Lumpectomy or Mastectomy? What You Need to Know

If you have been diagnosed with breast cancer, deciding what type of surgery to have can feel like one of the most important decisions in your treatment. The right choice depends on the type and extent of your cancer, your breast anatomy, whether radiation is recommended, your overall health, and your own preferences.

For patients with early-stage breast cancer who are candidates for either approach, lumpectomy followed by radiation and mastectomy are equally effective at saving lives. Choosing the more extensive surgery does not generally improve the chance of cure or long-term survival. Mastectomy may slightly reduce the chance of cancer returning in the breast or chest wall, but that does not mean it offers a better chance of surviving breast cancer.

“One of the biggest misconceptions about breast cancer surgery is that more surgery automatically means better outcomes,” says Dr. Surupa Sen Gupta, Breast Surgical Oncologist at Maryland Oncology Hematology. “For many women with early-stage breast cancer, a lumpectomy followed by radiation offers the same survival rates as a mastectomy. Every patient’s situation is unique, which is why we take the time to discuss all available options and develop a treatment plan that aligns with both the medical needs and personal preferences of the individual.”

What Is the Difference Between a Lumpectomy and a Mastectomy?

A lumpectomy, also called breast-conserving surgery, removes the cancer along with a rim of surrounding breast tissue while preserving the remainder of the breast. Lymph node surgery may also be performed when appropriate.

For most patients with invasive breast cancer who choose lumpectomy, radiation therapy is an important part of breast-conserving treatment. There are selected situations in which radiation may be shortened, limited to part of the breast, or occasionally omitted.

A mastectomy removes essentially all of the breast tissue. Depending on the individual situation, the breast skin and sometimes the nipple and areola may be preserved.

There are several types of mastectomies, including total (simple) mastectomy, skin-sparing mastectomy, nipple-sparing mastectomy, and modified radical mastectomy. The most appropriate option depends on the size and location of the cancer, lymph node involvement, and whether reconstruction is planned. Your breast surgeon can explain which approach may be best for your individual situation.

Are Lumpectomy and Mastectomy Equally Effective?

For appropriately selected patients with early-stage breast cancer, lumpectomy followed by radiation and mastectomy are equally effective treatment options. While mastectomy may reduce the risk of cancer returning in the breast or chest wall, the difference is generally small when modern breast-conserving treatment is used. Breast conservation should not be viewed as a less effective or less aggressive cancer treatment when it is medically appropriate. For patients who are good candidates for either option, both treatments offer equivalent survival outcomes.

The best choice can be different for patients with more extensive disease, multiple areas of cancer, certain genetic predispositions, prior radiation, difficulty obtaining clear margins, or other clinical circumstances. To learn more visit https://marylandoncology.com/cancers/breast-cancer/.