Choosing between Breast Conservation Surgery or Mastectomy
Breast cancer is the most common cancer diagnosed in women worldwide. With several effective treatment options available, care for breast cancer patients has become increasingly multidisciplinary and very personalized. Surgery is the spine of breast cancer treatment. As a newly diagnosed cancer patient with several surgical options, choosing the right one for yourself can be tricky. It may need a bit of effort since each method has its own benefits and risks. Reaching out to a doctor is well trained in cancer surgical treatment and reconstruction is important.
Breast-conserving surgery (lumpectomy) and total removal of the breast (mastectomy) are the two options available as part of a breast cancer treatment plan. Based on personal preference, you can choose to have less invasive breast conservation surgery with radiation if you wish to preserve your breast Or have a mastectomy.. However, choosing one over the other has no effect on the medication and follow-up care you may require for the rest of your life.
What is breast conservation surgery or BCS?
It is the surgery to remove the cancer part and some breast tissue surrounding the lump, followed by radiation therapy.
Why should you choose breast conservation surgery?
Breast conservation surgery might be a good option if,
- You have early-stage cancer that isn’t invasive
- You have a small lump located in a single area in the breast
- If you are young and the cancer is amenable to treatment without a mastectomy.
Because breast conservation treatment removes only a tiny portion of the breast tissue and leaves the rest, your cancer may likely to return. Hence, radiation is given to reduce chances of the cancer coming back. However, be informed that breast conservation surgery can be as effective as mastectomy. Many studies have shown that women who have a lumpectomy with radiation therapy have the same survival benefits as women who have a mastectomy.
What are the benefits of breast conservation surgery?
The primary benefit of breast conservation surgery is that it allows you to keep your breast’s appearance and feel. Furthermore, because it is less invasive, the chances of complications are reduced. It also has a shorter recovery time than mastectomy.
What are the risks of breast conservation surgery?
Breast conservation surgery, like any other surgery, may have some possible complications, which include:
- There might be a slight increase in the risk of recurrence in the breast.
- Need for additional surgeries if the margins are positive on final testing. (<5%)
- Poor cosmetic affect unless operated by a surgeon trained in oncoplastic surgery.
- Temporary breast swelling i.e breast edema.
What is a mastectomy?
- It is the surgical removal of one or both breasts.
- If a patient undergoes a mastectomy, she should be given the option of whole breast reconstruction either by using an implant or one’s own tissue.
Who should choose mastectomy?
Mastectomy may be recommended if a woman has:
- Cancer at multiple locations in the breast
- Cancer that has eroded through the skin
- Cancer with a discrepant breast tumor ratio.
- Risk factors for cancer recurrence and new cancer development
- Breast cancer that cannot be treated with breast-conserving surgery
- Had radiation therapy in the past and now unable to have one
- Genetic risk factor, such as the BRAC mutation
- Pregnancy and cannot have radiotherapy
What benefits mastectomy offers?
These include:
- Lesser need for additional surgeries
- Less likely need for radiation therapy in early breast cancer
What are the risks of a mastectomy?
Some probable disadvantages of this procedure are:
- Psychological effect of permanent removal of the breast
- Extended hospital stays and longer recuperation time if mastectomy is followed by breast reconstruction surgery
- Possible risk of infection, swelling, pain, and numbness at the surgical site
- Difficulty in proper posture if large breasted on the opposite side
- Back pain, Quality of life issues without a reconstruction
Factors affecting the choice of surgery
Your doctor may recommend a specific surgery or ask you to consider your options based on certain factors, such as:
- The size of your cancer
- The location of the cancer
- The size of your breast
- Your personal health
- Whether a tumor is in one or more than one area
- Your life expectancy
What is right for you?
To keep the breast or remove, it is a very personal and complex decision. Take some time to find out how you feel about the entire process. Consult with your doctor if you have any questions. Do not hesitate to even take a second opinion. Take guidance from those women who have undergone both treatments. With proper research, guidance, and participation in your treatment plans, you can make the right choice.
REMEMBER-
- If oncologically safe, your doctor will suggest a reconstruction in either of the cases (BCS or Mastectomy) so your breasts would look symmetrical.
- Make sure you ask your doctor about your options for reconstruction
References
- Lumpectomy vs. Mastectomy: Which is Right for You? (2017, December 22). Healthline. https://www.healthline.com/health/lumpectomy-vs-mastectomy
- Lumpectomy vs. Mastectomy: How to Choose. (n.d.). Retrieved April 3, 2021, from http://www.melbournebreastcancersurgery.com.au/lumpectomy-vs-mastectomy-how-to-choose.html
- Choosing between lumpectomy or mastectomy | Breast surgery | Cancer Research UK. (n.d.). Retrieved April 3, 2021, from https://www.cancerresearchuk.org/about cancer/breast cancer/treatment/surgery/lumpectomy or mastectomy
- Breast-Conserving Surgery (Lumpectomy). (n.d.). Retrieved April 4, 2021, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/breast-conserving-surgery
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