Lumpectomy as good as mastectomy for tumours up to 5 cm
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7256.261 (Published 29 July 2000) Cite this as: BMJ 2000;321:261
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The current evidence of the equivalent effectivness of lumpectomy and
modified radical mastectomy (MRM)in the treatment of breast neoplastic
lesions up to 5 cm may be interepted in favour of MRM. In developing
countries many surgeons can only trust their surgical skills to improve
long term and metastasis-free survival for patients with operable breast
carcinoma. The lack of facilities as well as the cost of other adjuvant
treatment modalities as well as the absence of organised national
multidiciplinary breast care programs can dramatically increase the
incidence of recuurent brast lesions after mastectomy. Many of these
lesions can easily , under lack of non organised haphazard follow ups,
progress to unoperable lesions and may therefore increase the overall
mortality and morbidity of operable breast lesions treated by lumpectomy
rather than by well performed MRM
Competing interests: No competing interests
Perhaps we should say lumpectomy with clean margins and radiotherapy.
Competing interests: No competing interests
It is heartening to see that for breast cancers up to 5cm in size,
there are options other than radical mastectomy.
However, lumpectomy is NOT such an option.
It is the case, however, that lumpectomy plus radiotherapy is an option,
and I assume that this is the treatment which is being described in the
Gottlieb article.
Competing interests: No competing interests
Lumpectomy: are there limiting factors?
The term lumpectomy is a misnomer i would agree that WLE with safety
margin and proper staging of the axilla together with radiotherapy for
patients having T2 tumor would provide matching loco regional control as
modified radical mastectomy. At Jordan university hospital in Amman, we
used to practice conserving breast surgery for the last fifteen years, we
found two significant reasons depriving patient, with T2 tumor, of their
chance of keeping the breast. when they had small breast(cup A)or had
excisional biopsy for diagnosis. We could overcome these two obstacles in
few patients by using local flaps to compensate for skin and glandular
loss. Centrally located T2 tumors were not excluded from our conserving
policy if sound oncological and cosmetic principles could be fulfilled.
Competing interests:
None declared
Competing interests: No competing interests