March 29, 2024

Mastectomy vs. Lumpectomy: Navigating Your Breast Cancer Treatment Options

Close up of woman in beige underwear conducting a self-examination of her breast

Breast cancer is a disease where abnormal cells grow in the breast tissue. Finding the right treatment is key because everyone’s situation is different. Your treatment plan will depend on the stage of cancer, type you have, and your overall health. This could include surgery, radiation, chemotherapy, hormone therapy, targeted therapy, or a mix of these. Personalized treatment plans are important because they focus on what is best for you, aiming to fight the cancer while keeping side effects as low as possible. It is important to talk openly with your healthcare team to understand your options and make choices that feel right for you.

Understanding Breast Cancer Treatments

Surgery is a common treatment for breast cancer, and there are two main types: mastectomy and lumpectomy. A mastectomy involves removing the entire breast affected by cancer, while a lumpectomy removes only the tumor and a small margin of surrounding tissue. Both surgeries aim to remove cancerous cells from the breast, but they differ in the amount of tissue removed. Your healthcare team will recommend the most suitable option based on factors like the size and location of the tumor, as well as your personal preferences and medical history. It is important to discuss the benefits and potential risks of each procedure with your healthcare provider to make an informed decision that aligns with your individual needs and goals.

What Is a Mastectomy? Overview and Types

A mastectomy is a surgical procedure used in breast cancer treatment to remove some or all of the breast tissue affected by cancer. The purpose of a mastectomy is to eliminate cancerous cells and reduce the risk of cancer recurrence. A mastectomy may be recommended for breast cancer patients in several situations, depending on factors such as the size and location of the tumor, presence of multiple tumors, genetic predisposition, previous radiation therapy to the breast, or personal preference. For individuals with large tumors relative to breast size, extensive ductal carcinoma in situ (DCIS), or a high risk of cancer recurrence, mastectomy may be chosen to ensure the complete removal of cancerous tissue. 

Additionally, mastectomy may be recommended for those with genetic mutations like BRCA1 or BRCA2, which significantly elevate the risk of developing breast cancer. Some patients opt for mastectomy as a proactive measure to reduce the risk of future breast cancer, especially if they have a family history of the disease or have already had breast cancer in one breast (unilateral mastectomy) and wish to lower the likelihood of cancer developing in the other breast. Ultimately, the decision to undergo mastectomy is highly individualized and should be made in close consultation with a healthcare team, considering both medical recommendations and personal preferences. There are several types of mastectomy, each with its own characteristics and extent of tissue removal:

  • Total (simple) mastectomy:  Involves removing the entire breast tissue, including the nipple and areola, but not the underlying muscle. 
  • Double mastectomy: A double mastectomy, also known as bilateral mastectomy, involves removing both breasts, often chosen by individuals with a high risk of developing breast cancer in both breasts.
  • Radical mastectomy: Radical mastectomy is a less common procedure where the breast tissue, nipple, areola, and some of the surrounding lymph nodes and chest muscles are removed. 
  • Skin-sparing mastectomy: A skin-sparing mastectomy preserves more of the breast skin, often used when immediate breast reconstruction is planned, aiming to maintain a natural appearance post-surgery.

What Is a Lumpectomy? Exploring Breast-Conserving Surgery

A lumpectomy, also known as breast-conserving surgery or partial mastectomy, is a surgical procedure aimed at removing the tumor and a surrounding margin of healthy breast tissue while preserving as much of the breast’s appearance and function as possible. The primary goal of lumpectomy is to effectively remove cancerous cells while maintaining the overall shape and size of the breast. This approach is often preferred for early-stage breast cancer, where the tumor is relatively small compared to the size of the breast and has not spread extensively.

What to Expect 

During a lumpectomy procedure, the surgeon makes an incision near the tumor site and carefully removes the cancerous lump along with a small rim of surrounding healthy tissue to ensure complete removal of cancer cells. The amount of tissue removed may vary depending on factors such as the size and location of the tumor, as well as the individual’s breast size and shape. Following the removal of the tumor, the breast tissue is typically reshaped and closed with sutures. In some cases, sentinel lymph node biopsy may be performed during the same procedure to determine if cancer has spread to the nearby lymph nodes.

