THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Friday, April 7, 1995 TAG: 9504070538
SECTION: FRONT PAGE: A4 EDITION: FINAL
SOURCE: NEWSDAY
LENGTH: Medium: 54 lines
One hundred years after the establishment of radical mastectomy as the preferred treatment for breast cancer, two studies add more evidence that the procedure is unnecessary in most cases.
The new data published in Thursday's New England Journal of Medicine show that chemotherapy and radiation continue to save lives many years after the treatment.
In one of the studies, lumpectomy with radiation continues to prolong lives 10 years after treatment as well as mastectomy. The other study showed that women who received chemotherapy after surgery for their cancers had better survival rates than those who didn't, even 20 years after the treatment.
Together, the two studies chip further at the assumption that extensive surgery is the way to stop breast cancer's spread, an assumption that has prevailed for the last century.
The success of modest surgery - lumpectomy takes only the tumor and the tissue around it - and radiation and chemotherapy seems to indicate that breast cancer spreads through the bloodstream rather than into adjacent tissue, so radical surgery at the source may be unnecessary.
``We're not seeing any differences after 10 years, and we're not seeing any marked change to lead us to expect any further changes drastically after 20 years,'' said Dr. Joan Jacobson, a radiation oncologist at the National Cancer Institute in Bethesda, Md., and the principal investigator in the lumpectomy study.
In Jacobson's study of 240 women, 72 percent of the patients who had a lumpectomy and radiation were disease-free after 10 years, compared with 69 percent of mastectomy patients.
The study underlines other findings that a recurrence of cancer in the breast has little effect on survival. One in five lumpectomy patients had a recurrence, but they then had mastectomies and most are now cancer-free. The proportion of women who had a recurrence of cancer in nearby tissue was the same for both lumpectomy and mastectomy patients, about 10 percent.
The other study, by Dr. Gianni Bonnadonna of the Istituto Nazionale Tumori in Milan, Italy, is a 20-year follow-up to studies published in the 1970s showing that chemotherapy, which attacks cancer cells throughout the body, improves survival.
After two decades, the women who had chemotherapy had a 26 percent better chance of surviving than those who didn't, indicating that patients can die even when surgery has stopped the cancer at its original site. by CNB