Success of Breast Conserving Surgery Is Not Diminished in Community Setting

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.