Monday, October 18, 2010

Removing healthy cells surrounding tumours drastically cuts chances of breast cancer returning

Women suffering from breast cancer can reduce their chance of the disease returning if they let surgeons remove small amounts of the healthy tissue surrounding the tumour.
Research has shown that the chance of the disease returning can be reduced by more than 90 per cent if at least 2mm of normal cells surrounding the cancer are taken out.
Surgery to remove part of a woman's breast is often an extremely distressing experience and many specialists will try and preserve as much healthy tissue as possible for cosmetic reasons.
Treatment: Early screening is vital but now doctors say that reducing the chances of breast cancer returning can depend on how much healthy tissue around the tumour is removed
But this latest research has prompted doctors to call for new guidelines to try and reduce the chances of the cancer returning.
The amount of breast tissue cut away varies between individual surgeons. 
While some will cut away just 1mm surrounding the tumours, others will remove more than 1cm in the hope the tumours will be less likely to return.
Doctors at the Good Hope Hospital in Sutton Coldfield, Birmingham found there was a dramatic reduction in tumour recurrence rates if more healthy tissue was cut out, particularly amongst women suffering from invasive breast cancer, the deadlier of the two types which often spreads to other organs.
In a study of 303 women they found that if at least 2mm of healthy surrounding tissue was removed there was a 2.4 per cent risk that tumours would return, compared to a 35 per cent risk if 1mm of surrounding cells were removed.
Lead author Dr Stephen Ward, from the hospital's department of breast surgery said: 'Patients undergoing breast conserving surgery are more likely to have recurrent cancer and the amount of tissue removed around the tumour, known as the free margin, remains controversial.
'A survey of 200 UK breast surgeons published in 2007 revealed wide variations in what they considered to be an adequate margin, with 24 per cent wanting a clear margin of 1mm and 65 per cent wanting a margin of 2mm or more.
'This study highlighted differences in practice across different units and the need for evidence-based guidelines.'
But the study, published in the International Journal of Clinical Practice, did not find a strong link between the amount of breast tissue removed and recurrence rates for non-invasive cancer, the less serious form.
Dr Ward added: 'Our research found that the overall probability of finding residual disease was 2.4 per cent if a woman had surgery where the free margin was 2mm or more from the invasive cancer.
'Based on these results, we feel confident that a free margin of 2mm from the area of invasive cancer is adequate to minimise residual disease, but the equivalent free margin for non-invasive cancer remains unclear.
'Eliminating the possibility of residual disease during breast conserving surgery is very important as nearly 50 per cent of patients with local recurrence go on to develop secondary breast cancer, which is a progressive incurable disease.'
Up to 45,700 women are diagnosed with breast cancer every year and 12,000 die.
Survival rates have dramatically improved over the last thirty years and now more than 8 in 10 sufferers will still be alive five years on from the first diagnosis.

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