West U. Doctor Finds Mastectomy Procedure Helps Only Some Breast Cancer Patients
A West University Place doctor who works at the M.D. Anderson Cancer Center recently co-published research results that show that a certain mastectomy procedure used to combat breast cancer will only offer survival benefits to some women, not all breast cancer patients.
Dr. George Chang, who lives in the 2900 block of Cason Street in West U., worked with Dr. Isabelle Bedrosian on a population-based study about contralateral prophylactic mastectomy, a preventive procedure to remove the unaffected breast in patients with cancer in just one breast. The researchers found that the procedure will only help patients age 50 and younger, who have the early-stage disease and are estrogen receptor negative.
Chang and Bedrosian recently published their results in the Journal of the National Cancer Institute. The findings should offer evidence to both the women making this often agonizing decision and the physicians responsible for their care.
“In our clinic, we’ve seen a dramatic increase in the number of women requesting [contralateral prophylactic mastectomy], and across the breast cancer community, studies have shown that the utilization of the procedure is skyrocketing,” said Bedrosian, assistant professor in M. D. Anderson’s Department of Surgical Oncology. “Until now, we’ve counseled these patients on a very important, personal decision in a vacuum. With our study, our goal was to understand the implications of the surgery and who may benefit.”
The researchers used a national cancer registry to identify 107,106 patients who underwent a mastectomy for treatment, as well as a subset of 8,902 women who had contralateral prophylactic mastectomy. Chang said they carefully designed their study to consider all types of factors that would affect survival benefits of the procedure.
“All alternative analyses resulted in the same conclusion; we found one group for whom this surgery offers a true survival benefit,” Chang said.
That survival benefit is for a select group of women that represents less than 10 percent of the breast cancer population. Those younger than age 50 with stage I or II cancer with estrogen receptor negative disease had a survival benefit of 4.8 percent at five years. However, both Bedrosian and Chang expect that future research will show increased survival benefit with longer follow-up in the population, as a patient’s likelihood of getting a second breast cancer increases with time.
While the findings should serve as a guideline for breast cancer patients and their physicians to have an informed, medically-based discussion about the procedure, they do not determine that it is medically inappropriate for all others with the disease, said the researchers.
In addition to Bedrosian and Chang, Chung Yuan Hu in the Department of Surgical Oncology, also authored the all-M. D. Anderson study.