When factoring in what is now known about breast cancer biology and heterogeneity, breast-conserving therapy (BCT) may offer a greater survival benefit over mastectomy to women with early-stage, hormone-receptor-positive disease, according to research from The University of Texas MD Anderson Cancer Center. The study findings defy the conventional belief that the two treatment interventions offer equal survival, and highlight the need to revisit some standards of breast cancer practice in the modern era. The research was presented on September 4, 2014 at the Breast Cancer Symposium 2014 (September 4-6) in San Francisco, California, by Catherine Parker, M.D., formerly a fellow at MD Anderson, and now at the University of Alabama-Birmingham. In the 1980s, both US-based and international randomized clinical studies found that BCT and mastectomy offered women with early-stage breast cancer equal survival benefit. However, those findings come from a period in time when very little was understood about breast cancer biology, explains Isabelle Bedrosian, M.D., associate professor, surgical oncology at MD Anderson. "Forty years ago, very little was known about breast cancer disease biology – such as subtypes, differences in radio-sensitivities, radio-resistances, local recurrence, and in metastatic potential," explains Dr. Bedrosian, the study's senior author. "Since then, there's been a whole body of biology that's been learned – none of which has been incorporated into patient survival outcomes for women undergoing BCT or a mastectomy. We thought it was important to visit the issue of BCT versus mastectomy by tumor biology," Dr. Bedrosian stated. The researchers hypothesized that they would find that patients' surgical choice would matter and impact survival with tumor biology considered.
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