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Consequently, both are the main choices of patients and physicians in treating the disease. Both procedures are also found to have equal survival rates. However, with the increasing awareness of women afflicted with breast cancer on the impact of surgery on their psychological state related to loss of their breast, more and more women are resorting to a less invasive treatment which is lumpectomy and adjuvant therapies. Added to this is the notion that mastectomy is over used. Lumpectomy is a surgical removal of the breast lump including some normal tissues.
Although, lumpectomy and adjuvant therapies are preferred methods of treatment for most women with breast cancer, their use is bombarded with several controversies. Body One distinct issue with lumpectomy includes the inadequate outcome data to the extent of its use and efficacy. Clinical trials included insufficient size to establish a convincing result of its application. Although, there had been multiple randomized trials of lumpectomy in patients with or without radiation, it was found out that the survival rates are based solely on unpublished analysis.
In addition, participants in several studies were over treated producing a bias result. This was revealed in the study by Cumming (n.d) where he added that using a meta- analysis pose a risk on grounds that methods might be a concern. Cumming also found out that in the case of ductal carcinoma alone, data is limited to show importance of lumpectomy and other treatments following it. Consensus among pathologists on pathologic staging is also a question because there is no recommendation as to the exact stage lumpectomy is effective.
It was further revealed that studies on radiation therapy after lumpectomy had no uniform techniques in using different radiotherapy agent such as iridium, electron beam, and cesium needle brachytherapy. Added to the above problem is controversy surrounding the falsified claim that lumpectomy with adjuvant therapy was as effective as mastectomy. The lead investigators are found to commit misconduct with the result of their study of not providing the correct result of their study. Although, lumpectomy has been found to be effective with the early stages of cancer, its credibility was damaged because of the controversy which ruined the trust not only of patients but the public in general towards lumpectomy and adjuvant therapies.
This shows that not only the lack of data on the efficacy of lumpectomy combined with adjuvant therapies is a problem but is accompanied with several other problems. Interestingly though, the study published in the Journal of National Cancer Institute ( 2004) reported that there is a significant decrease in the recurrence in the number of patients who went through lumpectomy with radiotherapy however not in lumpectomy alone. There is also no survival advantage even with the addition of radiotherapy.
Similar with the study of Cumming, the JNCI reported that information from current and previous studies are found to be deficient in attesting that lumpectomy in combination with adjuvant therapy is more promising. Whether lumpectomy is a choice of the patient or the physician, cost is also an issue for the choice of therapy among women with breast cancer. Lumpectomy with radiation therapy is more costly than mastectomy. Munoz and company (1986) found out in their
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