This study presents very important information for patients who have been or would be forced to have a mastectomy upon recurrence. It showed that salvage treatment of the recurrence using lumpectomy was approximately equal to radical mastectomy in terms of survival.
Dr. Daesung Lee of the Department of Therapeutic Radiation, Yale, said the best candidates for salvage lumpectomy are women with initial estrogen-receptor (ER) positive status, a node-negative status for the axilla, tumor size smaller than 1 cm at recurrence, and a recurrence diagnosed by mammography alone.
In this retrospective study, 1152 consecutive patients were treated with conservative surgery and radiation at Yale New Haven Hospital. Dr Lee said that women with these favorable characteristics had less than a 15-percent chance of requiring radical mastectomy at the time of recurrence.
The study showed there was no statistically significant difference in outcomes between women who had a radical mastectomy for recurrence and those who had lumpectomy, with respect to age, stage or other prognostic factors
A follow-up of 16 years from initial presentation and 10 years since recurrence demonstrated 82 percent survival for salvage mastectomy and 73 percent for lumpectomy salvage. This is NOT statistically significant.
There were also no statistically significant differences between distant metastatic survival (78 percent for
mastectomy salvage, 58 percent lumpectomy salvage) or cause-specific survival (90 percent versus 78 percent).
Ann's NOTE: I was presented with the demand by my surgeon to have a "salvage" mastectomy". I did not want to, in part because of the horrible terminology. Why don't doctors realize that how they say things matter to us? I consider this an excellent study because the results MATTER to us.
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