Medical Center of Aurora - October 03, 2018

You’ve completed a breast biopsy and have been diagnosed with breast cancer. Your surgeon has presented you with two treatment options: lumpectomy vs mastectomy. How do you know which one to choose?

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Understanding the terms

A lumpectomy is considered a breast-conserving surgery. The goal of the procedure is to remove the cancer and some of the surrounding normal tissue but leave the breast intact. Often, the physician will also remove a few surrounding lymph nodes during the procedure.

A mastectomy, on the other hand, removes the entire breast, and, depending on the type of mastectomy performed, other tissues will be removed as well, including muscles and lymph nodes.

Mastectomy types include:

  • Simple mastectomy
  • Radical mastectomy
  • Modified radical mastectomy
  • Subcutaneous (nipple sparing) mastectomy
  • Skin sparing mastectomy

If you will be undergoing any breast surgery, ask your physician if you should consult with breast reconstruction specialist or plastic surgeon beforehand.

Treatments in addition to surgery

Before surgery, you may be given chemotherapy to shrink the tumor (neoadjuvant therapy) and reduce the amount of tissue that needs to be removed. After surgery, you may be given radiation therapy, chemotherapy, or hormone therapy (adjuvant therapy) to destroy any remaining cancer cells.

Choosing the right option for you

Breast-conserving surgery is a good option if the cancer is an early stage and is limited to a specific area of the breast. Keep in mind that most patients undergoing breast-conserving surgery undergo radiation therapy afterward.

However, your surgeon may recommend a mastectomy if any of the following conditions exist:

  • The tumor is spread throughout the breast (diffuse tumor).
  • There are multiple tumors in different areas of the breast (multicentric tumors).
  • The tumor is directly beneath the nipple or large in relation to breast size.
  • You have had previous high-dose radiation therapy to the affected breast.

A mastectomy may also be a more appropriate choice in certain psychosocial situations, such as if the duration of radiation therapy would interfere with your ability to deal with other personal or work obligations.