Making the decision between lumpectomy and mastectomy can be a difficult one for women with breast cancer.
Mayo Clinic breast surgeon Judy Boughey, M.D., shares how she helps her patients make this decision. And why she encourages them to look to the future in the process.
A Mayo Clinic breast surgeon on how to choose between lumpectomy and mastectomy
Judy C. Boughey, M.D., Breast Surgical Oncology: Sometimes I'll have a patient come in and say, "So doctor, what should I do?" And I'll often say, "What are your concerns? How do you feel about radiation? How do you feel about losing your breast?" We can work through it together to come up with a plan that is most optimal for them.
Most of the decisions come down to the patient's personal preference in terms of preserving the breast versus removing the breast.
From the standpoint of a mastectomy, the disadvantage obviously is that the entire breast is removed. And so there is associated numbness of the chest wall and body image changes that they need to be prepared for. And (they need to be) prepared for what I describe as life after breast cancer — getting up in the morning, getting dressed in front of the mirror, going in the shower, being in the bedroom.
From the standpoint of a lumpectomy, usually that requires radiation therapy after the surgery. The surgery itself is a much more straightforward surgery. The patient is able to preserve the breast.
The risk of something coming back is slightly higher with a lumpectomy and radiation than it is with mastectomy. And many women have a lot of concern about future risk of breast cancer and they feel more comfortable proceeding with a mastectomy.
I talk with patients about how they would feel over the course of the next 10 to 15 years if they don't have a breast or if they just have a reconstructed breast mound versus how they feel about having a lumpectomy and coming in every year for mammograms and considering waiting for those test results.
With breast cancer survival being so high, these treatment decisions need to be the ones that will make them happy in 10- and 15-years' time, and not just what is the most convenient treatment option for this week or this month.
Dr. Boughey has dedicated her career to empowering breast cancer survivors.
Get more healthy action tips delivered daily when you download the Mayo Clinic App.