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DG DISPATCH - BREAST CANCER: Breast Conservation Viable In Developing Countries By Louise Gagnon Special to DG News OTTAWA, ON -- July 30, 1999 -- Breast conservation surgery is a viable modality of treatment for women in developing countries, where surgeons have traditionally performed complete mastectomies, according to prospective research presented at the second World Conference on Breast Cancer. Earlier data of psychoanalysis of patients found that many had decreased sexual activity and their social contacts had diminished, following complete mastectomies. That data prompted researchers to consider patients with early-stage breast cancer and locally-advanced breast cancer as candidates for breast conservation surgery. One of the advantages to breast conservation surgery is that patients maintain tactile sensations in the breast, explained Dr. Shashanka Bose, author of the study and professor of surgery and head of emergency services at the Postgraduate Institute of Medical Education & Research in India. All 53 patients, suffering from either early stage breast cancer or locally advanced breast cancer, in the non-randomised study had segmental mastectomy. The mean age of patients was 47. Two-thirds of patients were premenopausal and five patients had positive family history. Three quarters underwent axillary dissection in addition to segmental mastectomy. All patients received radiotherapy. A third of patients received chemotherapy, and more than half received tamoxifen. All cases were followed up for a median period of 48 months, with the range being 18 to 124 months. Loco-regional recurrence was seen in five (9.4 percent) cases while distant disease developed in eight (15 percent). Just one patient had both. Statistical analysis revealed that positive lymph nodes, age greater than 50, positive family history and advanced stage disease were risk factors for the development of local recurrence. "Our research has shown that breast conservation surgery is as safe as total mastectomy for early stage breast cancer," Dr. Bose said. "Patient satisfaction is very high with breast conservation surgery." E-mail this page to a friend or colleague! To print, use this version