Choosing Between a Lumpectomy and Mastectomy Support the cause

Choosing Between a Lumpectomy and Mastectomy

Many women with early-stage breast cancers have the option of choosing
between a breast-conserving surgery such as a lumpectomy or a
mastectomy which removes the entire breast tissue.

The main advantage of a lumpectomy is that it allows a woman to keep most of
her breast. A disadvantage is the usual need for radiation therapy — most
often for 5 to 6 weeks — after surgery. A (very) small number of women
having breast-conserving surgery may not need radiation, while a small
percentage of women who undergo mastectomy will still need radiation therapy
to the breast area.

When deciding between a lumpectomy and mastectomy, be sure to get all the
facts. Often times women have an initial preference for mastectomy. This is
a natural “gut reaction” to the diagnosis of cancer, as we would want to
take everything out as quickly as possible. The fact of the matter, however,
is that in most cases mastectomy does not give you any better chance of
long-term survival or a better outcome from treatment than lumpectomy.
Studies following thousands of women for more than 20 years show that when a
lumpectomy can be done, doing a mastectomy instead does not provide any
better chance of survival.

Most women and their doctors prefer lumpectomy and radiation therapy when
it’s a reasonable option, but your choice will depend on a number of
factors, such as:

How you feel about losing your breast
How you feel about getting radiation therapy (and the side
effects that go along with it)
How far you would have to travel and how much time it would take
to have radiation therapy
Whether you think you will want to have more surgery to
reconstruct your breast after having a mastectomy
Your preference for mastectomy as a way to get rid of all your
cancer as quickly as possible
Your fear of the cancer coming back

For some women, mastectomy may clearly be a better option. For example,
lumpectomy or breast conservation therapy is usually not recommended for:

Women who have already had radiation therapy to the affected
breast
Women with 2 or more areas of cancer in the same breast that are
too far apart to be removed through 1 surgical incision, while keeping the
appearance of the breast satisfactory
Women whose initial lumpectomy along with re-excision(s) has not
completely removed the cancer
Women with certain serious connective tissue diseases such as
scleroderma or lupus, which may make them especially sensitive to the side
effects of radiation therapy
Pregnant women who would require radiation while still pregnant
(risking harm to the fetus)
Women with large tumors (greater than 5 cm) that didn’t shrink
very much with neoadjuvant chemotherapy
Women with inflammatory breast cancer
Women with a cancer that is large relative to her breast
size

Other factors may need to be taken into account as well. For example, young
women with breast cancer and a known genetic (BRCA) mutation are at very
high risk for a second cancer. These women often consider having the other
breast removed to reduce this risk, and so may choose to have the cancer
treated with a mastectomy, as well. A double mastectomy may be done to both
treat the cancer and reduce the risk of a second breast cancer.

Michael A. Zadeh, M.D. is a Board Certified General Surgeon
practicing in the Los Angeles area. His expertise in minimally invasive
techniques, along with the application of the most up-to-date treatment
strategies, lead not only to great surgical results, but also enables him to
produce the best outcome for his patients. For more information on Dr. Zadeh
and his practice visit the website: www.zadehsurgical.com Email:
info@zadehsurgical.com