A lumpectomy, also called breast-conserving surgery, removes the tumour with a margin of healthy tissue while keeping most of the breast. A mastectomy removes the whole breast. For many women with early breast cancer, lumpectomy followed by radiation offers similar long-term survival to mastectomy. The right choice depends on tumour size, location, genetics, breast size and personal preference.
What Is a Lumpectomy?
- Removes the tumour and a rim of normal tissue
- Usually followed by radiation therapy
- Keeps the natural breast shape in most cases
- May need further surgery if margins are not clear
What Is a Mastectomy?
- Removes the entire breast tissue
- Radiation may or may not be needed
- Options include skin-sparing or nipple-sparing mastectomy
- Can be followed by reconstruction immediately or later
Factors That Guide the Choice
Tumour size compared to breast size
A small tumour in a larger breast is more suited to lumpectomy.
Number and location of tumours
Multiple tumours in different areas often need mastectomy.
Ability to have radiation
Lumpectomy usually needs radiation. Previous chest radiation or pregnancy may affect this.
Genetic risk
Women with BRCA mutations may consider mastectomy, sometimes of both breasts.
Personal preference
Some women prefer to keep their breast; others prefer mastectomy for peace of mind. Both are valid.
Can Chemotherapy Help Preserve the Breast?
In some cases, chemotherapy before surgery can shrink a large tumour enough to allow lumpectomy.
Does Mastectomy Mean Lower Recurrence?
For suitable early cancers, lumpectomy with radiation and mastectomy have similar survival outcomes. Local recurrence rates may vary slightly, but survival is comparable.
Recovery Differences
- Lumpectomy: shorter recovery, followed by several weeks of radiation
- Mastectomy: longer recovery, drains may be needed, possible reconstruction
Key Takeaways
- Lumpectomy saves the breast; mastectomy removes it.
- Survival is similar for many early cancers.
- Tumour size, number and genetics matter.
- Radiation usually follows lumpectomy.
- Personal preference is an important factor.
Final Thoughts
There is no single right answer for every woman. Understanding your options and discussing them openly helps you make a confident decision. For breast cancer surgery planning, you can consult Dr. Varadharajan, a surgical oncologist in Chennai.
