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Lumpectomy versus Mastectomy for Early Stage Invasive Breast Cancer

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“Women with early-stage invasive breast cancer who undergo breast-conserving therapy (BCT) have a higher rate of disease-specific survival than those who undergo mastectomy

As the study linked below explains, lumpectomy, or breast conserving surgery (BCT), is both less invasive therapy for the patient as well as has a higher rate of disease-specific survival. In layperson’s terms, breast cancer patients who have a lumpectomy and BCT have less surgery and live longer.

Further, there are dozens of evidenced-based but non-toxic therapies that can reduce the risk of breast cancer relapse. Nutrition, supplementation, detoxification, frequent, moderate exercise, all have been shown to reduce a person’s risk of breast cancer relapse.

I am both a cancer survivor and cancer coach. Painful experience has taught me that less is often more in cancer care. The studies linked and excerpted below explain why this is true.

Have you been diagnosed with breast cancer? If you would like to learn more about evidence-based, non-toxic therapies please scroll down the page, post a question or comment and I will reply to you ASAP.



Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

SEER Study: Less Surgery, Longer Breast Cancer Survival

“Women with early-stage invasive breast cancer who undergo breast-conserving therapy (BCT) have a higher rate of disease-specific survival than those who undergo mastectomy, according to an analysis published online January 15 in JAMA Surgery

Nonetheless, the 10-year breast-cancer-specific survival rates were 94% for patients who underwent BCT, 90% for those who underwent mastectomy alone, and 83% for those who underwent mastectomy plus radiation (P < .001)...

Dr. McGuire noted that the study by Dr. Hwang’s team and this study are part of a growing body of evidence indicating that BCT is “equivalent, if not superior, to mastectomy in terms of breast-cancer-specific survival.”

For Young Women, Breast Conserving Surgery May Be Acceptable Alternative to Mastectomy

… support [the idea] that breast conserving surgery with lumpectomy and radiation is an excellent option for young women, and may be the … stated the researchers. These new results suggest “that lumpectomy is indeed a safe option for young women,” said Dr. Buckley during …

Lumpectomy vs. Mastectomy for Early Stage Invasive Breast Cancer-

“A new study called “Decision Making about Surgery for Early-Stage Breast Cancer” finds that the women studied had major deficits in their knowledge about the pros and cons of having either a mastectomy or a lumpectomy followed by radiation.  For the purposes of this study, early breast cancer was defined as stage one or stage two invasive breast cancer.

Accurate and thorough knowledge is essential for anyone making decisions about cancer treatment.  Even though each cancer is unique, I would love to see some kind of standardized decision-making tools that would attempt to provide basic percentage chances of success with various treatment choices.

Because I believe there are significant differences between stage 1 and certain stage 2 breast cancers that have spread to the lymph nodes, I would like to see tools for both stages.  I also believe that decision-making is different for those who are premenopausal as opposed to post-menopausal and this should somehow be addressed.  It would also be beneficial if every woman understood exactly what is meant by “survival rate.”  For many studies it means you are considered to have survived if you live five years.  Most women currently diagnosed with early stage breast cancer will survive five years and eventually die of something other than breast cancer.  I certainly did not know this at the time of my diagnosis.

In this particular study, women were asked to recollect what they were told at the time of their diagnosis.  The studies were mailed to them approximately 1 to 3 years after diagnosis (the average was 2 1/2 years).  Even though it has been 8 years since my diagnosis, I decided to look up the study and attempt to answer the questions.  I was very surprised to discover a misconception I had about local recurrence rates for those who chose lumpectomy followed by radiation as opposed to who chose mastectomy.  I thought the recurrence chances were equal and was nearly certain that is what I had been told.  But, they are not quite equal.  There is a slightly higher risk of the cancer recurring in the same breast with lumpectomy and radiation as opposed to mastectomy.  It is the survival rate that is equal.

I checked the excellent notes my daughter took during my early appointments.  According to the notes, my surgeon said that the risk of recurrence for mastectomy was 3-5% and for lumpectomy followed by radiation it was around approximately 7%, although it had only just fallen to that percentage after years of the figure being 10-12%.  I had no recollection of having received this information.

The questionnaire asked how many women out of 100 would have their cancer come back in the treated breast if they were treated with lumpectomy and radiation or with mastectomy.  The study says the accurate answer is 2%-10% for mastectomy and 5%-15% for lumpectomy and radiation…

Women who have just been told that they have breast cancer are commonly in an emotional and fearful state of mind.  Some women apparently want to do every possible thing that will give them even a tiny additional chance of survival.  Others are somewhat willing to accept certain risks to avoid overtreatment with its potential long-term negative effects.  In either case, accurate and undistorted information is needed to assist in this decision-making.

Link to the study abstract: http://www.ncbi.nlm.nih.gov/pubmed/22056355

Science Daily article about the study: http://www.sciencedaily.com/releases/2012/01/120110140231.htm

Mary Miller- BC survivor and BC Profile in Courage


Leave a Comment:

Jana Bikas says 8 years ago


My mother had DCIS in 2012 and had a lumpectomy along with radiation for 6 weeks. Her mammograms have been clear, but she was just diagnosed with Stage IV Metastatic Breast Cancer that was found after a lymph node biopsy. The lymph node biopsied was above her collarbone and other lymph nodes around that area are enlarged on the scans. They did not find evidence that it had spread anywhere else after performing scans on head, chest and abdomen. Her bone scan was also negative.

