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Mastectomy Plus Reconstruction Increases Health Complications In Early Stage Breast Cancer Patients

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Women who choose to undergo mastectomy and reconstruction in early the early stages of breast cancer are almost twice as likely to suffer complications afterwards, compared to those who have a lumpectomy followed by radiation, a new study reports.

American women with early-stage breast cancer are now more likely to have the affected breast removed then reconstructed. But researchers from the University of Texas MD Anderson Cancer Center say that this form of treatment is not only more expensive, it also carries a higher risk of major post-operative problems.

“This is the first study to quantify the harm associated with the US’s rising mastectomy and reconstruction rates as opposed to simpler options,” says Dr. Benjamin Smith, lead author on the study and an associate professor of Radiation Oncology and Health Services Research. He adds,

The clear takeaway here is that if you’re diagnosed with early-stage breast cancer, lumpectomy plus radiation is the best complication profile and value.

Over 140,000 women in the United States are diagnosed with early-stage breast cancer yearly, with most of them eligible for several treatment options. These include lumpectomy plus whole breast irradiation or brachytherapy, mastectomy only, mastectomy plus reconstruction, and in older women, lumpectomy alone.

Researchers studied data from over 100,000 cancer patients from 2000 to 2011, composed of 44,344 patients younger than 65 years old and 60,867 patients 66 years and older. The documented problems following surgery included wound complications, infections, hematoma or seroma, breast pain, fat necrosis, rib fracture, pneumonitis, implant removal or graft failure.

The study found that the risk of complications was highest for mastectomy plus reconstruction at 56% for younger women and 69% for those older than 65 – almost twice the risks with lumpectomy plus radiation in both age groups.

Costs were higher, too. Mastectomy plus breast reconstruction cost roughly $88,000 per patient, while less extensive lumpectomies cost around $65,000. Patients also spent more than $9,000 in managing complications occurring after surgery.

Smith says the study aimed to give doctors and patients a better understanding on the pros and cons of each of these treatments, which have had little quantifiable data. He points out that the study is important as the rate of mastectomy and reconstruction has risen sharply in risen years, given the increasing accessibility of reconstructive breast surgery. He also says that the findings should help patients in choosing the right therapy for their case, and understand the consequences, along with their doctors, health care and insurance providers.


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