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Robert Wascher, M.D.: I am going to discuss recent developments in breast cancer surgery.
A lot has changed since I started my career in surgery 20 years ago. Most patients with
breast cancer would have their *** removed, they would have all their lymph nodes removed
even with early stage cancers. Now if you fast forward 20 to 25 years later, about 90%
of patients can safely undergo breast conserving surgery with a lumpectomy which is usually
combined with radiation therapy, and most patients will be able to avoid that more radical
lymph node surgery and have a more high tech sampling of the lymph nodes performed and
that is called a sentinel lymph node biopsy. About 90% of patients really can avoid mastectomy
altogether. We have abundant research data showing that the survival rates long term
are equivalent between mastectomy and lumpectomy, with the exception of patients that might
have other risk factors for getting a second or third breast cancer such as that inherited
gene for breast cancer or multiple sites of cancer or cancer on both sides. Really in
2013 and this time, we really think that breast conserving surgery is just a much better option
for most patients not all patients, and so that is our typical recommendation.