Mastectomy is often considered the safest way to prevent breast cancer from coming back.
But the latest research suggests that women live longer if just the tumor is removed rather than the entire breast.
Survival rates were better among patients who had a lumpectomy (in which only cancerous tissue is removed) plus radiation therapy than among those who had a mastectomy (complete removal of the breast).
They also had a lower risk of complications.
The findings, by UK scientists, could reduce the number of women undergoing mastectomies on the NHS in favor of less aggressive treatment.
Mastectomy is often considered the safest way to stop breast cancer from recurring and around 15,000 women each year in the UK undergo this operation.
Breast cancer is the most common form of the disease in the UK, with more than 55,000 new cases a year.
Around 15,000 women each year in the UK undergo this operation.
In addition to an increased risk of complications (such as infections and scarring), surgery can also have a serious effect on women’s sex lives and mental health, even if they undergo breast reconstruction.
Also, some evidence suggests that cancer can sometimes come back. After a mastectomy, this usually occurs in the lungs, liver, bones, or brain. One theory is that this is because major surgery has a significant impact on the body, suppressing the immune system and allowing remaining rogue tumor cells to proliferate.
Breast cancer is the most common form of the disease in the UK, with more than 55,000 new cases a year.
Treatment usually begins with a lumpectomy, followed by radiation therapy or chemotherapy, or a mastectomy to remove one or both breasts, sometimes followed by radiation therapy 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 also received radiotherapy.
It also found that lumpectomy and radiotherapy led to better survival rates than mastectomy in women under 50 years of age.
The research, published in the British Journal of Surgery Open, used data from 35 studies involving more than 900,000 women over a 23-year period.
The results echo those of 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 at Tufts University School of Medicine in the US also found longer survival times in those who had a lumpectomy along with radiation therapy, rather than a mastectomy.
The UK team said the reasons are unclear, but that improvements in radiotherapy, hormonal treatments and immunotherapy (which stimulates the immune system to kill cancer cells) may be key, allowing tumors to be attacked more effectively. precision.
The new findings were welcomed by Professor Kefah Mokbel, chair of breast surgery at the London Breast Institute, at Princess Grace Hospital, London.
He told Good Health this could lead to the number of NHS mastectomies being halved in the future.
“The common perception of ‘peace of mind’ associated with mastectomy is unfounded,” said Professor Mokbel.
“By preserving breasts, we not only maintain quality of life but also potentially improve patients’ quantity of life.”
He said if cancer comes back it is usually in the breast, and local recurrences can usually be treated with another lumpectomy.
But if the breast has been removed, the cancer settles 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.
This showed that while cholesterol-lowering pills did not reduce the risk of the cancer coming back, they did reduce the chances of dying from it if it came back.
Animal studies show that statins can prevent the growth of tumor cells by reducing the cholesterol needed to produce estrogen, which drives the growth of some breast tumors.