Breast cancer study: Women may be happier long-term with conservative surgery

Health News

ALBANY, N.Y. (NEWS10) – Having a mastectomy could affect a young woman’s satisfaction with life. Breast cancer survivors between the ages of 17-40 reported a lower quality of life, after either a partial or full mastectomy, according to a study by the National Cancer Institute (NCI).

The study included the answers of 560 young women asked questions about their mental, sexual and physical (breast) well-being. Women who had conservative surgical treatment reported higher satisfaction in all areas than those who had more aggressive treatments.

“Young women with early-stage breast cancer need to plan for their life after cancer. We have known for a while that lumpectomy is just as good as mastectomy for treating the cancer,” said Dr. Sarah Pesek, a breast surgical oncology specialist with St. Peter’s Breast Surgery.

Women ranked their satisfaction from one to 100 in three areas: breast satisfaction, psychosocial and sexual well-being. The average score in all three categories, for women who had conservative breast surgery, was between 57.4-65.5. For women who had a bilateral mastectomy with radiation, the average drops from 46.2-55.8.

Questions regarding breast satisfaction included finding out how women felt about how they feel, how they look, and how well they match. Other questions asked about their confidence in social settings, emotional health and self-esteem, NCI said.

The chart below shows the score for each category based on the type of treatment women received.

Breast satisfactionPsychosocial well-beingSexual well-being
Conservative breast surgery65.575.957.4
Unilateral mastectomy64.375.256.6
Bilateral mastectomy6471.351.4
Unilateral mastectomy with radiation54.666.150.4
Bilateral mastectomy with radiation55.865.146.2
Source: National Cancer Institute

“This study tells us that lumpectomy may be even better than mastectomy for long-term quality of life. Doing everything they can – meaning bilateral mastectomy – may be too much treatment, especially when the woman does not have a genetic predisposition,” Dr. Pesek said.

Because women who participated in the study had gotten treatment through a university hospital, Dr. Gabriel Kaufman, who specializes in breast cancer surgery at St. Peter’s Health Partners, said the study may not capture the whole picture – but he agrees that women can benefit from conservative breast surgery.

Dr. Kaufman said there have been many other studies, besides the one published on the NCI website, that shows the sexual well-being and self-esteem of women who opt for breast conservation surgery is greater than that of women who opt for a unilateral or bilateral mastectomy.

There is a sharp divide between his patients under or over 40, according to Dr. Kaufman. He said patients under 40 overwhelmingly chose conservative surgery, while his patients over 40 are more likely to choose a mastectomy.

Survival rates for patients who get conservative surgery versus a mastectomy are the same. However, there is a slightly higher chance of reoccurrence in women who opted for conservative surgery. What matters to him, Dr. Kaufman said, is that his patients make educated decisions.

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