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Study: Mastectomy and Lumpectomy Equally Effective
Aired October 17, 2002 - 14:49 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CAROL LIN, CNN ANCHOR: And now let's talk about a long-time debate in the medical community.
What's the best treatment for women with breast cancer? Mastectomy or lumpectomy? The results of two 20 year studies published in "The New England Journal of Medicine" say one option is as effective as the other.
That is good news for proponents of breast conserving therapy.
Dr. Carina Biggs is joining us right now to talk a little bit more about this. She is the chief of breast surgery at Maimondes Medical Center in Brooklyn, New York.
Good afternoon, doctor.
DR. CARINA BIGGS, MAIMONDES MEDICAL CENTER: Good afternoon.
LIN: So what does this study mean?
BIGGS: Well, this is a study which has confirmed what we have known for several years, which is that breast conservation is equivalent to mastectomy in terms of survival from breast cancer.
LIN: Equivalent in all cases?
BIGGS: Equivalent in terms of survival from breast cancer.
LIN: But not necessarily if there are multiple -- if there are multiple lumps found in one breast, right?
BIGGS: Absolutely. Absolutely. Those patients who are candidates or who are considering breast conservation need to be selected carefully. Those women who have cancer which involves several portions of the breast may not do so well with breast conservation and may favor the mastectomy.
So, when we talk about what you're referring to as a local recurrence, those women who undergo lumpectomy with radiation have a somewhat higher likelihood of cancer recurring. Those women who undergo mastectomy have a lower likelihood of cancer recurring.
But the overall survival in those two groups is the same.
LIN: That is remarkable. That is remarkable. I'm just wondering why is it that women are typically not told of this option, then, when they're diagnosed? BIGGS: Well, women -- all women should be told of the option of conservation and should be carefully assessed so that they can be considered for their candidacy as conservation candidates.
LIN: But why is it that most women are not? Because I believe that was part of the survey, that most women were not given that option and, therefore, did not consider that option and perhaps now are learning they had a mastectomy unnecessarily.
BIGGS: Well, breast conservation hasn't been embraced by all members of the medical community at the present time. Those physicians who take care of a lot of breast cancer patients do accept conservation as an acceptable approach.
LIN: Is it a liability issue? Is it -- is it safer and cleaner and more thorough to simply remove the whole breast? Is that generally how it's perceived?
BIGGS: No, not at all. As long as -- as long as a patient who undergoes a lumpectomy has a clear margin and undergoes radiation, her recurrence is low. It's on the order of 10 percent.
LIN: How do you usually handle this in your dialogue with your patients, when they're diagnosed?
BIGGS: Well, it's very important for us to do a clinical assessment, to examine the patient and assess the size of the tumor in relation to the size of the breast.
Mammography is very important because mammography can show us things that we can't feel on physical examination. So a lady may have what appears to be a small mass on clinical examination.
However, she may have an abnormality or two in a separate quadrant of the breast and if on biopsy that turns out to be a malignancy, that lady may have a higher local recurrence if she elects conservation and may be a better candidate to consider mastectomy.
LIN: Doctor, in several -- in several different states it's required by law that women are given this option. Would you support that for all 50 states?
BIGGS: I think women should be told of the option, but selection for conservation is still a consideration. Not all women are candidates for conservation.
LIN: All right. Good to know and good to know that you can ask those questions of your doctor.
Thank you very much, Dr. Carina Biggs for joining us today.
BIGGS: My pleasure.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired October 17, 2002 - 14:49 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
CAROL LIN, CNN ANCHOR: And now let's talk about a long-time debate in the medical community.
What's the best treatment for women with breast cancer? Mastectomy or lumpectomy? The results of two 20 year studies published in "The New England Journal of Medicine" say one option is as effective as the other.
That is good news for proponents of breast conserving therapy.
Dr. Carina Biggs is joining us right now to talk a little bit more about this. She is the chief of breast surgery at Maimondes Medical Center in Brooklyn, New York.
Good afternoon, doctor.
DR. CARINA BIGGS, MAIMONDES MEDICAL CENTER: Good afternoon.
LIN: So what does this study mean?
BIGGS: Well, this is a study which has confirmed what we have known for several years, which is that breast conservation is equivalent to mastectomy in terms of survival from breast cancer.
LIN: Equivalent in all cases?
BIGGS: Equivalent in terms of survival from breast cancer.
LIN: But not necessarily if there are multiple -- if there are multiple lumps found in one breast, right?
BIGGS: Absolutely. Absolutely. Those patients who are candidates or who are considering breast conservation need to be selected carefully. Those women who have cancer which involves several portions of the breast may not do so well with breast conservation and may favor the mastectomy.
So, when we talk about what you're referring to as a local recurrence, those women who undergo lumpectomy with radiation have a somewhat higher likelihood of cancer recurring. Those women who undergo mastectomy have a lower likelihood of cancer recurring.
But the overall survival in those two groups is the same.
LIN: That is remarkable. That is remarkable. I'm just wondering why is it that women are typically not told of this option, then, when they're diagnosed? BIGGS: Well, women -- all women should be told of the option of conservation and should be carefully assessed so that they can be considered for their candidacy as conservation candidates.
LIN: But why is it that most women are not? Because I believe that was part of the survey, that most women were not given that option and, therefore, did not consider that option and perhaps now are learning they had a mastectomy unnecessarily.
BIGGS: Well, breast conservation hasn't been embraced by all members of the medical community at the present time. Those physicians who take care of a lot of breast cancer patients do accept conservation as an acceptable approach.
LIN: Is it a liability issue? Is it -- is it safer and cleaner and more thorough to simply remove the whole breast? Is that generally how it's perceived?
BIGGS: No, not at all. As long as -- as long as a patient who undergoes a lumpectomy has a clear margin and undergoes radiation, her recurrence is low. It's on the order of 10 percent.
LIN: How do you usually handle this in your dialogue with your patients, when they're diagnosed?
BIGGS: Well, it's very important for us to do a clinical assessment, to examine the patient and assess the size of the tumor in relation to the size of the breast.
Mammography is very important because mammography can show us things that we can't feel on physical examination. So a lady may have what appears to be a small mass on clinical examination.
However, she may have an abnormality or two in a separate quadrant of the breast and if on biopsy that turns out to be a malignancy, that lady may have a higher local recurrence if she elects conservation and may be a better candidate to consider mastectomy.
LIN: Doctor, in several -- in several different states it's required by law that women are given this option. Would you support that for all 50 states?
BIGGS: I think women should be told of the option, but selection for conservation is still a consideration. Not all women are candidates for conservation.
LIN: All right. Good to know and good to know that you can ask those questions of your doctor.
Thank you very much, Dr. Carina Biggs for joining us today.
BIGGS: My pleasure.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
