Surgery(SIR-JER-REE) — Physical removal of a tumor is a very effective choice of treatment(TREET-MINT) — Techniques to help eliminate or control a disease to remove cancer in the breast and prevent it from spreading throughout the body. For breast cancer, a lumpectomy(LUMP-EC-TOE-ME) — Removal of only a breast tumor with a small amount of normal breast tissue and a mastectomy(MAS-TEC-TOE-ME) — The surgical removal of all breast tissue and some axillary lymph nodes are the two most common surgeries.
So—what’s the difference? How much normal breast tissue is left behind.
A lumpectomy removes only the cancerous breast mass while trying to keep as much normal tissue as possible. On the other hand, a mastectomy removes the entire breast and leaves behind as little normal breast tissue as possible.
Let’s use the garden and the dandelion to help show the difference.
Performing a mastectomy is like digging up an entire garden to remove any and all dandelions. The gardener then puts down a stone patio, leaving very little soil for weeds to grow in the future.
A lumpectomy is like a gardener using a shovel to remove a dandelion and its roots, without removing a lot of extra soil. It’s important for the gardener to remove all of the dandelion to prevent it from re-growing. At the same time, he or she tries very hard not to disturb the rest of the garden.
The amount of breast tissue removed also leads to three other differences: the need for radiation(RAY-DEE-A-SHUN) — High energy waves used to treat cancer in a specific area of the body, cosmetic outcome, and recovery time.
Because a lumpectomy only removes the cancer, it is recommended that a patient also receive radiation—high energy waves used to treat cancer in a specific area of the body—to the breast after a lumpectomy. Radiation after a lumpectomy is used to kill any cells that may have been left behind.1 It’s kind of like having a cleanup crew come into your garden to kill any remaining dandelion seeds that may have been left behind after digging out the dandelion.
In most cases, radiation is not needed after a mastectomy. A lumpectomy plus radiation has the same outcome (same chances of the cancer not returning in the breast) as a mastectomy.
Since a mastectomy removes almost the entire breast, the cosmetic outcome is not as good as it is with a lumpectomy. Because of this, many women choose to have breast reconstruction surgery to rebuild the breast after a mastectomy.
Finally, a mastectomy requires a larger incision than a lumpectomy. Therefore, there is a longer recovery period following a mastectomy. Additionally, if you choose to have reconstruction surgery, there is an additional recovery period.
- NCCN Clinical Practice Guidelines in Oncology: Breast Cancer (Version 2.2016). National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed February 14, 2017.