Mastectomy or lumpectomy? New study could help women decide

(CBS News) Women diagnosed with breast cancer can face a tough decision: whether to have a mastectomy or lumpectomy.

A new study out Monday by researchers at Duke Medicine says patients with early-stage breast cancer who are treated with lumpectomy and radiation have a better chance.

Fifty-year-old college professor Toni Spring was diagnosed last June with early-stage breast cancer. After consulting with two surgeons, she scheduled a double mastectomy.

"They take a marker, and they mark up your whole body, and you just -- it's a very, very, like -- it puts it into reality that you're getting carved up and getting re-attached and all kinds of things," Spring says.

Just before surgery, Spring decided to have a third consultation with Dr. Freya Schnabel of NYU Langone Medical Center, who encouraged her to consider a less invasive option: a lumpectomy -- in which only a small portion of the breast is removed -- plus radiation treatment.

"It made me feel very empowered that I really had a decision, where before I really didn't think I had such a decision," Spring says.

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The study of more than 112,000 women with early-stage breast cancer included patients such as Spring who are 50 and over and have tumors fueled by hormones. Those women were 14 percent less likely to die from breast cancer after lumpectomy and radiation than after mastectomy.

"I think it's particularly important today, when there has been an observed trend in America over the last few years of an increase in the rate of women having mastectomies, even if their breast cancers were suitable for treatment with breast-conserving surgery," Schnabel says.

The rate of mastectomies has increased as much as two percent each year since 2000, even though previous research found the two approaches had equivalent outcomes.

"I think that sometimes patients think that because a mastectomy is a bigger operation, that it means that it's a better treatment," Schnabel says. "And even though they would prefer, perhaps, a lumpectomy, their sense is that it's a better treatment and they opt in that direction."

Dr. Schnabel says some women with early breast cancer may choose to get a mastectomy for various reasons, such as a strong family history, not wanting to undergo frequent breast surveillance. But she said these women should understand that mastectomy is not giving them a better chance for a cure.

  • Jonathan LaPook

    Dr. Jonathan LaPook is the medical correspondent for the CBS Evening News. Follow him on Twitter at @DrLaPook

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