Making Decisions

Lumpectomy (Breast Conserving Surgery)

Removes part of the breast tissue instead of the whole breast

• Also called breast-conserving surgery or partial mastectomy
• May change the shape of the breast
• Reconstruction may be an option if a large amount of tissue is removed
• Newer “oncoplastic” approaches can partially or fully restore the shape of the breast and sometimes can compensate for the decrease in size of the breast with the cancer, by operating on the other breast to make them more equal or symmetrical.
• Shorter recovery time than mastectomy
• Radiation therapy is usually required after surgery
• A second surgery (margin revision) may be needed if margins are not clear (cancer cells are found at the edge of the removed tissue)
• In rare cases, a mastectomy may still be needed if margins continue not to be clear

“I had a lumpectomy first and when the pathologist determined that he was not happy with the margins, the surgeon had to go in and remove more breast tissue. He called it a partial mastectomy. Frankly, given that I had very small breasts to begin with, there wasn’t much left after the second surgery, although it was not a mastectomy.
~Karen~

Mastectomy

Removes the entire breast

• Single mastectomy: Removes one breast
• Double (bilateral) mastectomy: Removes both breasts
• Often recommended for larger and/or more aggressive tumours
• Longer surgery and recovery time than lumpectomy, which may involve an overnight hospital stay
• May not require radiation therapy, though some still require it

“The tumour in my breast was multi focal, which means that I had more than one tumour in my breast, and the largest tumour was 3cm. Therefore, my breast surgeon highly recommended a mastectomy. I opted for a bilateral mastectomy because I was young, and symmetry on both sides was important to me.
~Trisha~

Prophylactic Mastectomy

A preventative surgery that removes both breasts to lower the risk of developing breast cancer

• Considered for BRCA1 or BRCA2 mutation carriers to reduce breast cancer risk
• Recommended for people at high risk due to other gene mutations or extensive family history
• Patients undergoing a single mastectomy who want to reduce the risk of cancer in the other breast (Learn more about contralateral breast cancer risk)

“At the age of 18, I was diagnosed with the BRCA1 genetic mutation just as my mother, auntie, and sister before me. This meant that I was at high risk for contracting breast cancer. 
~Quinn~