What is Lumpectomy vs. Mastectomy?

Breast cancer can lead to many tough, critical decisions, especially on surgery for the treatment of early breast cancer, which can often be either lumpectomy (also called breast-conserving surgery) or mastectomy.

Patients should always have a clear understanding of their options, including the potential benefits, limitations, and other factors specific to their situation, discussed with their breast cancer care team.

Lumpectomy: What is it?

A lumpectomy is a type of breast-conserving surgery that removes the cancer along with a small amount of healthy tissue around it.

Lumpectomy may be an option if:

• The cancer or DCIS is small compared with the size of the breast.
• The cancer is in only one area of the breast.
• The patient can safely have radiation therapy (RT) when it is needed.

A lumpectomy is usually followed by radiation therapy to the breast to lower the risk of breast cancer coming back in that breast. Radiation therapy, based on X-rays or other types of radiation therapy used by doctors to destroy cancer cells, is tailored to the individual patient and the specifics of her breast cancer. The timing and course of treatment are based on many factors, including the type of surgery and the type of cancer.

Why is radiation therapy needed after a lumpectomy?

After lumpectomy, the tissue removed is sent to a pathologist to examine the margins (edges) where it comes from the breast. If cancer cells are present at the margins, additional surgery may be performed to remove any that may have been left behind.

Mastectomy: What is it?

During a mastectomy, the entire breast with the cancer or DCIS is removed.

A mastectomy may be an option if:

• The cancer or DCIS is large or in more than one area in the breast.
• The cancer or DCIS occurs under or around the nipple.
• The patient is unable or chooses not to have radiation therapy.
• Previous lumpectomy had cancer cells at the margins, or other factors.
• The patient has certain other medical or inherited conditions.

A mastectomy may be followed by reconstruction (rebuilding) of the breast, which may happen during the same surgery or later, as the surgeon will talk to the patient about reconstruction options.

Lumpectomy vs. Mastectomy: is one better than the Other?

There is not one best type of surgery for breast cancer. For many women who are candidates for either lumpectomy or mastectomy, studies have shown that both have similar rates of survival and recurrence (cancer coming back); therefore, the decision to have one or the other should not be based on which has a better survival but on other factors including the patient's wishes, other medical conditions, radiation treatment, cosmetic outcomes, recovery and other issues.

What are the recurrence rates for lumpectomy vs mastectomy?

Both lumpectomy and mastectomy have a risk of cancer recurring in the treated breast area. Following lumpectomy with radiation therapy, NCI estimates there is a 5% to 10% chance that the cancer will return in the treated breast within 12 years of the surgery. If local recurrence happens following lumpectomy, mastectomy can be an option. Following mastectomy, cancer can also recur in the chest wall or in the tissues that remain after surgery; this is estimated to occur in 5% of patients within 12 years of the surgery. For both treatments, the chance of recurrence depends on many factors including the type of cancer, tumor features, treatment, and other issues.

What is the recovery time for lumpectomy vs mastectomy?

The time it takes to recover from surgery varies for each person and their situation. In general, patients who have had a lumpectomy can resume most normal activities within about 2 weeks of the surgery, depending on the exact procedure and the individual's situation. Most people who have a mastectomy can expect to recover fully in about 3 to 4 weeks following the surgery. A mastectomy with reconstruction often takes longer for complete recovery, taking about 6 to 8 weeks or longer depending on the specific situation and reconstruction performed. Swelling, pain, fatigue, numbness, and other effects of surgery are common following either procedure. Specifics of recovery depend on the patient and the procedures performed and should be discussed with the surgeon and other members of the care team.

How does breast appearance differ after lumpectomy vs mastectomy?

Breasts following lumpectomy and mastectomy are very different. After lumpectomy, the patient has most of the breast tissue, and any changes to the shape or size of the breast will depend on the amount of tissue that needed to be removed to remove the cancer. The patient will have a visible scar at the surgery site. Following mastectomy without reconstruction, the patient has little or no breast tissue on the affected side, and the area will be flat and without a breast. Following mastectomy with reconstruction, the surgeon can use implants or tissue from other parts of the body to reconstruct a breast that resembles a natural breast. This surgery is the best treatment option during mastectomy or at a later time. Reconstruction may not always restore the appearance or sensation of the breast.

Will I lose sensation in my breast after surgery?

The sensation in the breast after surgery is also different for both lumpectomy and mastectomy. For those who have had lumpectomy, the natural sensation of their breast will remain intact. With mastectomy, there is a possibility that the patient may not have the same natural sensation in their breast, especially around the site of incisions and under the armpit.

What additional treatments are needed after breast surgery?

Surgery to remove breast cancer is only one part of treatment for breast cancer. Patients will need to work with their care team to determine if other treatments such as radiation therapy, chemotherapy, hormone therapy, targeted therapy, or immunotherapy are needed. Patients who have lumpectomy will generally require radiation therapy, though the specifics vary for each patient. Some patients who have mastectomy may need radiation therapy as well.

What questions should I ask before choosing lumpectomy or mastectomy?

Before choosing lumpectomy or mastectomy, patients should ask their breast surgeon and other members of their care team questions such as:

• Which surgery is right for me, given my diagnosis?
• Do I need radiation therapy following surgery?
• What is the likelihood of cancer recurrence with each surgery?
• What kind of appearance and sensation can I expect following each surgery?
• What is the recovery following surgery?
• Do I need other treatments such as chemo or hormone therapy?
• If I choose mastectomy, do I have options for reconstruction?
• Do I need additional surgery if I choose lumpectomy?
• What are the risks and benefits of removing the other breast?
• Would I benefit from a second opinion?

The NCI encourages patients to take the time following diagnosis to learn about their treatment options, discuss those options with their doctors and family, and consider what matters most to them. Getting a second opinion can help patients make the best choice about their care.

How do I decide between lumpectomy and mastectomy?

Deciding between lumpectomy and mastectomy requires more than just thinking about the tumor. It also requires women to think about their cancer and situation and what is the best option for their future. For an eligible patient, lumpectomy with the additional treatment has been shown to have similar survival outcomes as mastectomy; however, for some other patients, this may not be an option. For some patients, mastectomy may be a more appropriate treatment based on the size, location, spread, and other factors of their cancer.

At Tender Palm Hospital, the breast cancer care team can help patients make the best choice regarding their surgery and treatment. Patients should always consult with their breast cancer care team and surgeon to choose the best option for their specific diagnosis and personal situation.

Which breast cancer surgery is right for you?

If you have been diagnosed with breast cancer or DCIS and are considering lumpectomy and mastectomy, talk to a qualified breast surgeon before making any decisions.

The right kind of surgery can help you get the treatment you need for your breast cancer while also considering your medical and personal needs.

Call us at +91-9076972161
Email at care@tenderpalm.com

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