WASHINGTON--The effectiveness of breast conservation surgery,
as measured by survival of breast cancer patients, is similar
to that of mastectomy in day-to-day medical practice, as well
as in randomized clinical studies, according to a report by the
General Accounting Office (GAO).
In its report, the GAO examined whether the results of lumpectomy
and related treatment have been similar in day-to-day medical
practice, where the quality of treatment is often less certain
than in randomized clinical trials. According to the GAO, it used
a unique three-step analysis to reach its conclusions, combining
metaanalysis, statistical analysis of records from a medical practice
database, and cross-design comparisons of results.
5-Year Survival Rates Similar
The data indicated that 5-year survival was similar following
lumpectomy or mastectomy both in day-to-day medical practice and
in randomized studies, the GAO said in its report. Specifically,
for medical practice cases, the adjusted 5-year survival rates
were 86.3% for breast conservation patients and 86.9% for mastectomy
patients. These results correspond with the results of multicenter
randomized studies for breast conservation and for mastectomy,
the report said.
The analyses did suggest that a minority of breast conservation
patients might have achieved slightly better results with mastectomy.
These were patients for whom breast conservation therapy was relatively
unlikely to be used, because of such factors as residence in areas
where this treatment is relatively uncommon, the GAO report said.
The observed difference was not statistically significant, however.