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Lumpectomy vs. Mastectomy: What's the Difference?
When you receive a breast cancer diagnosis, your doctor will likely present you with several treatment options like chemotherapy, radiation, surgery, or any combination of the three. In some cases, a doctor will strongly recommend one option over another due to the nature of the cancer. In other situations, you will be left to decide. One choice you may face will be whether to undergo a mastectomy or lumpectomy.
Making a choice can be daunting, but it’s important to educate yourself on the two options and what they mean for your health. We’ve rounded up some of the basics to consider.
What is a lumpectomy?
Unlike a mastectomy, a lumpectomy only involves the removal of the breast cancer tumor and a small amount of healthy tissue around it. You may hear lumpectomy go by other names like wide local excision or breast-conserving surgery.
A lumpectomy is often recommended for small, early-stage cancers that are in one area of the breast. Oftentimes, your breast appearance after surgery will be very close to what it was pre-surgery. If there is significant distortion, reconstructive surgery is an option.
A lumpectomy is almost always paired with radiation therapy. Radiation, which is usually done over the course of several weeks, helps ensure that there are no remaining cancer cells surrounding the tumor site.
What is a mastectomy?
A mastectomy is the other option you may have and involves the total removal of one or both breasts. This procedure is typically done when a lumpectomy is not an option due to the size of the breast cancer or if a woman isn’t able to undergo radiation. Some may choose to have a double mastectomy due to a higher chance of recurrent breast cancer. Others simply decide to have a mastectomy for personal reasons.
Keep in mind that not all mastectomies are the same. Your doctor may recommend one of the following procedures:
- Total mastectomy (aka simple mastectomy)
- Modified radical mastectomy
- Skin-sparing mastectomy
- Nipple-sparing mastectomy
- Radical mastectomy
The difference between these different types of mastectomies is how the surgery is performed and how much/what tissue is removed. What your doctor recommends will depend on what stage your cancer is in and where, exactly, it is located.
Lumpectomy vs. Mastectomy: Advantages and Disadvantages
Like any major choice in life, weighing the pros and cons can help you make a decision. Here are some of the benefits and drawbacks of each procedure.
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Lumpectomy |
Mastectomy |
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Pro: It’s less extensive. Since your surgeon will only remove the cancerous tumor and surrounding region during a lumpectomy, this surgery is far less extensive and invasive. |
Pro: You might have greater peace of mind. Though overall recurrence rates are roughly the same for mastectomies and lumpectomies with radiation in early-stage cancers, many women feel that a mastectomy gives them greater peace of mind. Since some lumpectomies result in having to have a mastectomy anyway, some women choose to “get it over with” first. |
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Pro: Recovery is easier. Recovery after a lumpectomy will be easier than a mastectomy. Typically, most women are released the same day or day after surgery. Lumpectomy healing time can be anywhere between a few days to a little over a week. Recovery can be longer if lymph nodes are also removed. Pain and discomfort are typical after surgery, but not as intense as you would experience with a mastectomy. |
Pro: Radiation is not always needed. While most lumpectomies will be done in conjunction with radiation, not all mastectomies will require this additional treatment. In most cases, doctors will recommend radiation after a mastectomy only if your lymph nodes show signs of cancer, the tumor is larger than two inches, or there are still signs of cancer in your tissue margins. |
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Pro: Reconstruction is minimal. While you may still need to undergo a reconstructive procedure, it is typically less involved than a mastectomy. Since your nipple and skin are spared, it will closely resemble your original breast. |
Con: It’s more invasive. Having a mastectomy is considered a major procedure. |
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Con: You will have to do radiation. Typically, doctors will recommend radiation treatment in combination with a lumpectomy. Radiation reduces the risk that cancer will return in your affected breast. However, radiation comes with its own set of risks and side effects. |
Con: It requires a longer hospital stay and recovery. Because it’s a major procedure, expect a longer hospital stay after surgery, usually one to three days. Recovery will also be a longer process, lasting several weeks. Full healing often takes six weeks to several months. Pain and discomfort can be more intense compared to a lumpectomy. |
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Con: You may end up needing more surgery. In some cases, a doctor may find that cancer cells cover more area than previously thought. In this case, you and your medical team may decide that the best plan of action is a mastectomy, meaning you’ll need to have additional surgery. |
Con: Reconstruction can be a lengthier process. When more is removed, reconstruction can be a longer process, involving multiple surgeries and devices like tissue expanders. Even after surgeries, you may elect to have other cosmetic procedures done such as a 3D nipple tattoo or 4D nipple reconstruction to restore the look of your natural breast. |
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Con: There can be a greater psychological impact. Permanently losing one or both of your breasts can carry a heftier emotional toll. |
Other Factors in Your Choice
There may be other logistical factors to consider in making your choice. For instance, where you live may influence which option you choose. Women who live in rural areas far from a radiation center may opt to have a mastectomy since having a lumpectomy would mean staying close to a radiation center for up to six weeks or driving in for each appointment. On the other hand, living in an urban area close to doctors and hospitals may make a lumpectomy with radiation more feasible.
Making the Right Choice
The best way to make the right choice is to consult with and carefully weigh your options with your medical team and support system. Do your own research too, but remember— online, most people don’t know your exact situation. With so many cancer variations and types, it’s important to turn to the experts who understand exactly what you’re dealing with. If you feel like you don’t have enough information to make an informed decision, consult with your doctor or seek a second opinion.