Mastectomies not necessary, says study

Any woman concerned that she may be about to have an unnecessary mastectomy should talk to her consultant immediately, the Irish Cancer Society said yesterday.

This advice followed the results of two international studies, which found no difference in the survival rates between women who had a full breast removed, and those who had just the tumour removed.

The results were published in this week's New England Journal of Medicine. The studies, in Pittsburgh and Milan, showed similar death rates after 20 years for 2,552 women who underwent mastectomies and lumpectomies (tumour removal).

In an editorial in the journal, breast cancer specialist Dr Monica Morrow said the findings should convince "even the most determined sceptics that mastectomy is not superior to breast conservation".

She said women must be informed of the availability of breast-conserving surgery and its suitability. "Is is time to declare the case against breast conserving therapy closed," Dr Morrow said.

Ms Geraldine Gleeson, nurse manager of the Irish Cancer Society's helpline said the society expected an increase in phone calls from concerned women, following the release of the findings.

She said the most important thing was to ensure that women were fully informed about all their options before deciding on a course of treatment.

Women who are concerned should discuss their fears with their consultant or breast care nurses so they are comfortable with the choice of treatment, Ms Gleeson said.

In some cases, avoiding a mastectomy may not be possible because of the tumour's size or position, or because of the aggressive nature of the cancer. However, women must be fully informed of these reasons, she said.

"If a mastectomy is mentioned, women should ask if it is absolutely necessary and if so, why? They should ask if breast reconstruction is possible at the same time and if not, why?" she said. In cases where further treatment such as chemotherapy is planned, reconstruction may not be possible.

"Women can be so traumatised and distressed when they are with their consultant that these questions may not occur to them until afterwards," Ms Gleeson said.

Radical mastectomies, which involve the removal of the muscle and tissue as well as the breast, were more common 20 years ago, "but thankfully they are practically extinct now", she said.

These mastectomies were "extremely traumatic" for patients. "But anti-cancer treatments have improved so much in recent years," Ms Gleeson said.

In Britain, a group of women are taking legal actions against surgeons for mastectomies, which they claim were unnecessary. One case has already been settled out of court.

There are more than 1,700 new cases of breast cancer diagnosed in this State each year and women have a one in 13 chance of developing breast cancer in their lifetime. Age increases the risk of cancer, with about 80 per cent of breast cancers occurring in women over 50 years old.

The Irish Cancer Society's Action Breast Cancer helpline number is 1800 30 90 40 while the main helpline number is 1800 200 700.