Mastectomy vs. Lumpectomy: which is better and why?
Whether or not one is personally afflicted, awareness around breast cancer and tumors has found avenues enough for being discussed. From home, to the workplace and medical conventions alike, it has become important to educate the masses to lean towards open discourse to prevent alarming statistics surrounding breast cancer. As it stands, around 1 in 8 women will, in the course of their lives, develop invasive breast cancer, the number while being low for men (1 in 1,000) is still worth considering ramping up response systems to not only prevent breast cancer, but especially in treatment of such life-threatening conditions. (BreastCancer.org, Breast Cancer Statistics in the US)
It is however problematic that invasive procedures not only require the patients’ unbridled consent, they relies heavily upon it. The problem here is patients’ lack of understanding around cancer surgery options, that are nothing if not extensive and complex, not totally unlike the affliction itself rather fittingly. The presented discourse will examine the two predominant surgery-treatments for tumors and breast cancer, and endeavor to compare them.
Before anything, it is of the utmost importance to understand cancer, cancerous tumors and their development; aside from medical technicalities such as the tumor being benign or malignant to the question of it having spread to the lymph nodes, there are other important personal considerations such as consent of the patient regarding their operating procedure of choice. Procedures surrounding cancer treatment are varied, extensive and have lasting medical and personal consequences upon on the patient, and hence more attention and funds need to be resourced towards proliferating helpful information. (Excellence)
When thinking around Mastectomy and Lumpectomy options, it is important to note that the essential difference here is generally that lumpectomy, more often than not, falls on the spectrum of breast conservation procedures and surgeries whereas mastectomy prompts removal of a larger part of the breast tissue and is often followed by breast reconstruction procedures. (Komen)
It follows that if lumpectomy and mastectomy are both options, the decision relies primarily around the patients’ preference. There are however some primary considerations that should influence your line of reasoning for your desired procedure: The question of recurrence, possibility of severely painful recoveries, and importance of preservation of the natural breast to the patient. While the aforementioned are key considerations, other factors such as the size and nature of the tumor, genetic history of patient and age should be carefully examined and understood clearly.
How Mastectomy and Lumpectomy Options compare?
Overall Survival and Recurrence
Numerous studies comparing recurrence rates between women who have undergone mastectomy versus lumpectomy with radiation, cancer returning back in the breast (local recurrence) occurs at only a slightly higher rate in women who have undergone the latter option. On the other hand, metastasis or distant recurrence is the same for either procedure.
Even as there is less conclusive and empirical analysis, there are some medically-backed suggestions that lumpectomy with radiation is at least as good as mastectomy. However, other studies have suggested that lumpectomies even accompanied with radiation have higher survival rates.
Weighing the pros and cons
the major upper-hand that Lumpectomy has is that it serves more towards preserving the appearance and sensation of the breast, is less invasive as a surgical option, and generally has a lesser recovery time and is easier done than at least a complete mastectomy. As with a lot of other things, it carries certain potential disadvantages: the sometimes overbearing and overwhelming radiation therapy that may go on for weeks; the tendency of it to affect reconstruction options; a somewhat larger risk of developing recurrence; the possibility of more surgeries.
A major advantage that women who undergo mastectomy procedures as opposed to lumpectomy is the peace of mind that it offers to patients that are either at a risk of developing cancer or at a risk of it recurring. It is important to note that even though radiation therapy may not always follow mastectomy, it may still be needed depending upon the results. Mastectomy carries certain potential disadvantages: the length and duration of the procedure is larger and more invasive than a lumpectomy; the permanent loss of breast(s); the likelihood of having additional surgeries for breast reconstruction or augmentation.
The relevance of modern studies
Empirical data, as far as extensive literature and reports conclude, offers little finality in terms of declaring supremacy between the alternatives. Whereas certain medical circles prefer the overall security from recurrence that mastectomy procedures claim to provide, others contest the core validity of that claim, citing studies that show little to no deviation in recurrence rates obtained from both procedures and touting lumpectomy as more cost-effective and less invasive.
Regardless of empirical data and statistics, what is perhaps more important is understanding that a multitude of options exist and might produce the same results, with little to no general variance to enable prompt and prudent decision making on the patients’ end, and hence it is crucial that medical information surrounding these procedures is proliferated so that vulnerable patients have access to credible information to empower their decision and own it fully.
BreastCancer.org. “Breast Cancer Statistics in the US.” Understanding Breast Cancer (2017).
BreastCancer.org. “Mastectomy vs. Lumpectomy.” Understanding Cancer (2014).
Excellence, National Institute for Health and Care. “NIHCE Clinical Guidelines.” Clinical Guidelines 2003.
Komen, Susan G. “Deciding Between Mastectomy or Lumpectomy.” Komen.org (2011).
NEJM. “Full Review.” 2002.
Tuomo J. Meretoja, MD, PhD, MD, PhD Marjut H. K. Leidenius and MD, PhD Tiina Tasmuth. Pain at 12 Months After Surgery for Breast Cancer. Ontario: JAMA Network, 2014.
UK, Cancer Reasearch. “Cancer Statistics 2015.” 2015.
WebMD. “Preventative Mastectomy for Breast Cancer.” 2014.