It is important to understand both of these complex procedures so that you can make the right decision for your specific needs. Deciding between a mastectomy and lumpectomy can be incredibly difficult. It is also important to remember that a lumpectomy isn’t an option for everyone with breast cancer.
A mastectomy is used to remove all breast tissue if you have breast cancer or are at very high risk of developing it. You may have a mastectomy to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy).
A mastectomy may be a treatment option for many types of breast cancer, including:
• Ductal carcinoma in situ (DCIS), or noninvasive breast cancer
• Stages I and II (early-stage) breast cancer
• Stage III (locally advanced) breast cancer — after chemotherapy
• Inflammatory breast cancer — after chemotherapy
• Paget’s disease of the breast
• Locally recurrent breast cancer
Dr. Gunn may recommend a mastectomy instead of a lumpectomy if:
• You have two or more tumors in separate areas of the breast.
• You have widespread or malignant-appearing calcium deposits (microcalcifications) throughout the breast that have been determined to be cancer after a breast biopsy.
• You’ve previously had radiation treatment to the breast region and the breast cancer has recurred in the breast.
• You’re pregnant and radiation creates an unacceptable risk to your unborn child.
• You’ve had a lumpectomy, but cancer is still present at the edges (margin) of the operated area and there is concern about cancer extending to elsewhere in the breast.
• You carry a gene mutation that gives you a high risk of developing a second cancer in your breast.
• You have a large tumor relative to the overall size of your breast. You may not have enough healthy tissue left after a lumpectomy to achieve an acceptable cosmetic result.
• You have a connective tissue disease, such as scleroderma or lupus, and may not tolerate the side effects of radiation to the skin.
You might also consider a mastectomy if you don’t have breast cancer, but have a very high risk of developing the disease. A preventive (prophylactic) or risk-reducing mastectomy involves removing both of your breasts and significantly reduces your risk of developing breast cancer in the future.
A prophylactic mastectomy is usually reserved for those with a very high risk of breast cancer, which is determined by a strong family history of breast cancer or the presence of certain genetic mutations that increase the risk of breast cancer. Click here for more information regarding mastectomies.