Older breast cancer patients choosing lumpectomies

In In The News by Barbara Jacoby

LLH network pressFrom: San Francisco Chronicle

About 1 in 8 American women will be diagnosed with breast cancer at some point in her life, and those who’ve already been diagnosed know there are many decisions to make. Although every case is different, studies show new breast cancer treatment trends are emerging.

For one thing, in the Bay Area, women with early-stage breast cancer age 65 or older are choosing lumpectomies, surgeries that remove the cancerous part of the breast, more often than mastectomies, which remove the entire breast. Cancer survival rates for the two types of treatment are similar, but lumpectomies leave more breast tissue intact and usually require weeks of radiation treatment, which isn’t always necessary with mastectomies. In other parts of the country, mastectomies are more popular, indicating that this decision may have a lot to do with the preferences of the medical community where you live.

For women who choose mastectomy, it’s becoming more common to remove both breasts when only one has cancer. It’s a preventive measure, called a contralateral prophylactic mastectomy, that lowers the risk of cancer recurrence.

And although only about a quarter of mastectomy patients in the last decade chose to have breast reconstruction, those numbers are gaining, especially among women under 50 who have health insurance.

Doctors emphasize that the best course of treatment differs from one woman to another, depending on her type of cancer and family and medical history. Here is a look at the treatment trends, by the numbers:


The national rate of mastectomy for breast cancer patients 65 and older is three times higher than the rate in San Francisco, which has the lowest rate of mastectomies in the country, according to an analysis of Medicare data from 2008 to 2010.


The percentage of women in a national study of nearly 200,000 mastectomy patients who chose to have both breasts removed when only one had cancer. The 2013 study, which appeared in Plastic and Reconstructive Surgery, a Journal of the American Society of Plastic Surgeons, noted that this number has increased by about 15 percent each year for the last decade, while the number of single-breast mastectomies has decreased by about 2 percent each year.


The percentage of patients age 50 or younger who had mastectomies between 2000 and 2010 and had immediate breast reconstruction, according to a 2011 study by the American Association for Cancer Research. Less than 20 percent of women over 50 in the study made the same choice. Numbers in both age groups were higher among women with health insurance. The study involved 106,988 women.


The percentage of breast reconstruction surgeries in 2012 that involved silicone implants, according to the American Society of Plastic Surgeons. Just under 9 percent used saline implants, and about 21 percent reconstructed breasts using tissue from elsewhere on the patient’s body.

Kathryn Roethel