New in Breast Cancer: What’s the point of the science if nobody believes it?
Boston Globe, today February 4th. Health Monday, “the daily dose”. Deborah Kotz, author. ”Why Mastectomies are on the rise”.
Apparently surgeons are seeing a surge in requests from breast cancer patients to have both breasts removed rather than removing just the malignant lump. Ms Kotz says that “That’s despite findings from seven large clinical trials which showed that, for tumors that hadn’t spread beyond the breast, mastectomies didn’t provide additional benefits over more conservative surgery…” She then cites a recent article in the journal “Cancer” that lumpectomy with radiation might actually be BETTER than mastectomy. I can’t find that citation. I’ve asked her to send me the reference. I could do a whole literature search for you people at some other time, but the Globe is saying it so we’re going to go with it for now.
Here’s the kicker, and the reason for this post. The director of breast surgical services at Dana-Farber and Brigham and Women’s cancer center, Dr. Mehra Golshan, gives the following quote:
“It’s a nice study but it’s hard to imagine that less surgery with radiation gives a better outcome.”
But, but, but…. Dr. Golshan, rest easy because YOU DON’T HAVE TO IMAGINE IT. IT’S IN THE STUDY! Otherwise, what’s the point of doing research??? It’s a nice study? I’m sure the authors would be very grateful to hear you say that. You, the director of one of the most famous cancer centers in the world. Who are all us poor women going to listen to?
According to Ms Kotz, and I have heard this in other places also, there has been a sharp increase in the number of women diagnosed with stage 0 cancers, self-contained cells that are sometimes considered pre-cancer because doctors don’t know if they’ll ever grow to become a breast cancer. Fine. Better safe than sorry. But people, women are getting both their breasts removed completely, possibly for a few cells that may or may not become cancerous, JUST IN CASE?
Well, that’s ok, because insurance covers the entire cost of mastectomy and reconstruction. So these women can get breasts back. Well, sort of. To do that, you have to undergo multiple surgical procedures. One of these is a 12-15 hour marathon, which leaves you with a scar on your abdomen and a couple of lumps on your chest that then require revisions, nipple reconstruction, etc. etc. Or you can do implants, but you have to have tissue expanders first, then the implants, then whatever maintenance those require.
Some women can’t live with the uncertainty. Treatment sucks. They don’t ever want to do that again. I get it. But that’s what research is for – to infuse a little rationality into what is admittedly a very emotional decision. Let’s let the researchers help us.