Monthly Archives: March 2016

Initial Breast Cancer Surgery – Lumpectomy or Mastectomy?

For anyone being diagnosed with breast cancer today, there is some good news. There is a “less is more” concept that has been gaining ground. It refers to doing “less” while attaining comparable outcomes.

Today I’ll talk about your initial breast surgery. Due to mammography screening and breast cancer awareness, breast cancer is often diagnosed at the earlier stages – stages 1 and 2. Often, this means that the lump is small and a lumpectomy would be a good option.

But guess what? In the last 10 years, the rate of mastectomy on the cancerous breast, or removal of both breasts, has increased dramatically despite the advances we have made in doing “less”.

Why is that? There is a misconception that “taking it all off” will ensure you’ll never have the cancer come back. Let’s face it, we are (justifiably) afraid of having cancer come back and it is not a big leap to think that removing the whole breast will get rid of the problem once and for all.

You may think this, and your doctor or your surgeon may recommend it, even when a lumpectomy is a perfectly good option.

Well, I have news for you. Having that breast amputated is no guarantee of a cancer-free future. Studies show that if you have a lumpectomy plus radiation, then you have a better chance of being cancer-free than if you have a mastectomy.  Put another way, you have a greater chance of cancer recurrence with a mastectomy (2.5%) than with a lumpectomy plus radiation (1.7%).  With a mastectomy, some breast tissue remains. And without radiation, there may still be cells in there that can cause trouble down the road.

The key is the radiation therapy.  The standard of care when doing lumpectomies is to have radiation therapy too.  Lumpectomy + radiation is called “breast conserving therapy”.

If you’re leaning towards mastectomy, get the facts about your particular case:

–          How big is the cancer?

–          Can chemotherapy before surgery help to shrink it or make it go away completely?

–          Are you a good candidate for lumpectomy? (see previous questions)

–          Is the surgeon competent with oncoplastic techniques, which use plastic surgery techniques to achieve a good cosmetic result after lumpectomy?

There are numerous factors that go into a surgery decision, including your own fear.  Try to make decisions based on the facts.


One more thing to consider is recovery time and reconstruction options. Your general state of health will impact your recovery from any surgery. The physical recovery time for lumpectomy is usually faster than with mastectomy. And the emotional/psychological effects of mastectomy can last a lifetime.

I’m definitely pro-lumpectomy if you are a good candidate for this “less is more” approach to early breast cancer. You will need to assess all the factors that feed into your choice between lumpectomy and mastectomy.

Interested in all your choices in the treatment of early breast cancer? Get my new book Smart Decisions about Breast Cancer – choices, risks, living well, preventing recurrence at