After a lumpectomy, patients can expect some discomfort, swelling, and bruising in the breast area, which can be managed with pain medication and rest. Most individuals can resume their normal activities within a few days to a week, although strenuous activities and heavy lifting should be avoided for a few weeks. 

Who Is a Candidate?

A lumpectomy may be the preferred option for breast cancer removal in situations where the tumor is small relative to the breast size, allowing for effective removal while preserving the breast’s appearance and function. It may also be suitable for patients who desire breast-conserving treatment and are willing to undergo adjuvant therapies such as radiation to minimize the risk of recurrence. Ultimately, the decision to undergo lumpectomy should be made in consultation with a healthcare team, considering factors such as breast tumor characteristics, individual preferences, and overall health status.

Comparing Mastectomy and Lumpectomy: Risks, Benefits, and Considerations

Effectiveness in Preventing Cancer Recurrence

In terms of effectiveness in preventing cancer recurrence, both mastectomy and lumpectomy can be equally effective when combined with appropriate adjuvant therapies like radiation, chemotherapy, or hormone therapy. Mastectomy involves removing the entire breast affected by cancer, reducing the chance of cancer recurrence in that breast to almost zero. However, lumpectomy followed by radiation therapy has been shown to have comparable outcomes in terms of preventing cancer recurrence in the treated breast. The decision between the two procedures often depends on factors such as tumor size, location, and individual patient preferences.

Surgical and Recovery Times

Regarding surgical and recovery times, mastectomy generally involves a longer surgical procedure and recovery time compared to lumpectomy.  A mastectomy may require overnight hospitalization and typically involves a more extensive incision and tissue removal, leading to a longer recovery period. In contrast, a lumpectomy is usually performed as a shorter outpatient procedure, with patients often able to return home the same day. Additionally, the recovery time after lumpectomy is often shorter, with less discomfort and a quicker return to normal activities compared to mastectomy.

Cosmetic and Psychological Impacts

In terms of cosmetic and psychological impacts, lumpectomy generally results in a more cosmetically pleasing outcome since it preserves a larger portion of the breast tissue compared to mastectomy. However, both procedures can have significant psychological impacts on patients. Mastectomy may lead to feelings of loss of femininity, or body image concerns due to the removal of the entire breast, while lumpectomy may still cause distress due to changes in breast appearance and concerns about cancer recurrence. Supportive care and counseling are often recommended to help patients cope with these psychological challenges, regardless of the surgical option chosen. Ultimately, the decision between mastectomy and lumpectomy should be made based on a thorough discussion between the patient and their healthcare team, weighing the risks, benefits, and individual preferences.

Follow-Up Treatments Required 

Post-mastectomy therapies such as chemotherapy, radiation therapy, or hormone therapy may be recommended depending on the cancer’s stage and characteristics. Radiation therapy may not be necessary for patients with no evidence of cancer spreading beyond the breast tissue. Some patients may opt for breast reconstruction surgery to restore breast appearance. Long-term follow-up care includes regular surveillance mammograms, clinical breast exams, and imaging tests.

After a lumpectomy, radiation therapy is typically recommended to target any remaining cancer cells in the breast tissue and reduce the risk of cancer recurrence. Chemotherapy or hormone therapy may also be considered based on tumor characteristics. Patients may choose breast-conserving procedures or cosmetic interventions to enhance breast appearance. Regular surveillance with mammograms and clinical exams is essential for long-term monitoring.

Making Your Decision: Mastectomy vs. Lumpectomy

Consulting with your healthcare team before deciding between a lumpectomy or mastectomy is crucial as it allows for a comprehensive evaluation of important health factors such as: 

  • Stage and size of cancer
  • Personal and family history of breast cancer
  • Genetic factors
  • Personal preference and lifestyle considerations

The New Jersey expert healthcare professionals at Premier Surgical Network can provide valuable insights into the potential benefits and risks associated with each surgical option, helping you make informed decisions that are aligned with your goals and priorities. Additionally, discussing treatment options with a multidisciplinary team, which may include surgeons, oncologists, radiation therapists, and reconstructive surgeons, ensures all aspects of care are considered, leading to a tailored treatment plan. This collaborative approach empowers patients to actively participate in their treatment decisions and promotes the best possible outcomes in their breast cancer journey.