Sarah Cannon - August 20, 2020

You've completed a breast biopsy and have been diagnosed with breast cancer. Your surgeon has presented you with two treatment options: lumpectomy vs. mastectomy. How do you know which one to choose?

“Sarah Cannon physicians and nurse navigators are committed to personalizing every treatment plan to the unique needs of each person we meet,” says Dax Kurbegov, MD, Physician in Chief of Clinical Programs at Sarah Cannon. “To do that, it’s vital that we support our patients in understanding all of their treatment options, including the differences between a lumpectomy and a mastectomy.”

Understanding the terms

A lumpectomy is considered a breast-conserving surgery. Other names for this surgery are breast sparing surgery, segmental mastectomy, quadrantectomy, and partial mastectomy. The goal of the procedure is to remove the cancer and some of the surrounding normal tissue, but leave the remainder of the breast intact. Often, the physician will also remove several sentinel lymph nodes from the axilla (corresponding to the side of the cancer) during the surgery.

A mastectomy, on the other hand, removes the entire breast, and, depending on the type of mastectomy performed, other tissues, including muscles and sentinel lymph nodes from your axilla.

Mastectomy types include:

  • Simple mastectomy
  • Radical mastectomy
  • Modified radical mastectomy
  • Subcutaneous (nipple sparing) mastectomy
  • Skin sparing mastectomy

If you will be undergoing any breast surgery, ask your physician if you should consult with a plastic surgeon who specializes in breast reconstruction beforehand.

Treatments in addition to surgery

Before surgery, you may be given neoadjuvant therapy that may consist of hormonal therapy, targeted therapy, and/or chemotherapy to shrink the tumor to reduce the amount of tissue that needs to be removed at surgery. Following surgery, you may be given adjuvant therapy that may consist of hormonal therapy, targeted therapy, chemotherapy and/or radiation therapy, to destroy any remaining cancer cells.

Choosing the right option for you

Breast-conserving surgery may be a good option for you if the cancer is an early stage and is limited to a specific area of the breast. Keep in mind that most patients undergoing breast-conserving surgery undergo radiation therapy afterward.

However, a mastectomy may be a good option for you if any of the following conditions exist:

  • The tumor is spread throughout the breast (diffuse tumor)
  • There are multiple tumors in different areas of the breast (multicentric tumors)
  • The tumor is directly beneath the nipple or large in relation to breast size
  • You have had previous high-dose radiation therapy to the affected breast
  • Personal preference

“Your nurse navigator can be a valuable complement to your physician and other members of the care team,” says Dr. Kurbegov. “As highly specialized nurses, they have the training and tools to help you understand your cancer and your choices so that you know that your treatment plan is right for you.”