Lumpectomy vs. Mastectomy: Which is Best for You?

In In The News by Barbara Jacoby

From: healthline.com

A lumpectomy preserves more of your breast compared to a mastectomy. But you can choose a mastectomy that removes the entire breast or preserves the nipple and areola.

Lumpectomy and mastectomy procedures are both performed to remove breast cancer. While both are effective, they have different benefits and risks.

A lumpectomy preserves the breast, while a mastectomy removes all of it.

Your doctor will help you decide which is best for you. The location and stage of your cancer are significant factors when deciding between the two, as well as patient characteristics such as the size of your breasts.

Lumpectomy vs. mastectomy

Lumpectomy

A lumpectomy is a surgery that removes breast cancer while preserving the breast. Surgeons will leave as much of the breast alone as they can while removing all of the tumor.

Your doctor might also refer to it as a breast-conserving surgery (BCS) or partial mastectomy.

During this surgery, your doctor will remove the tumor and any surrounding margins of tissue that has been affected. This includes removing a healthy rim of tissue.

After the procedure, your surgeon will check to make sure all cancer has been removed. If it has, the lumpectomy was successful. If not, your surgeon may need to remove another margin tissue. In more severe cases, a lumpectomy may no longer be an option.

You will likely need radiation therapy (RT) after a lumpectomy to prevent recurrent cancer and to destroy any microscopic cancer cells in the breast that can’t be seen on the mammogram or felt at the time of surgery.

This procedure is recommended for patients with a less invasive form of cancer. If cancer has spread throughout the breast or if the tumor is too large, surgeons may recommend a mastectomy.

Mastectomy

A mastectomy treats breast cancer by removing the entire breast. If the cancer has spread to your lymph nodes, they will need to be removed in an additional procedure called a sentinel lymph node biopsy.

There are five types of mastectomy procedures:

  • Simple (total): In this procedure, the surgeon removes the entire breast, including the nipple and areola. A simple mastectomy is recommended for women looking to prevent breast cancer from ever occurring.
  • Modified radical: This mastectomy removes the entire breast, similar to a simple mastectomy. Surgeons perform this form of mastectomy when there is known disease in the axillary (underarm) lymph nodes. If it has spread, your level 1 and 2 lymph nodes will be removed from your underarm.
  • Nipple-sparing: This is a total mastectomy that doesn’t remove the nipple or areola.
  • Skin-sparing: As the name suggests, this procedure leaves the skin over the breast intact and removes the entire breast and nipple/areolar complex. The breast skin is saved for breast reconstruction.

Pros and cons

Lumpectomy and mastectomy procedures are both effective treatments for breast cancer.

The main differences between the two surgeries involve preference and potential side effects.

Lumpectomy benefits

The lumpectomyTrusted Source is less invasive compared to a mastectomy. The surgery focuses on the affected tissue and only a rim of healthy tissue, which helps to preserve the natural shape of your breast.

Patients who undergo a lumpectomy still maintain a sensation in their chest wall. Those who undergo mastectomy experience a loss of complete sensation of the chest wall skin afterward.

In many cases, a lumpectomy is a same-day procedure that allows you to return home following surgery. No overnight stay is necessary.

ResearchTrusted Source on Swedish women also suggests that BCS followed by RT is associated with a higher overall and breast cancer-specific survival compared to mastectomy followed or not followed by RT.

But some research suggests that there is no difference in overall survival rates of breast cancer in people who undergo BCS followed by RT versus those who undergo a mastectomy. A 2021 study suggests the two treatment types are at least equivalent in terms of overall survival of early breast cancer.

Lumpectomy risks

If your cancer comes back after a lumpectomy, which sometimes happens, you’ll need additional surgery.

People who get a lumpectomy also usually have to get RT to ensure all traces of cancer are gone. You might have to get RT five days per week for up to seven weeks.

Side effectsTrusted Source from RT include:

Mastectomy risks

A mastectomy is more invasive than a lumpectomy and requires a longer hospital stay. Your recovery time may be longer, and you may also experience some side effects, including:

  • infection
  • seroma
  • nerve pain
  • buildup of fluid in lymph nodes (lymphedema)
  • blood buildup at the surgery site (hematoma)
  • skin discoloration or darkening due to necrosis

A mastectomy is also a permanent removal of your breast, which can have psychological effects. Many women choose to have breast reconstruction following a mastectomy, which is another cost and has a longer recovery time.

Which procedure is right for you?

Determining which surgery to get is an important decision. Be sure to discuss your options with your doctor. They may recommend a type of surgery based on the following:

  • tumor size
  • if it’s affecting the lymph nodes and surrounding tissue
  • breast size
  • location and stage of cancer

With research and professional guidance, you can take an active role in your treatment by deciding which procedure is best for you.

The takeaway

Whether you choose a type of mastectomy or lumpectomy with or without radiation is up to you. Your doctor will have recommendations based on the location and size of the tumor, your cancer stage, breast size, and if it has spread to the lymph nodes or surrounding tissue.

A lumpectomy, in general, will preserve more of your breast compared to a mastectomy, but you may also consider breast reconstruction after undergoing a mastectomy. This, however, will have additional costs and a longer recovery time.

There are risks associated with both types of procedures, but talking with your doctor can help you choose which one is right for you.