Word: breasts
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...study, researchers at MD Anderson Cancer Center in Houston provide the first evidence that preventive mastectomy prolongs life, but only for a subset of breast-cancer patients. For the majority of women diagnosed with the disease, the drastic and deforming surgery is more than they need, the study concludes. (See the top 10 medical breakthroughs...
...Bedrosian's study, however, which involved 107,000 women undergoing mastectomy for breast cancer, most women did not obtain a survival benefit from preventive surgery in the unaffected breast. Only a specific group of patients - women under age 50 who had early-stage cancer (I or II) and tumors that were negative for the estrogen receptor - saw an increase in their chances of surviving to five years. That increase was small, just 4.8%, compared with women who did not have preventive mastectomy. Further, less than 10% of the breast-cancer population fits these criteria...
...while the benefit may seem slight, Bedrosian notes that in cancer terms, any percentage boost in survival is meaningful, particularly to patients. And when women are facing the decision to lose a healthy breast, every piece of information counts. (See more about health care...
...Anderson study highlights the combined effect of three major factors in improving breast-cancer survival: age, type of tumor and stage of cancer. Taken together, this suite of criteria makes sense, says Bedrosian. Women with estrogen-positive cancers can be treated with hormone-therapy drugs like tamoxifen or, if they are postmenopausal, the new aromatase inhibitors, which block the production of cancer-enhancing estrogen in the body. Women whose tumors lack the estrogen receptor, however, cannot take advantage of these drugs, since their cancers are not as dependent on estrogen for fuel. As a result, they have a lower survival...
...translate to the clinic, though, is another matter. Some experts are not convinced - yet - that the study results should be part of clinical decisionmaking, pointing out that many factors other than mastectomy may be driving the increase in survival. "Women who undergo a [preventive] mastectomy in the unaffected breast may be different from women who do not," says Dr. George Sledge, president-elect of the American Society of Clinical Oncology and a professor of medicine at Indiana University. "They may be overall healthier in that they see their physician more frequently, and their physicians may be more aggressive in treating...