A mastectomy is prudent when breast cancer returns after a lumpectomy, because survival rates are better than with another lumpectomy, according to a new report.

“We were surprised to find that so many women in our study – almost a quarter of them – had received another lumpectomy rather than a mastectomy,” Steven L. Chen, from the University of California Davis Cancer Centre in Sacramento, said in a statement.

“It’s likely,” he added, “that patients are asking for lumpectomies when their cancer is diagnosed a second time, and their doctors are simply complying with that request. Whatever the reason, that decision can shorten life spans.”

The study, in the American Journal of Surgery, involved 747 women who had a same-breast cancer recurrence after undergoing breast conservation therapy. Twenty-four per cent of these patients underwent a second lumpectomy.

The five-year survival rate was 67 per cent for women who had a lumpectomy compared with 78 per cent for those who had a mastectomy. An analysis confirmed that lumpectomy reduced the odds of survival by 50 per cent.

“As therapy for breast cancer becomes more targeted and researchers come closer to identifying those factors that make some breast cancers more aggressive than others, we may have the option of recommending second, and even third lumpectomies in select cases in the future,” study co-author Dr Steven Martinez commented.

“Until then,” he added, “mastectomy remains the best option for women experiencing a same-breast recurrence of their breast cancer.”

Source: American Journal of Surgery, October 2008.