Today's breast cancer news addresses hypnosis, breast conserving surgery and radiation.
Hypnosis during breast cancer surgery
Most of the news and research on hypnosis for breast cancer relates to managing hot flashes or pain. This week, the Toronto Sun reported on a Belgian study about hypnosis during breast cancer surgery. Of the 78 women in the study, 18 received a local anaesthetic plus hypnosis. The rest were given a general anaesthetic. Although the women who were hypnotized spent "a few minutes more" in the operating room, the time spent in recovery and in the hospital were "greatly diminished." In addition, according to one of the researchers, local anaesthesia can "block the body's stress response to surgery and could therefore reduce the possible spread of metastasis." At the UCL Hospital in Brussels, a quarter of all breast cancer surgeries are performed under local anaesthetic with hypnosis.
Multiple re-excisions are a safe alternative to mastectomy
According to a study in the Annals of Surgical Oncology, multiple re-excisions to obtain clear margins after breast conserving surgery (lumpectomy) are a safe alternative to mastectomy. In the study, 70 of 3,737 lumpectomy patients over a 10 year period had more than one re-excision. Of those 70, 49 eventually achieved clear margins. All 49 also received radiation. At a median follow-up of 64 months, 1 of the 49 patients had a local recurrence and 1 had a distant recurrence. The authors concluded that there was "an acceptably low risk" of recurrence "when negative margins are ultimately achieved."
Whole breast radiation when no breast mass is detected
Sometimes, when there is axillary metastasis, breast cancer will be diagnosed even with no palpable, mammographic or sonographic evidence of a breast tumor. This is called an occult primary. A UK study published in the European Journal of Cancer concluded that an occult primary should be treated with breast conserving surgery plus whole breast radiation or mastectomy. Although patients who did not receive radiation after lumpectomy experienced worse 5 year local recurrence and relapse free survival rates, there was no difference in overall survival rates. Also, the study suggested that it is "not necessary to irradiate the breast to more than 50Gy in 25 fractions." Higher doses made no difference in local recurrence rates.
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