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Choosing the surgery that is right for you

Many studies show that women with early stage breast cancer (stage I or stage II) who have breast-conserving surgery followed by radiation therapy have the same survival rates as women who have a mastectomy. This means that your doctor will give you a choice between the 2 surgeries, if there isn’t a medical reason for you to have one rather than the other.

The choice between breast-conserving surgery and mastectomy is a very personal one. Your feelings, preferences, priorities and lifestyle all play a part in your decision. You may choose to have breast-conserving surgery because you want to keep as much of your breast as possible. Or having a mastectomy may give you better peace of mind because it removes more breast tissue. Talk to your healthcare team about the advantages and disadvantages of each type of surgery. It may help you to also talk to women who have had each type of surgery.

Advantages and disadvantages of breast-conserving surgery

Breast-conserving surgery doesn’t remove as much tissue as a mastectomy. This means that it causes fewer changes to how the breast looks. Breast-conserving surgery may leave a scar or change the shape of the breast, but it may have less impact on a woman’s feelings about her body image and sexuality.

Breast-conserving surgery does not take as long to do and removes less breast tissue than a mastectomy. This means that there is less chance for complications during and after breast-conserving surgery.

Compared to a mastectomy, there is a slightly higher risk that the breast cancer will come back (recur) in the remaining breast tissue after breast-conserving surgery.

Breast-conserving surgery is followed by 4–6 weeks of daily radiation therapy. This means that treatment takes longer overall than if you only had a mastectomy. You’ll need to get to the treatment centre, which means that you may have to find transportation or travel to have radiation therapy. You may also have short- and long-term side effects from radiation therapy.

Advantages and disadvantages of mastectomy

Some women with early stage breast cancer who have a mastectomy don’t need to have radiation therapy. This means that they may avoid the side effects of radiation therapy. But if you have cancer in your lymph nodes or a very large tumour, you will have to have radiation therapy after a mastectomy.

Mastectomy takes longer to do because it removes more tissue than breast-conserving surgery. As a result, mastectomy has a longer recovery time and a greater chance for complications during and after surgery.

Some women may choose to have breast reconstruction surgery. If the surgeon does the reconstruction at the same time as mastectomy, you will be in the operating room longer. This can increase your risk for complications during surgery. If reconstruction isn’t done at the same time as mastectomy, you will need to have more surgery to have the breast reconstruction.

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