Mastectomy May Be an Inferior Oncologic Approach Compared to Breast Preservation

Multiple randomized studies have demonstrated that breast-conserving therapy (partial mastectomy plus whole breast radiation) can yield survival outcomes equivalent to those of mastectomy (1). However, newer population-based data suggest that breast cancer–specific survival and overall survival with breast-conserving therapy may actually be better than those with mastectomy (2-8). How is this possible? How can removal of the breast yield outcomes inferior to those of a therapy that leaves most of the breast intact and where in-breast failures are reported to occur in approximately 5% to 10% of patients at 10 years posttreatment in historical series (1) (albeit with lower rates over time (9), especially in favorable patients (10))?

https://ift.tt/2Qpj127