Breast Cancer – New Surgical Advances

Posted by Brigham and Women's Hospital May 3, 2016

Ann Partridge and Tari King,

Dr. Tari King, Chief of Breast Surgery, and Dr. Ann Partridge, Director of the Program for Young Women with Breast Cancer, discuss a case.

Current trends in breast cancer management incorporate a “less is more” approach in many cases. This includes surgical treatment for breast cancer.

“We are finding that we can perform less extensive surgery and offer easier approaches for many patients with breast cancer, while still achieving excellent outcomes,” says Dr. Tari A. King, Chief of Breast Surgery and a member of the Breast Oncology Center at Dana-Farber/Brigham and Women’s Cancer Center.

Previous surgical treatment plans, for example, included full lymph node surgery for the presence of any cancer in the lymph nodes located under the arm. This can result in long-term arm swelling, a condition known as lymphedema. Recent studies have shown that, in patients with a limited amount of cancer in the lymph nodes (cancer in one or two nodes), it is not necessary to remove all of the remaining nodes.  The lymph nodes can remain in place and the cancer can be successfully treated with other modalities, such as medical and radiation therapies.

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Preventive Mastectomy Rates Increase despite Lack of Survival Benefit

Posted by Brigham and Women's Hospital March 31, 2016

Patients and caregivers should weigh the expected benefits with the potential risks of .

Patients and caregivers should weigh the expected benefits with the potential risks of a contralateral (double) prophylactic mastectomy.

A recent Brigham and Women’s (BWH) study reveals that from 2002 to 2012, the number of women choosing to have both of their breasts removed as a strategy to prevent the recurrence of breast cancer – a procedure known as contralateral prophylactic mastectomy (CPM) – tripled in the U.S., but without a corresponding improvement in  survival. Researchers note that while CPM may have a survival benefit for patients that are at high risk of developing breast cancer, such as those with a genetic mutation, the majority of women undergoing CPM are at low risk for developing breast cancer in the unaffected breast.

“Our analysis highlights the sustained, sharp rise in popularity of CPM, while contributing to the mounting evidence that this more extensive surgery offers no significant survival benefit to women with a first diagnosis of breast cancer,” says senior author Dr. Mehra Golshan, Distinguished Chair in Surgical Oncology at BWH. “Patients and caregivers should weigh the expected benefits with the potential risks of CPM, including prolonged recovery time, increased risk of operative complications, cost, the possible need for repeat surgery, and effects on self image.”

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