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Lumpectomy vs Mastectomy
Breast-conserving surgery (lumpectomy) removes the cancer while preserving most of the breast; mastectomy removes the breast tissue.
For many people with early breast cancer both are accepted options. Suitability depends on the size and distribution of disease, the ability to achieve a clear margin, previous radiotherapy, inherited risk and personal preference — and is decided with the clinical team.
How the two approaches differ
| Breast-conserving surgery (lumpectomy) | Mastectomy | |
|---|---|---|
| What is removed | The cancer plus a margin, preserving most of the breast | The breast tissue; skin and nipple may sometimes be preserved |
| Radiotherapy | Usually recommended afterwards to reduce local recurrence | May still be recommended depending on tumour size, nodes and margins |
| Further surgery | Possible if a margin is positive on pathology | Less likely for margins; reconstruction may add stages |
| Reconstruction | Breast largely preserved; oncoplastic reshaping may be used | Optional — implant or autologous reconstruction, or remaining flat |
| Main drivers of eligibility | Tumour-to-breast size, single vs multiple lesions, margin, prior radiotherapy | Extent of disease, multiple areas, margins unachievable, high inherited risk, preference |
When breast-conserving surgery may be considered
- The known disease can be removed with an acceptable margin while preserving a reasonable breast shape
- Radiotherapy afterwards is medically suitable
- The relationship between tumour and breast size allows a good cosmetic result
When mastectomy may be recommended
- Disease involves a large area, or multiple areas cannot be removed in one operation
- Clear margins cannot be achieved, or radiotherapy is not suitable
- There is a high inherited risk of another breast cancer, or the patient chooses mastectomy after reviewing alternatives
Limitations
Common questions
- Is one operation safer than the other?
- For suitable patients with early breast cancer, breast-conserving surgery with radiotherapy and mastectomy are both established options. Which is appropriate depends on the individual case and is decided with the clinical team.
- Does mastectomy avoid radiotherapy?
- Not always. Post-mastectomy radiotherapy may still be recommended based on tumour size, lymph-node involvement and margins.
- Can I still have reconstruction after lumpectomy?
- Breast-conserving surgery preserves most of the breast; oncoplastic reshaping may be used. Reconstruction options are broader after mastectomy.
Related pages
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