A mastectomy may not automatically be required for women with multiple tumors in the same breast, new research shows.
Historically, women with multiple tumors in one breast have been advised to have the breast removed. Now they can be offered a less invasive option with faster recovery, Dr. Judy Boughey of the Mayo Clinic in Rochester, Minnesota, who led the research, said in a statement.
Her team studied 204 women over age 40 with two or three early-stage cancers in a single breast who were interested in avoiding mastectomy. The women had lumpectomies to remove the tumors, followed by whole-breast radiation plus extra radiation targeted to each lumpectomy site.
Over the next five years, 3% of the women had local recurrences, a rate similar to patients with a single tumor in a breast who have breast-conserving therapy, the researchers reported on Tuesday in the Journal of Clinical Oncology.
Most of the patients were postmenopausal, with estrogen receptor (ER)–positive/human epidermal growth factor receptor 2 (HER2)–negative breast cancer and with two sites of disease. None of those characteristics was predictive of recurrence, researchers said.
There was, however, a significantly higher recurrence rate in the 15 women who had not had an MRI exam before surgery. In this group, the five-year local recurrence rate was 22.6%, compared with 1.7% in the larger group of women who did have preoperative MRIs to confirm the extent of their cancer.
An MRI before surgery should be considered to ensure there is not more extensive disease, Dr. Boughey said.
"Some patients may still prefer or require a mastectomy, and that is a perfectly fine approach," she added. "But being able to provide more patients diagnosed with breast cancer with a choice is a great step forward."
This newsletter was edited by Bill Berkrot. Additional reporting by Shawana Alleyne-Morris.
