For analysis, the closest margins of the lumpectomies
and excisional biopsies were stratified into the groups: positive, less than 1 mm, 1 to 2 mm, and greater than 2 mm.
It is not clear in this study whether all of these tumours were resected en bloc, hence removing interpositioning tumour, or whether multiple lumpectomies
were done with the risk of leaving disease in between the various tumour foci.
The doctors who conducted this survey found that doctors recommended mastectomies to 45% of women who could have been treated successfully and safely with lumpectomies
. The lesson in this study applies to numerous conditions.
Surgeons strove to preserve as much as possible of even diseased breasts, opting for lumpectomies
whenever they could; general practitioners sometimes steered the small-breasted toward help.
Published in the medical journal Cancer, the report suggested that it was even possible that those with lumpectomies
might have a slightly greater five-year survival rate than the mastectomy subjects.
Peggie Findlay, breast-cancer radiology specialist for NCI, is undertaking an extensive research study that will randomly assign half of newly diagnosed female breast-cancer patients to lumpectomies
with radiation and the other half to mastectomies.
Among the mutation carriers, 31.3% opted for lumpectomies
, whereas 59.4% chose double mastectomies and one in eight decided to undergo ovary removal surgery.
The study cohort consisted of 730 lumpectomies
performed in 708 patients.
Another surgeon observed that if the more generous lumpectomies
that are now standard had been the norm in the 1990s when study participants had their surgery, their locoregional recurrence rate with tamoxifen alone would likely be even lower than it was in the study.