The effects of TCM on the outcomes after mastectomy: a large population-based study

Sufficient evidence concerning the impact of traditional Chinese medicine (TCM) on clinical outcomes for breast cancer patients in Taiwan is not available. This study sought to examine the association between TCM integration and post-operative outcomes among women undergoing mastectomies.

Utilizing a large insurance database, the Taiwanese researchers identified a cohort of adult women who underwent breast cancer surgery during the 2010–2019 period. They compared sociodemographic profiles and comorbidities between TCM users and non-users. Multiple logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for both mortality and postoperative complications.

Among 91,298 eligible patients, the one-year pre-operative prevalence of TCM utilization was 40%. Compared to the control group, TCM users demonstrated:

• a significantly lower likelihood of postoperative stroke (OR 0.76, 95% CI 0.62–0.93),
• and a reduced requirement for intensive care (OR 0.74, 95% CI 0.59–0.91).

Moreover, the cumulative exposure of more than 4 TCM consultations within the year preceding surgery was linked to a decreased risk of stroke (OR 0.76, 95% CI 0.61–0.95).

The authors concluded that “our findings indicate that integrating TCM during the year preceding breast cancer surgery is correlated with lower risks of postoperative stroke and a reduced requirement for intensive care. Nevertheless, these observed benefits warrant further verification through prospective and large-scale clinical investigations. Based on these results, we suggest that both Western medical practitioners and public health administrators should be mindful of TCM’s role in the comprehensive care of patients with breast cancer.”

In the paper itelf, the authors “hypothesize that pre-operative TCM integration contributes to the observed reduction in stroke risk and intensive care requirements following mastectomy. These prior insights provide a plausible biological foundation for the favorable outcomes observed in our study”. In other words, they believe that the associations is causal.

I beg to differ!

Much research has demonstrated that people who use so-called alternative medicine (SCAM) in addition to conventional therapies differ from those who don’t. In general, they tend to be more health concious – if not, they would not go to the trouble of using and paying for SCAM. This difference alone suffices to bring about the observed outcomes – even if TCM has no or perhaps a slightly negative overall health effect.

But let’s be generous!

Let’s assume the authors are correct in assuming that the association is causal and that TCM brought about the observed outcomes.

What does that actually mean?

TCM consists of many different modalities. If we just focus on oral medications and assume that there are 1000 different ones [in fact, the number is about 6 times higher], which one do we take to experience the observed outcome? Perhaps all of them?

What I am trying to point out that such research is meaningless; it has zero practical consequences, even if its results were real – which they probably are not.

In the end, it boils down to one main thing: the promotion of unproven (and occasionally dangerous) TCM.