Study showing higher local recurrence for TNBC with MX vs. LX??

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CarolinaAmy
CarolinaAmy Member Posts: 281
edited February 2016 in Surgery - Before, During, and After

I'd gone through the decision-making process and chosen to do a BMX with reconstruction, but in looking for a study that has shown potential improved outcomes for younger TNBC women who have mastectomies, I came across this study again and it's freaking me out. I saw it last fall but dismissed it for some reason that I can't remember. Before I go annoying my surgeon (who will think I'm waffling), can you all tell me what you know about this one? I seem to remember thinking that it didn't account for stage, when later stages tend to get mastectomies but also start off with greater risks?

http://cancerology.blogspot.com/2011/06/lumpectomy-better-than-mastectomy-for.html

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  • Kathy044
    Kathy044 Member Posts: 433
    edited February 2016
    Trying to make the link hot

    http://cancerology.blogspot.com/2011/06/lumpectomy-better-than-mastectomy-for.html

    I am not triple negative but I am from Canada and remember reading about this study when it came out in 2011. I am sure that there are more recent studies on the benefits of radiotherapy for triple negative but believe the findings are the same.

    In this study, the way I read it, the only difference in recurrance between the three groups (mx, mx+rads, or lx+rads) after adjusting for stage, tumour size, nodal status etc. was the inclusion of radiation.

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  • Kathy044
    Kathy044 Member Posts: 433
    edited February 2016
    Here Caroline, to confuse matters further, this info published 2014 showed no additional benefit with radiation all things being equal.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881939/
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  • CarolinaAmy
    CarolinaAmy Member Posts: 281
    edited February 2016

    Ugh. So here's what I finally emailed my surgeon this morning, along with his response. I really don't feel like my question was answered, though.


    Good morning, Dr. ______.

    I had a couple of questions I hoped you could answer just to reassure my mind. I unexpectedly came across a study that surprised me and wanted to know your thoughts on this vs. the study that showed potential improved outcomes with mastectomy for younger TNBC patients. I remember seeing this study some time ago and dismissing it for some reason, and I’m hoping you’ll be able to say, “They’re idiots and didn’t factor in that later stages are more likely to undergo mastectomy but also more likely to have reduced overall and disease-free survival.”

    Also, is there any possibility I’m putting myself at potentially GREATER risk of recurrence (distant or otherwise) by choosing mastectomy rather than lumpectomy? Occasionally I have seen mention of the idea that the body’s healing response to a serious surgery such as mastectomy may be itself oncogenic (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171628/). I’m hoping I’m misunderstanding this.

    Thank you so much for your time and any guidance you can give me.

    Sincerely,

    *********************************

    And here's his response this evening:

    Hi Amy,

    Interesting but just one study.

    I would not over read it.

    There is always some risk of complications and reduced immune function with more surgery but you are young and healthy and should do well.

    Kind Regards,

    _____ __________

    *************************************

    I appreciate him writing back, but this really didn't answer my questions. Please help me.


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