Dr. Dixon on the Discrepancy in the Rate of Mastectomies

J. Michael Dixon, MBChB, MD, Professor of Surgery, Consultant Surgeon, University of Edinburgh, Clinical Director of the Edinburgh Breast Unit, Western General Hospital, Edinburgh, Scotland, discusses the discrepancy in the rate of mastectomies.

In the right patient with breast cancer, Dixon says, mastectomy is the right treatment. He says that it is difficult to understand why there are less mastectomies being performed in Europe compared to the U.S. There is recent evidence that shows survival may be better with breast-conserving surgery and radiotherapy, suggesting that fewer mastectomies need to be performed.

It has always been thought that mastectomy is the safer option in patients with breast and that rates of mastectomies have been so high due to fear of recurrence. Dixon says that there have been dramatic reductions in recurrence after breast-conserving surgery.

Finally, Dixon says that over-treatment is a problem: screening is diagnosing more women with early-stage disease and the question remains as to whether or not it makes sense to treat them with mastectomy when a large portion will never have problems.