Mastectomy vs. Lumpectomy: Which Is Right for You?
If you’ve been diagnosed with early-stage breast cancer, your doctors may say that you have a choice of which surgery to get to remove the cancer. The two main options are:
lumpectomy (also called breast-conserving surgery), which removes just the tumor and a small amount of healthy tissue surrounding it, usually followed by radiation therapy
mastectomy, which removes the entire breast
When is mastectomy recommended?
Mastectomy is usually a better option than lumpectomy for people who have certain risk factors. For example, mastectomy will probably be recommended for you if:
you have a tumor that is large relative to the size of your breast
you have multiple or very large areas of ductal carcinoma in situ (DCIS) or other tumors in different parts of your breast
you have already had one or more lumpectomies, but your surgeon could not completely remove the cancer and get a rim of healthy tissue surrounding it (called the clear margin)
you have an inherited gene mutation that increases your risk of developing a second breast cancer, such as a BRCA1 or BRCA2 mutation
you have inflammatory breast cancer
radiation therapy is not a good option for you
Radiation may not be recommended for you if you’ve already had radiation to the same breast, or you have a disease that makes you sensitive to radiation side effects (such as scleroderma or lupus), or you’re pregnant.
When do you have a choice between mastectomy and lumpectomy?
If you have early-stage breast cancer with an average risk of recurrence, you may be offered the option of a lumpectomy or a mastectomy. That’s because studies have shown that — for people in this situation — mastectomy and lumpectomy with radiation work equally well to lower the risk of dying from breast cancer. Long-term survival rates are about the same for both approaches. They also work equally well to lower the risk of recurrence.
That means that if you’re given the choice of a lumpectomy or a mastectomy, you’ll have to think about what’s most important to you.
Lumpectomy: pros and cons
The main advantages of lumpectomy are:
You can usually keep most of your breast tissue and nipple (although you may have some changes in the shape of the breast).
You can usually retain sensation in the breast area.
It’s a less invasive and shorter surgery, with a quicker and easier recovery.)
It has a lower risk of complications.
Many people opt for lumpectomy if they have other health conditions, like diabetes or heart problems, that could make a bigger surgery like a mastectomy riskier.
The main disadvantages of lumpectomy are:
You may need one or more surgeries to take out tissue in the area where the tumor was (re-excision lumpectomy).
You’ll probably need to get radiation therapy.
You’ll still need to get regular screening mammograms.
Mastectomy: pros and cons
The main advantages of mastectomy are:
Some people find that it gives them peace of mind and makes them worry less about the breast cancer coming back.
You may be able to skip radiation therapy and regular screening mammograms or other imaging tests.
The main disadvantages of mastectomy are:
Permanent loss of the whole breast and loss of sensation in the breast area, which can be distressing.
It’s a more extensive, longer surgery, with a higher risk of complications and a longer recovery time.
There’s a risk of developing chronic pain.
How to decide what’s right for you
When weighing decisions about surgery, be sure that you talk with your oncologist and surgeon and get all your questions answered. You may want to seek a second opinion to get a better understanding of your options.
Keep in mind that choices about surgery and other treatments can be deeply personal. It may be helpful to talk with other people who’ve decided between a mastectomy and a lumpectomy and those who’ve had each type of surgery. You can connect with others who’ve had or are considering mastectomy and lumpectomy in Breastcancer.org’s community discussion forums and virtual support groups.
