Breast cancer surgery has undergone many transformations over the years. Radical mastectomy (removal of all breast tissue and axillary or underarm lymph nodes) was the treatment of choice for the early-to-mid 20th century.
But radical mastectomies were disfiguring operations fraught with many long-term complications. Later in the 20th century, surgeons tried less-invasive breast cancer operations and found equivalent outcomes.
In the Journal of the American Medical Association, researchers randomized subjects to determine the 10-year survival of breast cancer patients with lymph node metastases treated with lumpectomy and removal of one sentinel lymph node.
Specifically, they studied whether that course of action was inferior to women treated with full axillary dissection (mastectomy). The researchers found no significant difference in survival for women treated with the two procedures.
The accompanying editorial stated, “Less can be more in clinical medicine.”
Just because there’s a consensus in medicine does not make it correct. In this study, women with breast cancer had no better survival when they received much harsher treatments.
Currently, one in seven American women is suffering from breast cancer. We need appropriate studies to determine why that is the case.
Most studies, such as this one, only measure treatment outcomes. If you are faced with surgery for breast cancer, it is important to have a dialogue with your surgeon.
Depending on the type of tumor you have, you may not need more radical surgery.
If you do not feel you are receiving the appropriate answers from your surgeon, there is nothing wrong with getting a second opinion.
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