If you’ve recently been diagnosed with breast cancer, there’s a good chance you’ll need surgery—a common part of many women’s breast cancer treatment plans. Depending on your cancer’s stage and many other factors, your oncologist or breast surgeon may present you with two surgical options: a lumpectomy or a mastectomy.
Both procedures have benefits and downsides, so choosing the right option can feel daunting. Here’s the good news: For most early-stage breast cancers, both surgeries are often equally successful at prolonging your life. The choice is often about your cancer’s stage and type, your lifestyle, and your long-term health goals.
In this blog, we’ll discuss the differences between a lumpectomy and a mastectomy, their pros and cons, and questions to consider as you decide between the two.
Understanding Lumpectomy
A lumpectomy is a procedure to remove only the breast cancer tumor and a small amount of surrounding tissue, but not the entire breast. The procedure allows you, for the most part, to maintain your breast’s natural look and feel.
Breast surgeons sometimes refer to lumpectomy surgery as “breast-conserving surgery” or a “partial mastectomy.”
The Cons of a Lumpectomy
Most patients who undergo lumpectomy will need radiation therapy, which can be associated with minor side effects, such as skin changes and fatigue. Radiation therapy treatments typically last just a few minutes, but receiving them means driving to a treatment center five days a week for several weeks.
In addition, not everyone with breast cancer can have a lumpectomy. You may not be a candidate if:
- You have a tumor in multiple areas of the breast.
- You have a tumor larger than 5 centimeters or one that is large compared to the size of your breast.
- A genetic test has shown that you have a genetic mutation that increases your chances of breast cancer coming back.
- You are pregnant (radiation can be harmful to a baby). However, pregnant women may be able to have a lumpectomy if they don’t need radiation therapy immediately.
- You have certain health conditions, like lupus, that increase your sensitivity to radiation side effects.
- You have had previous radiation or a lumpectomy in that breast.
- You have inflammatory breast cancer.
Understanding Mastectomy
A mastectomy is a surgery to remove your entire breast. Your surgeon may recommend one if you have inflammatory breast cancer or cancer in multiple spots in the same breast.
A mastectomy may offer peace of mind, especially for women who are at high risk and those who have mutations in the BRCA1, BRCA2 and other breast cancer-related genes. Some women may also choose this option if they cannot receive radiation.
Types of Mastectomy
Breast surgeons can perform a mastectomy in different ways. If you choose this procedure, talk with your surgeon and a reconstructive surgeon beforehand to learn your breast reconstruction options. They’ll help you decide which of the following types of mastectomy to have based on your anatomy, cancer stage and type, and personal preferences:
- Simple mastectomy: Your surgeon removes the entire breast—along with your nipple, areola and excess skin.
- Modified radical mastectomy: This procedure is similar to a simple mastectomy but also includes underarm lymph node removal.
- Skin-sparing mastectomy: Your surgeon removes breast tissue, your nipple and your areola but keeps most of the skin. This makes it easier to use an implant or your own tissue to rebuild the breast.
- Nipple-sparing mastectomy: Your surgeon removes breast tissue but leaves the skin, nipple and areola. This helps a reconstructive surgeon recreate a more natural-looking breast. However, there is no function or sensation of the preserved nipple.
Lumpectomy vs. Mastectomy: Recovery Time
In many cases, it takes less time to recover from a lumpectomy than a mastectomy. Lumpectomy recovery typically only takes a few days, at which point you’ll likely be able to return to your daily activities. However, that time depends on how extensive your surgery was. Your surgeon can give you a realistic timeframe for your recovery.
A mastectomy is a more significant surgery and sometimes requires an overnight stay in the hospital. In general, recovery takes about four weeks, but as with lumpectomy, that timeline depends on many factors. Your surgeon can help you set realistic expectations for the amount of downtime you’ll need to plan for.
Should I Get a Mastectomy or a Lumpectomy?
Ultimately, your decision comes down to a conversation with your oncologist or breast surgeon. Many factors affect treatment options, and some treatments, such as chemotherapy or hormone therapy, may be needed to shrink the size of your tumor to allow lumpectomy. Only you and your doctor can determine what’s right for you.
When you are weighing your options, ask your doctor these questions:
- How long will my recovery take?
- How will either option affect how my breast looks or feels?
- What are the chances my cancer might come back after surgery?
- Will I need radiation therapy with either option?
In addition, consider getting a second opinion to help you feel more informed about your options and comfortable with your decision.
In Conclusion
To decide between a lumpectomy vs. a mastectomy, you should understand how each procedure works and how it might affect your appearance and long-term health. Your surgeon can help you weigh the pros and cons of each based on:
- Your cancer’s stage and type
- Whether you have cancer in multiple areas
- Whether you want to preserve your natural breast or are OK with having one or both breasts removed
These are big decisions, and your team at Capital Health Cancer Center’s Center for Comprehensive Breast Care is here to help you navigate them.
Are you researching breast cancer treatment options? Request an appointment with a Capital Health Cancer Center breast cancer specialist.