Can Surgery Cause Breast Cancer to Spread?

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Some new evidence has been uncovered that supports a controversial theory about breast cancer and surgery. The theory? That surgical intervention to remove a tumor could actually promote the spread of cancer in certain women, leading to a greater risk of mortality.

Now, don’t panic. Let’s take a look at this theory and the weight of the evidence for it first before we come to any conclusions.

According to the National Institutes of Health (NIH), there will be 178,480 new cases of breast cancer in women and 2,030 in men in the U.S. in 2007. The mortality rates this year are expected to average out at 40,460 women and 450 men; disturbing numbers for sure.

Normally, to treat breast cancer that has not yet spread, your specialist will recommend radiation therapy and/or surgery to destroy the tumor — surgery being by far the most common strategy. However, some scientists believe that there’s something about surgery that could be causing great harm in some women.

A research team comprised of researchers from the U.S., U.K., and Italy has been looking into the theory that surgery to remove a primary malignant tumor from the breast could actually cause the cancer to spread to other areas. Back in 2005, this same team looked back on historical medical theory and at other evidence and concluded that surgery could trigger the “animation” of tiny tumors that exist undetected in other areas of the body.

So, when the primary tumor is removed from the breast, a signal is either released or some kind of control inhibiting activation is removed and tiny tumors that were not active before begin to grow and spread. A study the team did on Italian women showed that 20% of premenopausal women had their cancer spread after surgery, compared to approximately 10% of postmenopausal women. Based on this study, it seems that a woman who has not entered menopause is more likely to have a negative reaction to surgery than a woman who has. Could there be a hormonal connection?

Moving on, this latest analysis takes a look at breast cancer in African American women. Breast cancer is more likely to be fatal in this section of the population — 1.5 to 2.2 times more likely — even though the rates of this type of cancer are higher in white women. Some say that it’s the differences in medical care at the varying levels of society that are causing this gap, but this research team is now suggesting that it’s the type of treatment and the way the body reacts to it that are hiking up the mortality rate.

To make this leap, you’d have to know that African American women are diagnosed with breast cancer at the average age of 46 and that white women are usually diagnosed around the age of 57, perhaps due to genetic or hormonal differences. That’s a huge difference in age — and it means that African Americans are often starting treatment, usually surgery, while they’re in their premenopausal years. It’s this timing that researchers believe could be the key to the surgery-metastasis link.

In addition to their 2005 study findings, the researchers have looked into laboratory and animal studies that back up the theory that, while in the body, a primary tumor sends out a substance called an “angiogenesis inhibitor” that blocks the growth of new blood cells, meaning that it keeps the aforementioned tiny tumors around the body inactive.

When the tumor is removed, there’s nothing stopping the other tumors from thriving and spreading. Moreover, surgery stimulates the body into releasing its own “angiogenetic promoters” in an effort to heal itself faster, which just adds fuel to the cancer fire. Note that none of this has been proven yet in biological studies on humans.

Since all of this research is speculative and has not been proven satisfactorily, the researchers cannot recommend that changes be made in the way breast cancer is treated. Whatever your age, as a woman, you must continue to get screened for this disease on a regular basis and must take immediate action on any findings. If you are diagnosed with cancer, follow the advice of your doctors. Surgery could still give you the best chances of healing and survival.

This research only serves to point out that methods must be reevaluated and that more research needs to be done. If it is true that surgery could cause a chain of events that could increase the risk of the cancer spreading, it doesn’t mean that surgery is not an option. It just means that certain measures should be taken to make it safer, such as administering angiogenesis inhibitors before and/or after the operation.

If you’d like to know more about breast cancer and its treatment, talk to your doctor or visit the National Cancer Institute web site at www.cancer.gov. If you think you might have the disease, get checked out by a medical professional right away.

 

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