Breast Conservation Versus Mastectomy:

Patient Survival in Day-to-Day Medical Practice and in Randomized Studies

PEMD-95-9: Published: Nov 15, 1994. Publicly Released: Nov 15, 1994.

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Pursuant to a congressional request, GAO reviewed the survival rates of patients receiving breast-conservation therapy versus mastectomy therapy, focusing on whether patients' survivability is affected by having treatment in single-center studies rather than multi-center studies.

GAO found that: (1) the 5-year survival rates for breast cancer patients treated with breast-conservation therapy were similar to that of mastectomy in community medical practices; (2) patients that were treated at single-center facilities usually had slightly higher survivability rates than patients who received treatment at multi-center facilities; (3) on average, breast cancer patients appear to be at no appreciable risk by selecting breast-conservation therapy rather than mastectomy; (4) although patient survivability data were vulnerable to hidden selection bias, such bias was unlikely since the group of patients reviewed were homogeneous and adjustments were made for patients' health and demographic characteristics; and (5) although a minority of patients who voluntarily chose breast-conservation therapy over recommended mastectomy therapy could have achieved slightly better results with mastectomy, the differences were not statistically significant.

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