Warning to cancer victims who refuse breast removal: One in five who opt for less drastic surgery need second operation
09:32 GMT, 13 July 2012
Thousands of breast cancer patients who refuse to have a mastectomy – and instead opt for a less drastic operation – will need further surgery to remove tumours, a study reveals.
Researchers found that a fifth of women who have a form of surgery which does not take away their entire breast will need a second operation.
They warn that the treatment causes women added ‘emotional distress’ during what is already a very upsetting time.
And the ordeal of having a second operation will further delay their recovery and return to normal life.
'Emotional distress': Thousands of breast cancer patients who refuse to have a mastectomy may need further surgery, researchers say. (File photograph)
Many women with the illness choose to have only a small section of affected tissue taken out – a process known as ‘breast conservation surgery’.
A mastectomy – where the whole breast is taken away – may better ensure tumours are removed.
More than half of the women who are diagnosed with breast cancer in England opt for breast conservation surgery.
It has become increasingly widespread in recent years due to the development of better scans and improved surgery techniques.
Researchers from the London School of Hygiene and Tropical Medicine looked at 55,297 women who had undergone this procedure between 2005 and 2008.
Disease: About 45,000 women are diagnosed with breast cancer in England every year. (File photograph)
They found a total of 11,032 had needed a second operation because the first had not completely removed the tumours.
And of these, around 40 per cent had to have their entire breast taken out.
The researchers believe that surgeons are not always removing enough of the affected tissue.
This is partly because there are no proper guidelines telling them exactly how much should be removed. In addition it can be difficult for them to know exactly how widespread the tumours are.
Their study, published in the British Medical Journal, urges them to ‘review their technique’ to avoid women unnecessary distress.
It adds: ‘Reoperation also puts women through the emotional distress of being told that their cancer has not been completely excised and leads to delays in their recovery.
‘This extended recovery period can hinder the ability of women to resume work and other activities, so it has an adverse socio-economic effect.’
Around 45,000 women are diagnosed with breast cancer in England every year of whom 58 per cent have breast conservation surgery. They usually have a course of radiotherapy after the operation to try to ensure any remaining tumours are banished.
Some studies have found that the overall survival chances of women having only a section of their breast removed are similar to those who undergo a full mastectomy.
But others have found there is a higher chance the cancer will return if they do not have the entire breast removed.
Dr Emma Pennery, Clinical Director at Breast Cancer Care said: ‘Surgery is the first treatment for most people with breast cancer and some people will be offered the choice between a mastectomy and breast conserving surgery.
‘It’s really important that women are aware of all the potential benefits and drawbacks when they make this decision so their choice is informed.
'While the majority of people who choose breast conserving surgery won’t need another operation, it’s important everyone knows beforehand that it is a possibility.’