August 26th, 2011 at 4:02pm
Should You Choose a Mastectomy or a Lumpectomy?
By Vera Viner
Thirty years ago, when a woman was diagnosed with breast cancer, she had little choice when it came to her surgical procedures. A mastectomy was the only option for women. Thankfully, the 1980s brought about a change: great progress in lumpectomies took place.
Strangely, there are many women who still choose mastectomies when a lumpectomy would suffice. The reasons for this vary. Sometimes the woman’s surgeon recommends it because they may be more familiar with a mastectomy and had gone to medical school prior to the advances found within lumpectomies. There are regional differences seen in the medical practices in the US. In fact, more mastectomies are executed in the Midwest and Southeast. The type of hospital a woman chooses her treatment in has a great effect on her surgical options. Small, non-teaching hospitals tend to lack a radiation center, which is a necessity if a woman goes through a lumpectomy. Age is a factor: elderly women tend not to worry about losing their breast as much as the younger generation. Some women choose to have their whole breast removed due to fear of recurrence. And, of course, the type of insurance a woman has and other socio-economic factors influence this decision.
The major reason to choose a mastectomy includes having tumors located in more than one part of the breast, especially if the two areas are on opposite sides of the breast. Also, if radiation therapy is not likely to be effective in your case, it is beneficial to choose a mastectomy. If precancerous changes are found in more than one-quarter of your breast, a mastectomy should be chosen. If the breast cancer is quite large, a doctor will recommend removal of the whole breast. If the lumpectomy is likely to leave you with a deformed breast with little tissue, it may make more sense to get a mastectomy. If you have lung disease(s) or connective tissue disease, radiation should not be part of your treatment. Because of this, a lumpectomy would not be appropriate. Also, if you are pregnant, radiation may be dangerous to your unborn baby, and a mastectomy may be the best choice. However, if losing your breast will leave you feeling depressed and it is not a necessity, it is probably best to choose a lumpectomy.
For women who have early-stage breast cancer, studies found that their survival rates are the same whether they choose a lumpectomy with radiation or a mastectomy. The spread of the cancer is ultimately the biggest indicator of which surgical option is needed. If the tumor is small or is found at the side of the breast, breast conservation surgery is more appropriate. However, some negatives of a lumpectomy include a slightly increased risk of the cancer coming back and the side effects of radiation therapy. Other great medical advances have brought breast reconstructive surgery to the women who’ve gone through mastectomies.
There is actually one more choice for some women – a pa
rtial mastectomy. In this procedure, the surgeon cuts out the tumor, a large section of the breast around it, and the lining over the chest muscles under the tumor. However, the majority of the breast remains.
rtial mastectomy. In this procedure, the surgeon cuts out the tumor, a large section of the breast around it, and the lining over the chest muscles under the tumor. However, the majority of the breast remains. The stage a woman’s breast cancer is in will indicate the best surgical option for her. A doctor discovers the breast cancer stage a woman is in by performing blood tests, bone scans, lymph node biopsies, and X-rays. Overall, both treatments have the same survival rates for women and neither is considered the better treatment.
One of the risks found within mastectomies include a weight shift that leads to neck and back pain. Also, a reconstructed breast lacks the sensation of the original breast and there are additional risks within having a second surgery. A lumpectomy, however, will leave most of your natural breast with full sensitivity and only leaves a small scar. The negatives of a lumpectomy include higher chances of recurrence and the side effects of radiation, such as fatigue and skin discoloration. Ultimately, the decision comes down to you. Weighing the risks and benefits and taking into account your breast cancer stage will greatly help you make an informed decision.
References
“Decision of Mastectomy Over a Lumpectomy.” Health Searches. HC Search Corporation. Web. 26 Aug. 2011. <http://www.healthsearches.org/Categories_of_Q&A/Treatment/1156.php>.
“Why Women Choose a Lumpectomy or a Mastectomy.” TheBreastCareSite.Com. Web. 26 Aug. 2011. <http://www.amoena.com/tbcs/NewlyDiagnosed/BreastSurgeries/Mastectomy/Choosing+A+Lumpectomy+or+a+Mastectomy.htm>.
“Mastectomy vs. Lumpectomy: Making Your Decision – Breast Cancer – Health.com.” Health.com: Health News, Wellness, and Medical Information. 6 May 2008. Web. 26 Aug. 2011. <http://www.health.com/health/condition-article/0,,20188813,00.html>.
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