Lumpectomy vs Mastectomy and Breast Reconstruction

Many women who have breast cancer can choose between having the whole breast removed – a mastectomy – or, part of it removed – a lumpectomy – followed by radiation therapy. Which is the best choice for you depends on your specific case and physician’s opinion.

Current medical advice is that a lumpectomy and radiation is often as effective as mastectomy for women who have just one cancer site in the breast and if the tumor is less than 4 centimeters.

This guide offers comprehensive information about a lumpectomy vs mastectomy, as well as breast reconstruction surgery.

Critical Deciding Factors For Lumpectomy vs Mastectomy

Most women opt for a lumpectomy because it’s less invasive. However, which choice is best for you hinges on how you feel about the following topics:

  • Do you want to keep the breast? If keeping the breast is critical to you, you probably want to have a lumpectomy with radiation.
  • Do you want the breasts to be as close in size as possible? Most women have favorable cosmetic results from a lumpectomy. In a rare situation where large quantities of breast tissue must be removed, the breast could look distorted or smaller. But there are breast reconstruction surgeries your surgeon can perform to deal with this matter (more information on breast reconstruction follows below).
  • How worried are you about the cancer returning: if taking out the whole breast helps you to worry less, you may want to consider mastectomy.

There also are other factors that matter when deciding between a lumpectomy and mastectomy:

Where You Live

Medical research suggests that women in the US are more likely to undergo mastectomies than those in other nations. In the Midwest and South, mastectomies are more common. It’s unclear why this is, but some believe it’s related to women’s attitudes and their physicians.

Where You Go For Cancer Treatment

Lumpectomies are often done in university hospitals than in community hospitals.

When The Plastic Surgeon Was Trained

Older plastic surgeons in some areas of the US may be more likely to do mastectomies. Until the 1980s, mastectomy was the most common procedure to treat breast cancer.

If you have strong feelings about one or the other, talk to your plastic surgeon about how many of each procedure he does and why. Feel free to ask for a second opinion to understand your options better.

Lumpectomy Advantages and Disadvantages

The main reason to opt for a lumpectomy is it preserves more of the breast tissue. It’s less invasive, so you have a faster recovery time.

Disadvantages include:

  • You will probably have radiation therapy for 5-7 weeks.
  • Radiation therapy affects when you have breast reconstruction as well as your surgical options.
  • You may have a higher risk of cancer recurring.
  • Your breast cannot take more radiation if you have cancer recurrence in that breast after a lumpectomy.
  • You could need another surgery after a lumpectomy.

Mastectomy Advantages and Disadvantages

Some women find that taking out the whole breast gives them additional peace of mind, which is understandable. Cancer is frightening, and some want to reduce the risk of recurrence as much as possible. However, there are some disadvantages to think about:

  • A mastectomy takes longer and is a more complicated surgery than a lumpectomy.
  • This surgery means a permanent loss of the breast.
  • You may need more surgeries to rebuild the breast.

Breast Reconstruction Surgery

After your mastectomy or lumpectomy, you can choose from many types of breast reconstruction. As you think about which method is best for you, it’s essential to talk to your plastic surgeon about your preference and general health.

The primary breast reconstruction options to discuss with your plastic surgeon are:

  • Breast reconstruction with saline or silicone implants
  • Breast reconstruction with your tissues (also known as flap procedures)
  • Nipple and areola reconstruction after breast surgery

Some surgeons recommend the breast implant and flap method together to rebuild the breast. Also, fat grafting and nipple and areola tattooing can make your reconstructed breast look more natural.

SEE ALSO: Is It Worth Getting Breast Implants?

Note that many women who opt for a lumpectomy or partial mastectomy may not require breast reconstruction. But it’s possible you could have a breast deformity from your cancer surgery.

For instance, there could be dimpling caused by removing a big tumor from a smaller breast.

Which Breast Reconstruction to Have

If you decide to have breast reconstruction, you’ll need to go over your options and case with your doctor. Below are some of the factors to consider:

  • Health, including any factors that influence your healing, such as health conditions or smoking
  • The location and size of the breast cancer tumor
  • The size of the breast
  • Whether you had a lumpectomy or mastectomy
  • Whether you need more treatments for the cancer
  • How much tissue is available – for example, a thin woman may not have enough belly tissue available for reconstruction
  • Whether you need reconstruction on both breasts
  • How fast you want to recover
  • How different surgeries impact other areas of your body

Your surgeon will go over your health and medical history and talk about your options based on your health, age, lifestyle, body type, and goals. Talk to him frankly about what you want, and voice any concerns you have.

SEE ALSO: The Importance of Board Certification in Plastic Surgery

Book Your Dallas Breast Consultation Today

After you’ve had your lumpectomy or mastectomy, now it’s time to talk to your plastic surgeon about breast reconstruction. The breasts are a vital part of a woman’s identity, and plastic surgeon Dr. Raj can help you with this situation, so please schedule a Dallas breast reconstruction consultation appointment today.

You won’t regret your decision!


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