Of all the treatment options available for breast cancer, doctors usually recommend mastectomy. This HerHaleness article tells you if mastectomy is indeed better than lumpectomy, which is another treatment option for breast cancer, and why.
Lumpectomy and mastectomy are the two surgical options recommended for the treatment of breast cancer. The former involves removing a small part of the breast, while in mastectomy, the whole breast is removed. Lumpectomy is useful when the tumor is small and diagnosed in its early stages. However, recent studies show that number of patients opting for mastectomy has increased, despite having localized tumor growth. This trend has been attributed to the lower risk of cancer recurrence associated with mastectomy.
As mentioned earlier, lumpectomy is as beneficial as mastectomy when it comes to treating breast cancer that has not spread in the surrounding tissue. While mastectomy is a major surgery and cannot be done without general anesthesia, lumpectomy is a minor surgery and carried out under local anesthesia. Mastectomy is also an extensive surgery and may take 1 – 2 hours to complete the procedure.
- Also referred to as breast-sparing injury, the procedure is less invasive as only a small part of the breast may be removed. The recovery time is also less and the patient can resume his daily routine within a week after surgery.
- Lumpectomy has little impact on the normal appearance of the breast as a major part of the breast tissue may be preserved. Hence, reconstruction surgery might not be necessary.
- In most cases, the patient has to undergo radiation therapy after lumpectomy. This is done to minimize recurrence and destroy cancer cells that may remain after surgery. Patients generally have to attend radiation treatment sessions 5 days a week for around 6 – 7 weeks, which is time-consuming.
- The time consumed in taking radiation therapy may prolong the date of reconstructive surgery, if necessary.
- Despite undergoing radiation therapy, the risk of cancer relapse exists, which is more than mastectomy. Also, repeated radiation exposure to treat cancer recurrence in the same site won’t be tolerated. In such circumstances, the doctor may recommend a mastectomy.
- As patients are aware that mastectomy carries a very small amount of cancer recurrence risk as compared to lumpectomy, they may feel relaxed after surgery. This, in turn, may help them to focus on their daily routine, without much worrying about the cancer returning.
- Attending repeated sessions of radiation therapy may not be required after mastectomy. To put it simply, frequent trips to the hospital to undergo radiation therapy may be avoided post a mastectomy.
- In mastectomy, the entire breast is removed. Dealing with the emotional impact of breast removal can be quite difficult for some women.
- In order to re-create a natural appearance, wearing a prosthesis or undergoing a major reconstruction surgery is imperative. Breast reconstruction may be done during the operation or at a later period.
- As the procedure is extensive, the recovery period can go up to a few weeks, which may be prolonged if breast reconstruction surgery is done at the same time.
- Patients with mastectomy also have to deal with a higher number of postoperative side effects as opposed to those who undergo lumpectomy.
Lumpectomy May Provide a Better Survival Rate
When it comes to enhancing survival rates of early stage breast cancer patients, lumpectomy (breast conversation surgery) wins hands down, as found in a recent study. Mastectomy, that involves removing the breast completely, is often the first choice in patients diagnosed with preliminary stage breast cancer. However, according to new data, the chances of survival in patients undergoing lumpectomy plus radiation is more as against those treated with mastectomy.
A study conducted by the research team at Duke Cancer Institute under the supervision of Shelley Hwang, MD., MPH, pointed out the benefit of lumpectomy over mastectomy. The research analyzed a massive 14 years of medical data from the California Cancer Registry. The team studied documented health records of 112,154 women affected with early stage breast cancer from 1990 and 2004. The medical records also showed that out of these, 55% had been treated with lumpectomy and radiation, while the rest 45% opted for mastectomy. The patients’ health was monitored for around 9.2 years and other parameters such as tumor size, age, and cancer aggressiveness scale were also taken into consideration to check whether they had any impact on survival rates.
While the study was ongoing, 31,416 patients expired; 39% due to breast cancer, with the remaining from other causes. Patients who had undergone lumpectomy in conjunction with radiation showed lower mortality rates than their counterparts treated with mastectomy. The study also pointed out that lumpectomy was found to be most effective in women over 50 who were suffering from tumors that relied on progesterone and estrogen for growth. This group, that had hormone-sensitive tumors, had 13% less chances of succumbing to breast cancer, and 19% less chances of succumbing to other causes. The study also revealed that in the first 3 years after surgery, mastectomy patients had a higher risk of succumbing to heart diseases as against lumpectomy patients. This may indicate that women who had lumpectomy were healthier than those who had mastectomy. However, women below 50 and diagnosed with hormone-sensitive tumors did not show any difference in survival rates, irrespective of their choice of treatment.
Nevertheless, the results of the study reveal that lumpectomy in combination with radiation may have an edge over mastectomy when it comes to improving survival rates in women with stage I and stage II breast cancer. It demonstrates that as compared to mastectomy, breast conservation therapy is a better strategy to deal with early stage breast cancer.
Although the study may suggest lumpectomy to be a better approach to increase survival rates in early stage breast cancer patients, researchers have not considered all the parameters that could influence survival rates of the study group. For instance, during the course of the study, after 1999, new developments in lumpectomy may have improved chances of survival in women who underwent breast conservation therapy. Also, mastectomy recipients might not have received better medical facilities, which may have influenced their survival rates. Researchers also agree that these factors have not been taken into account, that might have affected the results in favor of the lumpectomy group. However, the study does point out that lumpectomy is no less effective than mastectomy in women with early stage breast cancer. On the whole, it is best to consult a doctor and then decide the appropriate treatment option for breast cancer.
Despite breast cancer being diagnosed in the early stages, the doctor may advise the patient to avoid lumpectomy due to the following reasons:
- The patient has multiple tumors in different areas of the breast.
- There is just one single tumor but it is large with a diameter of 4-5 centimeters.
- Higher risk of cancer returning due to faulty genes running in family.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.