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Choosing between lumpectomy or mastectomy

Get information about the advantages and disadvantages of different types of surgery for early breast cancer. This can help you to decide between them.

Why you might have a choice

The treatments work equally well in curing the cancer but they each have different benefits and disadvantages.

Your doctor might offer you a choice between:

  • removing the cancer with a surrounding border of normal breast tissue (called a wide local excision or lumpectomy) followed by several weeks of radiotherapy
  • removing the whole breast (mastectomy) and then possibly having a new breast made (breast reconstruction)

Things to consider

There are no right or wrong answers when you are making a decision between treatments. Women each feel very differently. You can decide what feels best for you.

Some women want to keep their breast if at all possible, so they choose a lumpectomy (wide local excision) and radiotherapy.

Other women feel that once they have breast cancer they would rather have the whole breast removed because it makes them feel it is more likely to remove all of the cancer. They can then choose to have a new breast made (breast reconstruction).

Some women feel strongly that they don't want radiotherapy. Others welcome it if it means keeping their breast.

What to take into account

To help you decide, you might want to think about:

  • how you feel about having the whole breast removed
  • how you feel about having only part of the breast removed
  • how you feel about having radiotherapy
  • how quickly you want the treatment to be finished
  • how you would cope with travelling to hospital daily for radiotherapy
  • whether you would want to have a breast reconstruction after mastectomy
  • whether you would want reconstruction straight away or some months after surgery

The most important thing is to take time to find out how you feel and make the right decision for you. You can say to your specialist that you need some time to think over your options.

You can discuss the issues with family or friends, or reflect on your own about how you feel. Before making a decision you can also ask your specialist nurse questions about the different treatments if you need to.

Advantages of lumpectomy

Removal of just the area of cancer:

  • aims to keep most of the breast tissue
  • is less of a change to your body than mastectomy
  • has a recovery time of a few weeks

Disadvantages of lumpectomy

After this operation:

  • your breast might be mis-shapen or dimpled or unequal to the other one
  • you will need radiotherapy to the breast for 3 to 5 weeks afterwards
  • radiotherapy can make you tired for a few months
  • if the cancer comes back some time later, you won't be able to have radiotherapy again and would need a mastectomy

Advantages of mastectomy

Removal of the whole breast means:

  • you might feel more confident your cancer won't come back
  • you usually won't need radiotherapy after the surgery
  • you can have radiotherapy to the area if your cancer comes back in the future

Disadvantages of mastectomy

After a mastectomy:

  • you have permanent removal of your breast
  • if you have breast reconstruction it can take some months to recover
  • if you don't have reconstruction you might need to wear an external breast shape (prosthesis)

Factors affecting which surgery might be best for you:

Your doctor or breast care nurse will discuss the options with you. They take into account:

  • the size of your cancer
  • where the cancer is in your breast
  • whether there is more than one area of cancer
  • the size of your breasts
  • your general health

Information and help