One in five breast cancer victims who refuse mastectomy need second operation

By
Sophie Borland

19:22 EST, 12 July 2012

|

02:08 EST, 13 July 2012

Thousands of breast cancer patients who refuse to have a mastectomy – and instead opt for a less drastic operation – will need further surgery to remove tumours, a study reveals.

Researchers found that a fifth of women who have a form of surgery which does not take away their entire breast will need a second operation.

They warn that the treatment causes women added ‘emotional distress’ during what is already a very upsetting time.

And the ordeal of having a second operation will further delay their recovery and return to normal life.

'Emotional distress': Thousands of breast cancer patients who refuse to have a mastectomy may need further surgery, researchers say. (File photograph)

‘Emotional distress’: Thousands of breast cancer patients who refuse to have a mastectomy may need further surgery, researchers say. (File photograph)

Many women with the illness choose to have only a small section of affected tissue taken out – a process known as ‘breast conservation surgery’.

A mastectomy – where the whole breast is taken away – may better ensure tumours are removed.

More than half of the women who are diagnosed with breast cancer in England opt for breast conservation surgery.

It has become increasingly widespread in recent years due to the development of better scans and improved surgery techniques.

Researchers from the London School of Hygiene and Tropical Medicine looked at 55,297 women who had undergone this procedure between 2005 and 2008.

Disease: About 45,000 women are diagnosed with breast cancer in England every year. (File photograph)

Disease: About 45,000 women are diagnosed with breast cancer in England every year. (File photograph)

They found a total of 11,032 had needed a second operation because the first had not completely removed the tumours.

And of these, around 40 per cent had to have their entire breast  taken out.

The researchers believe that surgeons are not always removing enough of the affected tissue.

This is partly because there are no proper guidelines telling them exactly how much should be removed. In addition it can be difficult for them to know exactly how widespread the tumours are.

Their study, published in the British Medical Journal, urges them to ‘review their technique’ to avoid women unnecessary distress.

It adds: ‘Reoperation also puts women through the emotional  distress of being told that their cancer has not been completely excised and leads to delays in  their recovery.

‘This extended recovery period can hinder the ability of women to resume work and other activities, so it has an adverse socio-economic effect.’

Around 45,000 women are diagnosed with breast cancer in England every year of whom 58 per cent  have breast conservation surgery. They usually have a course of radiotherapy after the operation to try  to ensure any remaining tumours  are banished.

Some studies have found that the overall survival chances of women having only a section of their breast removed are similar to those who undergo a full mastectomy.

But others have found there is a higher chance the cancer will return if they do not have the entire breast removed.

Dr Emma Pennery, Clinical Director at Breast Cancer Care said: ‘Surgery is the first treatment for most people with breast cancer and some people will be offered the choice between a mastectomy and breast conserving surgery.

‘It’s really important that women are aware of all the potential benefits and drawbacks when they make this decision so their choice is informed.

‘While the majority of people who choose breast conserving surgery won’t need another operation, it’s important everyone knows beforehand that it is a possibility.’

Here’s what other readers have said. Why not add your thoughts,
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The comments below have not been moderated.

I was given the choice – mastectomy or quadrant section in which a quarter of the breast is removed. It was my choice, with no guidance as to which. I said “If it is all removed, then there is nowhere for it to return to”, to which the consultant responded that it could return but if it did, the lump would be visible. This made me raise the question of if I opted for conservative surgery, could any return of cancer be picked up earlier by mammography before the lump became large enough to feel. Answer “yes”, so this is what I chose. Thankfuilly, five years down the line, it has not reappeared and instead of yearly mammography, I am now to have it every three years. I hope this article will not lead women into losing a breast unneccessarily.

So 4 in 5 women who refuse a mastectomy survive their cancer without further surgery. With odds like those I think I know what decision I would make. Women don’t generally like to avoid having their breasts chopped off. Funny that.

So let me get this straight. 1 in 5 will need a secondary surgury. Studies show both a similar success rate and a slightly higher rate of recurrance with the conservative surgury vs the mastectomy. So you advocate… that ALL FIVE should have the full mastectomy? Is that some sort of joke? So 4 in 5 will NOT have a recurrance, but they should further butcher themselves just in case? Not to mention the psychological injury of losing the breast, plus the likelyhood of reconstructive surgury, plus having to deal with implants… and they think the 1 in 5 chance of a recurrant tumor is emotionally worse? These people must not know many people who have actually HAD cancer, as most prefer not to be carved up like a turkey just to have to put it back together later, like a zombie turkey.

breast cancer ,what causes it ….deodorants and stop you sweating sprays .same reason alleges have increased anti-septic sprays ,wipes have stopped kids from developing their own immune systems .

Yes ,and four out of five dont !

the tone of the writing in this article makes it sound like women are “refusing ” to have the whole breast removed against their doctors advice which just isn’t true. In the past, women were assured that they didn’t need a complete mastectomy, and i know some who were mede to feel they were over reacting when they asked for the whole breast to be removed – which is after all a major operation.

It is true that many women that have a lumpectomy need a masectomy later and the prognosis is not as good as before.
I work in a cancer center and I have seen women that would rather die than loose a breast or hair because of chemo.
When I was diagnosed years ago I told my doctor that I wanted the most agressive treatments and I rather loose a breast and be alive than dead with two.

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