February 24, 2009

Breast Cancer Surgery Warning

A top breast cancer expert is warning that women who choose minimally invasive breast surgeries for better cosmetic outcomes could be putting their lives at risk.

In an editorial on the British Medical Journal's Web site, Monica Morrow, the chief of breast service at Memorial Sloan-Kettering Cancer Center in New York, wrote effectiveness and safety, as well as aesthetic outcomes, need to be considered when planning surgery for breast cancer.

She said over the past 30 years, surgery has become increasingly devoted to improved cosmetic outcomes.  New techniques that involve minimal skin incision, including oncoplastic and endoscopic surgery, are now possible, but a review of the evidence reveals that the oncological safety of these new procedures is often not being evaluated thoroughly, Morrow said.

She said she worries if this trend continues; there will be a greater risk of losing some of the gains in survival seen in the past decade.

"We must ensure that surgical approaches designed to improve cosmetic outcomes do not increase local failure and the risk of subsequent death from breast cancer," Morrow was quoted as saying.

Morrow said the developing fields of minimally invasive breast surgery require rigorous assessments of patient-reported outcomes to ensure that new procedures actually improve outcomes that are important to patients.

SOURCE: Published on the British Medical Journal's Web site on February 20, 2009


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