Shoshana Rosenberg, ScD, of Dana-Farber Cancer Institute and Harvard School of Public Health, and her colleagues evaluated 277 women who were diagnosed with breast cancer at age 40 or younger, who reported having a choice between a mastectomy and a breast conserving lumpectomy, and whose cancer ranged from stage 1 to stage 3. She will present the findings (abstract 6507) on Monday, June 3, 10:15 am CT, S404, McCormick Place.
"Women diagnosed with breast cancer at an early age typically have a different set of medical and psychosocial issues and concerns than do older women," said Rosenberg. "We were interested in learning from women who had a choice about surgery what factors were associated with their decisions."
A lumpectomy involves surgically removing the tumor and some of the healthy tissue around it, but it typically spares most of the breast. It is standard to treat the area with radiation therapy following surgery to destroy any remaining cancer cells. A mastectomy removes most or all of the breast, and possibly chest muscle and some lymph nodes to prevent spread of the disease. Most women do not need radiation therapy after a mastectomy, though many chose to have additional surgery to reconstruct the breast. Studies have shown that the overall survival rates for lumpectomy followed by radiation compared with mastectomy are the same.
Overall, the researchers found that 172 of the women, or 62 percent, opted to have either a single or double mastectomy. Factors associated with choosing a mastectomy included having a genetic mutation, an overabundance of the HER2 protein in tumor cells, signs of spread to the lymph nodes, higher tumor grade, lower body mass index, having two or more children, increased anxiety, and greater patient involvement in the decision. Other factors of interest, including age, race, marital status, tumor size, having an estrogen-sensitive tumor, having a first degree relative with breast or ovarian cancer, fear of recurrence, and depression, were not significantly associated with having a mastectomy.
"Rates of mastectomy, particularly in young women with breast cancer, are on the rise, and it is not entirely clear why," said Rosenberg. "Our data suggest that disease and genetic factors may be related to choice, as well as anxiety and how the decision was made. Further research is clearly warranted in an effort to help ensure women can make informed, quality decisions about their breast cancer therapy."
The study's other co-authors are Kathryn Ruddy, MD, MPH, Shari Gelber, MS, MSW, Meghan Meyer, Eric Winer, MD, and Ann Partridge, MD, MPH, of Dana-Farber; Karen Sepucha, PhD, and Lidia Shapira, MD, of Massachusetts General Hospital; Rulla Tamimi, ScD, of Harvard School of Public Health and Brigham and Women's Hospital; Steven Come, MD, of Beth Israel Deaconess Medical Center; and Virginia Borges, MD, of the University of Colorado Denver.
The study was funded by the Susan G. Komen for the Cure and the National Cancer Institute Education Program in Cancer Prevention (NIH 5 R25 CA057711).
About Dana-Farber Cancer Institute
Dana-Farber Cancer Institute is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center, designated a comprehensive cancer center by the National Cancer Institute. It provides adult cancer care with Brigham and Women's Hospital as Dana-Farber/Brigham and Women's Cancer Center and it provides pediatric care with Boston Children's Hospital as Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Dana-Farber is the top ranked cancer center in New England, according to U.S. News & World Report, and one of the largest recipients among independent hospitals of National Cancer Institute and National Institutes of Health grant funding. Follow Dana-Farber on Facebook and on Twitter: @danafarber.
Bill Schaller | EurekAlert!
Do microplastics harbour additional risks by colonization with harmful bacteria?
05.04.2018 | Leibniz-Institut für Ostseeforschung Warnemünde
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.
Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.
Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.
Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...
Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.
The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...
Stable joint cartilage can be produced from adult stem cells originating from bone marrow. This is made possible by inducing specific molecular processes occurring during embryonic cartilage formation, as researchers from the University and University Hospital of Basel report in the scientific journal PNAS.
Certain mesenchymal stem/stromal cells from the bone marrow of adults are considered extremely promising for skeletal tissue regeneration. These adult stem...
In the fight against cancer, scientists are developing new drugs to hit tumor cells at so far unused weak points. Such a “sore spot” is the protein complex...
13.04.2018 | Event News
12.04.2018 | Event News
09.04.2018 | Event News
20.04.2018 | Physics and Astronomy
20.04.2018 | Interdisciplinary Research
20.04.2018 | Physics and Astronomy