Specialist Surgeon | Female Health Care | Cape Town Mediclinic
A lumpectomy removes the cancer with some surrounding normal tissue and keeps most of the breast; a mastectomy removes the whole breast. For women who are suitable for either, the two treatments work equally well in curing the cancer. The choice depends on the cancer, the breast and your own preferences.
What Is a Lumpectomy?
A lumpectomy, also called breast-conserving surgery or wide local excision, removes the cancer and some normal tissue around it. Radiotherapy to the remaining breast is needed afterwards.
What Is a Mastectomy?
A mastectomy removes all of the breast. There are several types:
- Simple mastectomy: removes the breast tissue, nipple and some of the skin.
- Skin-sparing mastectomy: removes the breast tissue and nipple but keeps most of the skin.
- Skin- and nipple-sparing mastectomy: removes the breast tissue but keeps most of the skin, the nipple and the areola.
Breast reconstruction may be possible at the same time as the mastectomy or later.
How Is the Decision Made?
The decision takes into account:
- The stage and size of the cancer, and the size of the breast.
- Whether there is more than one area of cancer.
- The position of the cancer in the breast.
- Previous radiotherapy to the breast.
- Your general health.
- Your preferences, including whether you want reconstruction.
A mastectomy may be recommended when the cancer is large relative to the breast, lies in the middle of the breast, is in more than one place, involves large areas of DCIS, or the breast has had radiotherapy before. A mastectomy may also be considered for women at very high risk of breast cancer because of family history or a gene change.
Treatment is planned with the oncology team and, where reconstruction is considered, a reconstructive surgeon. The options are set out on the breast cancer surgery page.
What About the Lymph Nodes?
Either operation is usually combined with surgery to check the lymph nodes in the armpit. See Understanding Sentinel Lymph Node Biopsy.
Frequently Asked Questions
Does a mastectomy give a better chance of cure?
No. For women suitable for either, the two treatments work equally well in curing the cancer.
Will I need radiotherapy after a lumpectomy?
Yes. Radiotherapy to the breast is needed after breast-conserving surgery.
Can I have reconstruction?
Reconstruction may be suitable for some women, either at the time of mastectomy or later.
Is there a right answer?
There is no right or wrong answer when choosing between suitable treatments. Your surgeon discusses the options with you before a decision is made.
If you have been diagnosed with breast cancer and would like to discuss your surgical options, please arrange a consultation with Dr. Loots.
Book a ConsultationThis article provides general information only and does not constitute medical advice. If you are concerned about your health, please seek advice from a doctor.