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Invited Commentary
January 2015

The Swinging Pendulum

Author Affiliations
  • 1Department of Surgery, Johns Hopkins Medicine, Bethesda, Maryland
JAMA Surg. 2015;150(1):16. doi:10.1001/jamasurg.2014.2902

After the landmark National Surgical Adjuvant Breast and Bowel Project–B27 study, which showed no survival difference between mastectomy and lumpectomy with radiation, breast conservation surgery (BCS) emerged as the preferred option for early-stage cancers.1,2 This led to a steady increase in BCS, but the seminal article in this issue by Kummerow et al3 reveals a surprising rise in the rate of mastectomy for early-stage cancers. The authors attribute this rate increase to developments in reconstructive techniques, better served by mastectomy.