow, M.D., of Vanderbilt University Medical Center, Nashville, Tenn. shows that the rate of women choosing mastectomy is higher than expected.
Researchers analyzed 1.2 million cases from the National Cancer Data Base. Overall, 35 percent of the women who had the chance to choose one of the two procedures went for full breast removal. The rate went up from 34.3 percent in 1998 to 37.8 in 2011.
While younger women favored mastectomy, older women preferred the radical approach when the tumor was larger than 2 cm. In that period, the number of breast reconstructions went up. Just 11 percent of the women had their breasts reconstructed in 1998, while the rate went up to 36 percent in 2011.
If only one breast contained cancerous tissue, the odds of women choosing mastectomy was 2 percent in 1998. The rate rose to about 11 percent in 2011.
“Our finding of still-increasing rates of mastectomy, breast reconstruction and bilateral mastectomy in women with early-stage breast cancer using 14 years of data from the NCDB has implications for physician and patient decision making as well as quality measurement. Further research is needed to understand patient, provider, policy and social factors associated with these trends,” according to the authors.
Why more women chose mastectomy instead of lumpectomy is not known. Some women may prefer symmetry, while others may be influenced by the fact that they had breast cancer running in the family. Although the range of reasons may be much larger, researchers claim that women should be fully informed on the consequences of both procedures when making a choice.
Kummerow said they cannot tell what the future trend will look like. But she underscored the importance of having clear data on the trend. The new information can guide practitioners and policy makers in the effort to improve health care services.
The study was published in JAMA Surgery.