What is a Mastectomy?

Over the last 15 years, many advances have been made in breast cancer treatment. This can be overwhelming to patients. Once diagnosed with breast cancer, patients are sometimes confused by all 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 two main surgical options for breast cancer treatment: lumpectomy, also called breast conservation, and 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. A majority of the time, radiation will follow a lumpectomy.

Mastectomy is the surgical removal of the entire breast, more accurately about 90% to 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 can 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 have some choice between these options, so there are a few factors that can help you decide which one is best for you. Questions to ask yourself when trying to make this decision include:

• Do I want to save my breast?
• How anxious am I about the cancer coming back?
• Am I willing to undergo radiation?

Pros and Cons of Breast Conservation Surgery

The major advantage of lumpectomy is that it’s 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. We are Hidden Scar Certified and perform most lumpectomies through less visible scars for improved cosmetic results. We also use oncoplastic techniques, such as oncoplastic reduction, where patients can have a breast reduction at the same time resulting in excellent outcomes.

The major disadvantage of lumpectomy is the need for radiation in most cases. Conventional radiation usually lasts about 3-6 weeks, with patient receiving treatment every day 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 a 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 a mastectomy include loss of the entire breast and longer recovery time. There are emotional and psychological side effects from this as well. Even when we can save the nipples and skin, there is no sensation left intact. Additionally, when women undergo mastectomy, even with initial reconstruction at the same time, there are usually additional surgeries 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!

Editor’s note: This article was originally published on January 18, 2017