OPTIONS FOR WOMEN
Cancer therapies compared

FOR THE FIRST time, a
large study on women
treated for breast cancer has
proven that women who
choose lumpectomy rather
than complete removal of
the breast have the same
chance of survival with less
radical surgery.

Total mastectomy has
been the treatment of choice
for some years, but the less
disfiguring lumpectomy has
become the focus of heated
medical debate, partly
because of increasing
pressure from women that it
at least be available as an
option.

Dr. Edward Fish, Director
of Toronto’s Henrietta Ban-
ting Breast Centre, says,
“This new study at last gives
a true scientific basis to con-
sider segmental mastectomy
(lumpectomy) with radiation
as the best treatment.”’

The Canada-U.S. study, —

involving 1,843 women in-
cluding 812 Canadians, was
the first clinical study of its
kind.

It compared the survival
rates after total miastec-
tomies and lumpectomies, in
which only the tumorous
lump and the surrounding
tissue are removed.

The women in the study ;
were in the early stages of;
breast cancer, with tumors’
of four centimetres or less.
They were randomly assign-

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ed to one of three groups for
treatment: total mastectomy
(removal of the breast but
not the underlying muscle),
and segmental mastectomy
with or without radiation
therapy.

After five years, the study
found no difference in the
survival rates of the three
groups.

However, radiation did
seem to reduce the likelihood
of recurrence of the tumor.

Ninety-two per cent of the
patients treated with radia-
tion after lumpectomy re-
mained free of tumor after
five years, while only 72 per
cent of those who had
lumpectomy but no radia-
tion treatment were disease-
free.

The study provides en-
couraging statistics on life
expectancy for breast cancer
victims.

At the end of five years,
the numbers of women
disease-free were: 464 of 586
women treated by total
mastectomy; 499 out of 632
who had lumpectomy
without radiation; and 522
out of 625 who had lump
removal with radiation.

The study also looked at
advanced. cancer
and found that only two per
cen: of those treated with
radiation and chemotherapy
had a tumor after five years,
compared with 36 per cent

ideas for

patients, .

of those treated with
chemotherapy alone.

The Henrietta Banting
Breast Centre was one of
several institutes involved in
the study. Dr. Bernard Fish-
er of the University of Pitt-

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sburg was the principal in-
vestigator. The results were
released recently by the U.S.
National Cancer {nstitute in
Washington and published
in the New England Journal
of Medicine. ‘

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