Written By Missy Bryson, MSN, APRN, CNP

If you have been recently diagnosed with breast cancer, making decisions about your treatment can be an overwhelming part of an already difficult time. While your options will vary depending on the stage and type of cancer you have, as well as your overall health, many people with breast cancer will have some form of surgery as a part of their treatment plan. Some patients with early-stage breast cancer may have a choice between the two main types of surgery: lumpectomy or mastectomy.

Your cancer care team will help develop a plan that best fits your breast cancer diagnosis and your treatment goals. Understanding your options can help give you peace of mind as you move forward through your cancer journey.

Our job at Cincinnati Breast Surgeons is to work with you to help you understand your options for your breast cancer treatment. As a part of your cancer care team, we will be with you every step of the way.

What is the Difference Between a Lumpectomy and a Mastectomy?

A lumpectomy, also called breast-conserving surgery, removes the tumor and some surrounding healthy tissue. Some lymph nodes may also be removed. This is usually followed by radiation therapy to treat any remaining cancer cells. Patients given a lumpectomy can usually keep most of their breast.

A mastectomy removes the tumor by removing the entire breast. While some patients may need radiation therapy following mastectomy, many do not. There are several types of mastectomies:

• Total mastectomies remove the breast tissue, nipple, areola, and some skin
• Modified radical mastectomies remove the breast tissue, nipple, and areola, in addition to some lymph nodes under the arm
• Skin-sparing mastectomies remove the breast tissue, nipple, and areola while removing less skin
• Nipple-sparing mastectomies remove the breast tissue while preserving the nipple areola, and skin

What are the Advantages and Disadvantages of Each Surgery?

Lumpectomy is a less extensive surgery, and most patients are able to go home the same day. Since only part of the breast is removed, this surgery may not change much of the original appearance of the breast. The patient may also keep most of the sensation in the area.

The risk of cancer coming back in the breast after a lumpectomy is low, but it is a higher risk than with a mastectomy. Lumpectomies are almost always followed by radiation therapy to destroy any remaining cancer cells. If you cannot have radiation therapy or do not want to undergo radiation therapy, lumpectomy may not be the best surgical option.

Because mastectomy removes the entire breast, some patients may feel more at ease. Recurrence in the breast after mastectomy in early-stage breast cancer is extremely low. While some patients may need radiation therapy following surgery, many will not.

Mastectomy is a more extensive surgery and results in permanent loss of a breast. If you opt for breast reconstruction, this could result in additional surgeries. At least one overnight hospital stay will be needed following a mastectomy.

It’s important to note that for early-stage breast cancer, research shows mastectomy and lumpectomy have similar overall survival rates.

What Should I Ask My Doctor as I Consider My Options?

While both surgeries are effective treatments for early-stage breast cancer, the choice between lumpectomy and mastectomy can be very personal. The ‘right’ choice for you can depend on a variety of lifestyle factors and personal preferences. While your physician will help you make the most informed choice possible, here are a few things you may want to ask:

• What is the risk of recurrence? Is there a significant difference in recurrence for my type of cancer with either type of surgery?
• If I need radiation therapy, what side effects can I expect?
• How long will it take to recover? How long will it take to recover if I also have reconstruction surgery?
• What kind of changes to my breast can I expect after a lumpectomy? Will I be able to preserve the skin or nipple during my mastectomy?
• Will breast reconstruction surgery interfere with chemotherapy, radiation therapy, or any other treatment I may have?
• Is reconstruction surgery recommended during the initial breast cancer surgery, or should I wait?
• Should I consider surgery on both breasts to help them look alike?
• How will I be screened for cancer in the future?
• Are there any resources to connect me to other breast cancer patients who have undergone either surgery?

The breast surgeons at Cincinnati Breast Surgeons work collaboratively with you and the rest of your breast care team to create the optimal treatment plan for your breast cancer. For more information about lumpectomy, mastectomy, or other treatment options, please call 513-221-2544 or visit cintibreastsurgeons.com