Lumpectomy vs. Mastectomy: Two Surgical Options for Treating Breast Cancer

Author: Gerlinde Tynan, MD

The breast surgery specialists at Rocky Mountain Breast Specialists (RMBS) provide detailed information about each procedure and when they’re most effective. 

Breast surgery is a common treatment option for breast cancer. Both a mastectomy and lumpectomy have similar outcomes. The right type of surgery depends on a patient’s treatment goals, stage, overall health, and type of breast cancer. Whether a patient plans to undergo breast reconstruction can influence their surgical treatment decision. The multidisciplinary care team at RMBS provides support to help every patient choose the surgery option that’s best for them.

What Is a Lumpectomy?

A lumpectomy is the partial removal of breast tissue. It’s often called breast-conserving surgery since only cancerous breast tissue is removed. It may include removing lymph nodes under the arms or near the breast. Removing lymph nodes is called a lymph node biopsy, and the tissue is examined under a microscope for cancer. After a lumpectomy, radiation therapy is recommended to ensure the cancer does not reoccur.

How much of the breast is removed during a lumpectomy depends on the size of the tumor and whether the cancer has spread to the surrounding tissue. The area around a tumor is called the margin. Breast surgeons remove parts of the margin around the tumor to ensure the margin is clear. 

There are several types of lumpectomy procedures offered at RMBS.

• Oncoplastic lumpectomy. This procedure involves both a lumpectomy and plastic surgery techniques to reconstruct the remaining breast tissue as needed. This includes minimizing any scarring, preventing a dent where the lump was removed, and helping to keep the nipple intact. 
• Localized lumpectomy. Also called an excisional biopsy, this procedure involves the removal of a lump found in an imaging scan that a surgeon cannot feel. 
• Wire-guided localized lumpectomy. This form of lumpectomy involves placing a small wire in the breast on the day of surgery. A surgeon uses the wire to find the exact location of the cancerous tissue to be removed.
• Wire-free localized lumpectomy. This form of lumpectomy uses advanced technology called the SAVI SCOUT system. A small, 1-centimeter device called a reflector is placed in the breast approximately seven days before surgery. During the procedure, a surgeon uses a radar signal to find the reflector inside the breast and determine the lump or tissue to remove. This technology helps increase a surgeon’s accuracy during the lumpectomy.

Is a Lumpectomy Right for Me?

A lumpectomy is a good option for patients with early-stage cancers who have not had prior radiation or breast surgery. A lumpectomy is not recommended for patients with inflammatory breast cancer since partial removal is often not sufficient in those cases. 

A lumpectomy may be right for you if:

• Preserving the breast is the goal. For women who want to keep their breast, a lumpectomy is the best option. 
• The tumor is less than 2 inches in size. A smaller tumor is easier to remove while preserving the remaining breast tissue.
• There’s only cancer in one area of the breast. A single or small area of cancer helps save more breast tissue.
• No gene mutations. Patients positive for mutations in the BRCA1 and BRCA2 genes have a higher likelihood of breast cancer recurrence, making a lumpectomy less effective. 
• You’re able to receive radiation therapy. Radiation is used after a lumpectomy to ensure all cancerous cells are gone. Pregnancy, fertility, and even transportation to a radiation clinic are important factors for patients to consider before choosing a lumpectomy.

What to Expect During a Lumpectomy

Each patient’s surgical experience is different. Generally, a lumpectomy procedure is performed in a day and may not require an overnight hospital stay. Depending on the lumpectomy procedure, recovery is approximately two weeks. 

Patients can expect manageable side effects after breast surgery. The cancer care team at RMBS will provide post-surgery support to speed healing and get you back to active life.

What Is a Mastectomy?

Mastectomy is a breast surgery to remove all the skin and breast tissue of one or both breasts. A mastectomy often involves the removal of lymph nodes under the arms and around the breast. The procedure may also include removing part of the pectoralis major muscle — the main muscle in the chest. 

Mastectomies may be used to treat breast cancer or as a preventive measure for women at high risk of developing breast cancer. A unilateral or single mastectomy is the removal of one breast. A bilateral or double mastectomy is the removal of both breasts.

There are several types of mastectomy procedures performed at RMBS.

• Simple (total) mastectomy. This procedure involves removing the entire breast, the skin and nipple, and part of the pectoralis major muscle. A sentinel lymph node biopsy may be performed. Sentinel lymph nodes are those most likely to be cancerous. A few are removed, tested for the presence of cancerous cells, and treated accordingly. 
• Modified radical mastectomy. This procedure is the same as a simple mastectomy, except it involves an axillary lymph node removal. Axillary lymph nodes are primarily under the arms. 
• Skin-sparing or nipple-sparing mastectomy. This procedure is the same as a simple mastectomy but preserves the breast skin and/or nipple. Sometimes a surgeon can preserve nerve sensation in the skin and nipple. It also helps create a more realistic breast reconstruction. 
• Risk reduction mastectomy. For women with a high risk of developing breast cancer or having it reoccur, a mastectomy may lower that risk. 

Is a Mastectomy Right for Me?

A mastectomy is a good surgical option for patients who have inflammatory breast cancer, have had cancer return after a lumpectomy, or are uninterested in or unable to have radiation therapy. A mastectomy is also an option for women who choose to reduce their breast cancer risk through breast removal. 

A mastectomy might be right for you if:

• Surgery is preferred over radiation therapy. Some women may choose a more extensive surgery than undergoing radiation treatment.
• The tumor is larger than two inches in size. A larger tumor or cancer in multiple locations throughout a single breast may require the removal of the entire breast.
• The patient is pregnant. Breast cancer patients who are pregnant may choose a mastectomy to avoid exposing the fetus to radiation.

What to Expect During a Mastectomy

A mastectomy is a more complex surgery than a lumpectomy. Most patients stay overnight in the hospital for a day or two. Healing depends on the type of mastectomy procedure, though full recovery is expected four weeks post-surgery. Breast reconstruction may increase a patient’s recovery time.

Breast Reconstructive Surgery

Choosing to have breast reconstruction after breast cancer surgery is a deeply personal decision. Every patient may have different emotional and physical preferences. The cancer care team at RMBS empowers patients to make the best decision for them. 

Meet Leslie, a patient at RMBS who did not choose to have breast reconstruction, and Erin, a patient at RMBS who did choose reconstruction.

The Breast Surgeon Team at RMBS

Our breast surgery specialists have dedicated their careers to treating breast cancer. Their experience and compassion mean patients at RMBS can expect leading-edge treatment from a dedicated team. 

Meet our breast surgery specialists and discover the care advantage offered at RMBS.

Learn more and listen to board-certified breast surgeon Dr. Gerlinde Tynan in breast cancer surgery.

Updated December 2023