We were all in disbelief… She is ERneg/PRneg/HER2Postive and is scheduled to start chemo on 12/23. I have searched all over the internet (although the doctors tell us not to), hoping to find someone with a similar diagnosis. We were surprised when a mammogram this week also shows that she is free from cancer in both breasts. I’m assuming that a cancer cell got into her blood stream during the lumpectomy and her doctor agreed that this is probably what happened… I am so worried about her receiving chemo and am pretty convinced that nutrition could do wonders, but the oncologist told me that no food is going to kill the cancer. At this point, I am out of my mind with worry, and am searching for everything and anything that can help her… I am trying to get her to avoid ALL processed foods and sugar and to eat a plant-based diet, but it is a work in progress. I see tons of info online but worry if anything I’m getting her to eat may affect her chemo treatment? Example, turmeric… and any other foods that are recommended to heal cancer. Any info you can provide is greatly appreciated.

    David Emerson says 8 years ago

    Hi Jana-

    I am sorry to learn of your mother’s metastatic breast cancer diagnosis. I believe that you are correct in thinking that a breast cancer stem cell from your mom’s DCIS is the reason for the spreading of BC. I will try to enumerate what I see as the first therapy issues for you and your mom to address. Please reply with any and all questions you may have.

    1) Yes, nutrition can do wonders as you say. Nutrition is as much about enhancing your mom’s immune system healthy as it is about killing the cancer. First and foremost, try to ease your mom into different nutrition habits. You are attempting a lifestyle change, not a diet.

    Chemo and radiation may effect what your mom eats, smells, her appetite, etc. Smoothies, fruits, veggies, etc. can be a priority at different times. Try hard to listen to your mom about what she is feeling.

    I don’t follow any one specific diet as a cancer survivor. I follow basic rules such as 1) as little processed sugar as possible 2) fruits and veggies throughout the day 2) as little alcohol as possible 3) frequent, moderate exercise (this may not seem like a nutrition change but a walk around the block daily will build appetite, help your mom sleep, etc.

    For the basic direction for diet please watch Dr. Bill Li’s Ted Talk- 18 mins.

    2) Bone Heath- please read the study linked in the blog post- the studies found that early bone therapy (bisphosphonates) BEFORE cancer spread to the bones helped significantly.

    Bisphosphonates may prevent bone metastasizes in Breast Cancer, study finds

    3) As for nutrition and conventional therapy such as chemo and radiation. Nutritional antioxidant supplementation such as curcumin/turmeric, entails several important issues.

    1) Yes, some supplements have documented evidence of reducing the efficacy of a specific chemotherapy. The key is to research chemotherapies and specific supplements. I will give one good and one bad example below-

    Good- A common class of chemotherapies for breast cancer is anthracyclines. This family has documented heart/cardiotoxicity. CoQ10 has been documented to reduce or prevent the cardiotoxicity of this class of chemo. I underwent Vincristine (anthracycline) therapy in 1995. I have lived with chronic A-Fib since ’10.

    Bad- green tea extract (EGCG) has been documented to reduce the efficacy of Velcade. If your mom was about to undergo Velcade therapy I would tell her to stop all green tea consumption in anticipation of her chemo treatment.

    The key is to research what chemotherapies and what supplements work together and which don’t. I can do the research but you must tell me what chemotherapies your mom’s oncologist has recommended in anticipation. I will provide you with the studies, if any, any you make the decisions. Many antioxidant supplements both enhance the efficacy of chemo while they reduce the toxicity.

    I personally believe that this form of integrative therapy is the key to managing incurable cancer. I live an integrative lifestyle and I have survived my incurable cancer, multiple myeloma, since 1994. I will provide you with the studies and you and your mom decide.

    Jana- the three issues above are what my experience has taught me are important. Let me know if you have questions.

    Take a deep breath. I have input for caregivers too but that’s a later email…

    Hang in there,

    David Emerson

PJ MacDonald says 8 years ago

I need to find a breast cancer surgeon in Riverside County for a second opinion and another biopsy. I was diagnosed with invasive ductal carcinoma.Prefer someone who will do a lumpectomy and leave my lymph nodes alone. My HER2 was negative.

Please advice–I need help.

Thank you.

    David Emerson says 8 years ago

    Hi PJ-

    My research is turning up many doctors who are “near” Riverside. I assume you are talking about Riverside, California. The doctor linked below is relatively close by at 14.4 miles, is board certified in general surgery yet specializes in breast cancer, is patient oriented (“Dr. Lalezarzadeh’s Care Philosophy Patient oriented. Treat the whole person: mind, body, soul. Patient needs to participate in their own care to get better. Educate patient to understand their disease and the surgery.) and should provide a second opinion that is worth listening to.


    Please consider contacting me again to discuss anti-breast cancer nutrition, antioxidant supplementation, lifestyle all to reduce your risk of relapse as much as possible.

    I want to spend a bit more time looking for BC surgeon in your area. I will reply again with what I find.


    David Emerson
    Director PBC

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