Lumpectomy: Advantages and disadvantages

The main advantage of lumpectomy is that it can preserve much of the appearance and sensation of your breast. It is a less invasive surgery, so your recovery time is shorter and easier than with mastectomy.

Lumpectomy has a few potential disadvantages:

  You are likely to have 5 to 7 weeks of radiation therapy, 5 days per week, after lumpectomy surgery to make sure the cancer is gone.
  Radiation therapy may affect the timing of reconstruction and possibly your reconstruction options after surgery. Radiation therapy also may affect your options for later surgery to lift or balance your breasts.
  There is a somewhat higher risk of developing a local recurrence of the cancer after lumpectomy than after mastectomy. However, local recurrence can be treated successfully with mastectomy.
  The breast cannot safely tolerate additional radiation if there is a recurrence in the same breast after lumpectomy. This is true for either a recurrence of the same cancer, or for a new cancer. If you have a second cancer in the same breast, your doctor will usually recommend that you have a mastectomy.
  You may need to have one or more additional surgeries after your initial lumpectomy. During lumpectomy, the surgeon removes the cancer tumor and some of the normal tissue around it (called the margins). A pathologist looks to see if cancer cells are in the margins. If there are cancer cells, more tissue needs to be removed until the margins are free of cancer. Ideally, this is all done during the lumpectomy, but analyzing the margins can take about a week. So sometimes after the pathology report is done, the margins are found to contain cancer cells and more surgery (called a re-excision) is needed.

Mastectomy: Advantages and disadvantages

For some women, removing the entire breast provides greater peace of mind (“just get the whole thing out of there!”). Radiation therapy may still be needed, depending on the results of the pathology.

Mastectomy has some possible disadvantages:

  Mastectomy takes longer and is more extensive than lumpectomy, with more post-surgery side effects and a longer recuperation time.
  Mastectomy means a permanent loss of your breast.
  You are likely to have additional surgeries to reconstruct your breast after mastectomy.

Making your own decision

Your breasts may be such an important part of your identity - your sense of who you are - that you’ll go to great lengths to preserve them. That’s a completely acceptable approach to take, no matter what your age or figure - AS LONG AS it doesn’t endanger your overall health and chances for a full recovery.

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Thomas G. Frazier, M.D.