Breast cancer occurs when the cells in the breasts start to grow uncontrollably, forming a tumour. It can cause a lump in or near the breast or in the underarm area, or it can lead to changes in the size or shape of the breast. Moreover, a person may experience dimpling or puckering in the skin of the breast. Anyone who suspects having breast cancer should get themselves examined and undergo the necessary screenings. Doctors suggest early diagnosis is the key to effective treatment and a positive outcome.
Treatment for breast cancer is wide-ranging. Depending on factors such as the stage and grade of the cancer, the type of breast cancer, whether certain biomarkers are present, overall health, and your preferences, treatment procedures can be determined. The most common options are lumpectomy and mastectomy, which are surgical procedures that are said to be effective. However, the choice to get them can be overwhelming, and therefore, understanding what they are is crucial to deciding which one you should get.
Also Read: Advances in Breast Cancer Treatment: Expert Explains Targeted Therapies and Immunotherapy
Mastectomy Versus Lumpectomy
In an interaction with the OnlyMyHealth team, Dr Karishma Kirti, Consultant, Breast Specialist and Oncoplastic Surgeon- Jaslok Hospital and Research Centre, Mumbai, shares that surgery is often the first step in the treatment of breast cancer. This includes either a mastectomy, where the entire breast is removed, or a lumpectomy, where only the tumour and a small margin of surrounding tissue are removed along with lymph node surgery.
When Is A Mastectomy Recommended?
Dr Kirti says, "A mastectomy is recommended in cases of large tumours relative to breast size, multiple tumours in different quadrants of the breast, recurrence of cancer after previous breast-conserving surgery, and for individuals with genetic factors such as BRCA1 or BRCA2 gene mutations."
"Some patients also opt for mastectomy as a personal choice, sometimes for peace of mind or to avoid radiation therapy," she adds.
According to the National Cancer Institute (NCI), bilateral risk-reducing mastectomy, or the removal of both breasts, is the main type of surgery to reduce breast cancer risk. Data suggests that it can lower the chances by at least 95% in women who have a harmful variant in the BRCA1 gene or the BRCA2 gene and up to 90% in women who have a strong family history of breast cancer.
However, there are certain risks or side effects associated with mastectomy, which include an increased risk of infection, flap or wound complications, and a higher risk of future lymphoedema (arm swelling).
When Is A Lumpectomy Recommended?
As far as a lumpectomy or breast conservation surgery is concerned, it is typically recommended for early-stage cancers when there is a single, small tumour, and if the tumour can be removed with clear margins without significantly deforming the breast, highlights Dr Kirti.
She adds that sometimes, in larger lumps, chemotherapy can be given before surgery to reduce the size of the breast mass to facilitate breast conservation, or plastic surgery manoeuvres can be incorporated to achieve a symmetrical and well-matched breast mound.
Also Read: 7 Tips To Maintain Healthy Breasts To Prevent Breast Cancer
How To Know What Procedure Suits You Best?
It is important to know that both mastectomy and lumpectomy, when combined with appropriate adjuvant therapies such as radiation or chemotherapy, can be equally effective in treating early-stage breast cancer, notes Dr Kirti, adding that lumpectomy followed by radiation is equally as effective as mastectomy for people with only one site of cancer in the breast and clear margins after excision.
But when it comes to deciding what is most suitable for you, here are a few questions the doctor urges you to ask yourself:
- Do you want to keep your breasts?
- Do you want your breasts to match each other and be as symmetrical as possible?
- How anxious will you be about breast cancer coming back if you decide to save your breast?
She adds, “Ask your doctor to explain all the steps and possible outcomes. Often enough, the surgeon can also show you pictures of items previously operated on to help you make your choice. It is okay to take your time and meet your doctor more than once to come to a decision that is both oncologically safe and acceptable to you.”
“Ultimately, the decision between mastectomy and lumpectomy should be made based on medical advice, the patient’s specific circumstances, and personal preferences,” Dr Kirti concludes.