A photograph of the inside of a building with two people sitting in chairs, and a doctor in the forefront reading a file.

Decisions, Decisions, Decisions

  • While having too many options can be overwhelming at times, for a patient newly diagnosed with breast cancer, having a number of treatment options to choose from can be a good thing. Many women faced with breast cancer immediately assume that mastectomy may be the better option when compared with breast-conservation therapy (which includes lumpectomy) because it involves removing all of the breast tissue—increasing the odds of preventing secondary tumors later.

    However, although difficult for some patients to understand, breast-conservation therapy and mastectomy have equal survival rates—a fact that has been confirmed through a number of clinical studies, involving tens of thousands of women, comparing the two techniques.

    Unlike mastectomy, breast-conservation therapy doesn’t rely upon surgery alone.

    A collage of drawings showing a breast lump, where the incision would be in a breast conserving surgery, and the lump and surrounding tissue removed.

    When a breast surgeon talks about “breast-conserving surgery” they are talking about the surgery (lumpectomy) itself—again just the surgery. But when they talk about “breast-conservation therapy” they are referring to a combined treatment involving surgery as well as radiation to the whole breast. The combination of surgery and radiation is what makes breast-conservation therapy equivalent to mastectomy—without radiation, lumpectomy alone does not provide the same outcomes as more radical surgeries.

    I hope that this post will help those newly diagnosed with breast cancer understand that having multiple options, like breast-conservation therapy and mastectomy, is a good thing. The more treatment options you have the more educated a decision you can make.

    Richard J Bleicher, MD, FACS

    Associate Professor in the Department of Surgical Oncology

    Director of the Breast Fellowship Training Program at Fox Chase Cancer

    A collage of drawings showing where the incision would be in a modified radical mastectomy, the breast and surrounding lymph nodes removed, and the final result.