Q: What factors should a woman consider when choosing between a lumpectomy and a mastectomy?
A: the decision to have a mastectomy or lumpectomy, which I prefer to call breast-conserving surgery, is best made by a woman and her doctor based on a variety of factors.
Multiple studies have demonstrated that patients with early-stage breast cancer can be treated with either breast-conserving therapy (BCT) such as lumpectomy and radiation therapy or mastectomies such as a modified radical mastectomy. These are medically equivalent options in the local management of breast cancer and it is important for people to realize this.
However, in certain conditions, BCT is contraindicated. These conditions include the first or second trimester of pregnancy, two or more gross tumors in separate breast quadrants, diffuse malignant microcalcifications, previous irradiation to the breast region as well as surgical margins that are persistently positive for tumor.
Relative BCT contraindications for BCT include a large tumor/breast ratio, collagen vascular disease except rheumatoid arthritis, if the tumor is located beneath the nipple and large breast size.
In conclusion, there is no one best treatment for all types of breast cancer. Each patient should be educated by her physician about the different treatment options. She must also participate in the decision-making process with her doctor.
