What is a Lumpectomy?

Lumpectomy, or partial mastectomy, refers to the surgical removal of a breast tumor along with some of the surrounding tissue.  The nipple and the majority of the breast skin and breast tissue are not removed.  When a lumpectomy is performed, radiation therapy is always recommended.  A lumpectomy may result in a contour deformity of the breast, which can be treated by a plastic surgeon with a breast tissue rearrangement, to fill the empty space.  If the size of the breast is significantly reduced by the lumpectomy, the other healthy breast can be treated with a symmetry procedure, such as a breast reduction or breast lift.

 

What is a Mastectomy?

A mastectomy is a surgical procedure in which the entire breast gland is removed.  There are several different types of mastectomy, which differ based on whether other structures, such as the nipple or the breast skin, are also removed.  A mastectomy can be reconstructed by a plastic surgeon using breast implants or your natural tissues.

 

What is the difference between a lumpectomy and a mastectomy?

Your breast surgeon will guide you, based on tumor stage and biology, to decide which procedure is best for you.  In some cases you will have a choice of which procedure to undergo.  There are three similarities and three differences between a lumpectomy and a mastectomy to consider.

 

Similarities:

• Survival is the most important thing to consider when treating cancer.  In early stage breast cancer a lumpectomy combined with radiation therapy has the same survival rate as a mastectomy.  (New England Journal of Medicine 2002; 347: 1233-1241)

• Both operations require sampling lymph nodes from your underarm.

• Both operations have the same potential need for other therapies such as chemotherapy, monoclonal antibody therapy, or hormonal therapy.  Whether you need any of these additional therapies is decided with your medical oncologist, and is not influenced by what surgery you have.

 

Differences:

• Different rates of recurrence.  This is related to breast tissue remaining after a lumpectomy. (New England Journal of Medicine 2002; 347: 1227-1232)

• Different need for radiation therapy.  A lumpectomy is always followed with radiation therapy; a mastectomy will only require radiation therapy in some cases.

• Different operations.  A mastectomy is a bigger operation and has a longer recovery.  Different types of reconstructive surgery are possible following each procedure.

 

 

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