Monday, August 24, 2015

WOMEN'S HEALTH - Breast Cancer, Early Treatment or Not?

"Study raises questions about treatment for early breast cancer" PBS NewsHour 8/20/2015


SUMMARY:  A new study has found that women who received lumpectomies and mastectomies for very early stage breast cancer had similar survival rates to those who had less radical treatments.  Dr. Steven Narod of the Women's College Research Institute and Dr. Monica Morrow of Memorial Sloan Kettering Cancer Center discuss the findings with Judy Woodruff.

JUDY WOODRUFF (NewsHour):  There was other big news today related to cancer.

A study published in “The Journal of the American Medical Association Oncology” found that women given lumpectomies and mastectomies as treatment for very early-stage breast cancer had similar survival rates to those patients who had less radical cancer treatments.  Those findings may call into question some of the standard assumptions on how to treat the disease.

For a closer look at the study and its potential implications, we turn to two cancer specialists.  Dr. Steven Narod is a researcher at the Women’s College Research Institute in Toronto.  He was the study’s lead author.  And Dr. Monica Morrow is chief breast cancer surgeon at Memorial Sloan Kettering Cancer Center in New York City.

Dr. Morrow, Dr. Narod, welcome to you both.

I’m going to start with you, Dr. Narod.

On this study, we did read that it’s the most extensive collection of data ever analyzed on this particular type of cancer.  Boil down the findings for us.

DR. STEVEN NAROD, Women’s College Research Institute:  We focused on 100,000 women with the earliest form of cancer.  Some say it’s not even cancer.  It’s a precursor lesion.  We call it DCIS, or ductal carcinoma in situ.

So, this, because it’s a very good prognosis, we followed the 100,000 women for up to 20 years and we found that, at 20 years, about 3 percent of them had died of breast cancer.  Roughly a third of the patients were treated with lumpectomy alone, which is removing the DCIS, the focus of cancer.  One-third of the patients, probably, had a lumpectomy plus radiotherapy, and one-third of the patients approximately had the entire breast removed through mastectomy.

And what we found, that there was no difference in the survival at 20 years between women treated with any of the three ways.

JUDY WOODRUFF:  What is the — you said one-third, one-third, one-third.  What do these findings tell you that the treatment should be?

DR. STEVEN NAROD:  Well, it tells us about — something about the early stages of breast cancer.

The reason I say that is because, of those 3 percent of the women who died of breast cancer, most of them, 54 percent of them, between the time they had DCIS and the time they had a distant recurrence or a metastatic disease, never experienced another breast — cancer in the breast.

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