Mastectomy v Lumpectomy: which works best?
A recent study from the Netherlands – which claims that women with early stage breast cancer have higher survival rates if they forgo a mastectomy and undergo breast-conserving surgery instead – has attracted a lot of media attention.
The study – which assessed the medical records of 130,000 Dutch breast cancer patients, making it the largest breast cancer survey of its kind – discovered that certain women over 50 and with other health issues increased their survival rates by a third by opting for a non-mastectomy treatment plan.
As Professor Sabine Siesling, the lead author of the study, pointed out; “We believe this information will have potential to greatly improve shared treatment decision-making for future breast cancer patients. However, we would like to emphasise that these results do not mean that mastectomy is a bad choice.”
Here’s a (very) brief guide to the differences in the procedures. Obviously, your consultant or practitioner will be able to give you the full picture, but here’s what you need to know for now:
What, in laypersons’ term, are they?
Simply put, a mastectomy is a complete removal of the breast, while a lumpectomy involves a partial removal of breast tissue – specifically the cancerous tumour and some of the unaffected tissue around it. This is then followed by a programme of radiation therapy. This usually involves five days of treatment per week, for a period of five to seven weeks, in an attempt to eliminate the possibility of the cancer returning.
What are the advantages of a lumpectomy over a mastectomy?
As it is a less invasive surgical procedure than a mastectomy, much of the appearance and sensation of the breast can be preserved. Also, the recovery time will be shorter and easier. And if you choose to opt for reconstructive surgery, it goes without saying that the procedure will be quicker and less extensive than it would be for a mastectomy patient.
And the disadvantages?
Two words: radiation therapy. Not only will you have to undergo an extensive stint of treatment, it can also leave your breast feeling much firmer and more tender. Furthermore, there could be the possibility of further surgery down the line, as the pathology report on the affected breast takes 4 or 5 days to be conducted – and if cancer cells are still present in the breast, another procedure will be required. Finally, there is no guarantee that a lumpectomy will rid the breast of cancer for good: if the cancer returns, a mastectomy procedure is recommended.
What are the advantages of a mastectomy over a lumpectomy?
Some women are more inclined to undertake a full mastectomy as a piece-of-mind procedure: when the breast is gone, the possibility of the cancer returning in the breast is almost gone too. Also, opting for a mastectomy can, in many instances, eliminate the need for radiation therapy – although it may still be needed depending on pathology results.
And the disadvantages?
Mastectomy surgery is a longer and more extensive procedure than lumpectomy, with a higher chance of post-surgical side-effects and a longer recuperation time. Obviously, due to the breast being completely removed, there could be additional and more extensive surgeries to reconstruct the breast, should you decide to take that route.
Which treatment is right for me?
As with most breast cancer issues, it’s the call of the person affected with breast cancer. It’s a completely natural reaction to want to preserve as much of your breast as possible, no matter how old you are, but your surgeon will want to give you the best chance possible for a full recovery.
If you would like to discuss this in more detail, please contact us to make an appointment.