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Mastectomy and reconstruction not really a good combination for early breast cancer treatment

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A new study from the University of Texas MD Anderson Cancer Center reviewed treatment types for women with early breast cancer, and mastectomy and reconstruction had the most complications and complication-related costs.

The combination was also seen to be the most expensive treatment option for younger patients.

The study was presented by Benjamin D. Smith, M.D., who is an associate professor of Radiation Oncology and Health Services Research, at the 2015 San Antonio Breast Cancer Symposium. The research serves to help patients and physicians to know what the best treatment options are, as well as determine which
treatment options give the best value for the money being paid by the patients.

Women who have early stage breast cancer have many guidance-concordant therapies to choose from.
These include: lumpectomy with whole breast irradiation (lump + WB) or brachytherapy (lump + brachy); mastectomy alone (mast alone) or plus reconstruction (mast + recon), or in older aged patients, lumpectomy alone (lump alone). All of these therapies give the same chances of survival, however, they
are different in terms of what the patient has to endure.

Smith says that when physicians talk with their patients, they usually explain that they will be able to receive treatments such as lumpectomy, whole breast irradiation or mastectomy, with or without reconstruction. On the other hand, the physicians themselves sometimes do not have a clear understanding of the pros and cons of each of these therapies.

Understanding the differences is quite important, especially because in the last ten years, the number of patients receiving mast + recon treatment has continued to increase in the United States, as reconstruction has become more accessible to patients. This study is the first to show that there is actually some form of harm involved in this treatment combination.

Breast Cancer Treatment Options

The researchers collected data from 2000-2011, from a total of 44,344 patients younger than 65 and 60,867 patients aged 66 and older. Data from the younger set of patients were taken from the MarketScan research database and the older generation from the SEER-Medicare database.

From the younger age bracket, mast + recon had the highest risk for complication, at 56%. The same was seen in the older population with a 69% risk of complication for mast + recon treatment. In terms of cost, in the younger generation, mast + recon was the most expensive, at an average of around $89,000. On the other hand, in the older patients, the most expensive form of treatment was lump + brachy, at around
$38,000, as compared to mast + recon at $36,000.

The study shows for the first time the fact that as patients undergo surgery, they may be taking more risks as to what could possibly happen. If the patient can have a lumpectomy and radiation, it may be a smoother course than going through a mastectomy, reconstruction and potentially other surgeries, says Smith.

Comprehending this type of information is very important to those involved in health care. Despite the results of this research, though, Smith emphasizes that for some patients with early breast cancer, mast + recon is still the best option for treatment.