Magazine article Science News

New Treatment May Reduce Breast Surgeries

Magazine article Science News

New Treatment May Reduce Breast Surgeries

Article excerpt

New treatment may reduce breast surgeries

Researchers this week described an experimental therapy that may make radical breast surgery, or mastectomy, unnecessary in most women with tumors previously considered too large to treat more conservatively. The treatment shrinks tumors to a fraction of their original size, so surgeons can remove them using a less disfiguring operation popularly known as a "lumpectomy."

Apparent successes in nearly all of the first 90 patients studied suggest that total removal of cancerous breasts may fall almost entirely out of practice within the next five years, some experts say. But others express skepticism of such far-reaching conclusions, saying there remain compelling reasons for women to opt for mastectomy. Either way, the new findings provide fuel for a growing debate about how best to treat this potentially fatal cancer, which will strike 142,000 U.S. women this year.

Increasingly, physicians in the United States and abroad recommend lumpectomies for small breast tumors, especially when no evidence exists the cancer has spread. But tumors greater than 2 or 3 centimeters in diameter generally spur surgeons to perform a modified radical mastectomy, where they remove the entire breast and some surrounding tissues. Chemotherapy treatments often follow in an attempt to destroy any remaining tumor cells (SN: 3/4/89, p.135).

Gianni Bonadonna and his colleagues at the Instituto Nazionale Tumori in Milan, Italy, reversed this common therapeutic sequence for women with large tumors by treating them first with standard anticancer drugs for three months, then performing surgery. They found chemotherapy shrunk 95 percent of tumors with diameters of 3 to 5 cm and 73 percent of tumors measuring 5 to 8 cm to less than 3 cm, allowing surgeons to do lumpectomies. Even the largest tumor, 11 cm, withered to 3 cm. …

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