Over the last 15 years, many advances have been made in breast cancer treatment. This can be both exciting and overwhelming. Once diagnosed with breast cancer, patients are sometimes confused by all of the options available to them. What is the next step? What treatments do I need? Surgery? Radiation? Do I need chemotherapy? Hormonal therapy?
Here are some of the surgical options available to patients who are diagnosed with breast cancer. It is important to remember each patient’s treatment course will be individualized based on their individual results.
Surgical options for Breast Cancer
There are 2 main surgical options for breast cancer treatment: lumpectomy (also called breast conservation) vs. mastectomy.
LUMPECTOMY is the surgical removal of the cancer and a small amount of normal breast tissue surrounding the cancer. This is also referred to a partial mastectomy or breast conserving surgery. Majority of the time, radiation will follow a lumpectomy.
MASTECTOMY is the surgical removal of the entire breast, well actually about 90-95% of the breast tissue. Nowadays, there a many options available to women in regards to mastectomy. Classically, mastectomy resulted in a flat chest with a straight-line incision. Now, there are reconstruction options available that can be done at the same time. We offer nipple-sparing mastectomy, where we are able to save the entire skin envelope and nipple at the time of mastectomy. We also offer skin-sparing mastectomy, where the nipple is removed but majority of the skin envelope is preserved.
What are the pros and cons of both options?
Most women are able to choose between these options, so there are factors that can help you decide which one is a better option for you. Questions to ask yourself when trying to make this decision include:
- Do I want to save my breast?
- How anxious are you about the cancer coming back?
- Am I willing to undergo radiation?
Pros and Cons of Breast Conservation Surgery
The major advantage of lumpectomy is it is a less invasive surgery, usually outpatient, with a shorter and easier recovery time. It can also result in excellent cosmetic outcomes, preserving both the shape and sensation of the breast. The major disadvantage of lumpectomy is the need for radiation the majority of the time. Conventional radiation usually lasts about 5-7 weeks, everyday Monday through Friday. At Ochsner, there are additional radiation options depending on your individual results that allow us to deliver the radiation over one week or sometimes three weeks.
Pros and Cons of Mastectomy
The major advantage of mastectomy is greater peace of mind! However, the chance of the cancer returning is actually similar when we compare lumpectomy with radiation to mastectomy. Major disadvantages of mastectomy include loss of the entire breast and longer recovery time. There are emotional and psychological side effects from this. Even when we can save the nipples and skin, there is no sensation left intact. Also, when women undergo mastectomy (even with initial reconstruction at the same time), usually additional surgeries are needed later.
Ultimately, it is the patient’s choice to decide which option is better for them. From an oncology standpoint, we consider them equal!