An elderly patient sits in conversation with her doctor.
An elderly patient sits in conversation with her doctor.
An elderly patient sits in conversation with her doctor.

Mastectomy Versus Lumpectomy: 3 Questions to Ask Your Doctor

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Women who’ve been recently diagnosed with breast cancer are almost immediately faced with treatment choices. The most common options are to remove the cancerous tissue in part of the breast (lumpectomy) or to remove the entire breast (mastectomy).

Over the past decade, women with early-stage breast cancer are increasingly opting for mastectomy or double mastectomy — removal of both breasts — in hopes that they will reduce the risk of recurrence.

The increased availability of advanced breast reconstruction techniques and the federal law requiring that reconstruction be covered by insurance have contributed to the trend, says Lisa Jacobs, a surgical oncologist with the Johns Hopkins Breast Center.

The topic also garnered national attention in 2013 after actress Angelina Jolie’s national announcement about her decision to have a prophylactic double mastectomy.

If you’re weighing your treatment options, here are a few things to ask your doctor:

Is a mastectomy my only option for preventing breast cancer?

Getting a tumor in your breast does not necessarily mean you will have to remove your breast entirely. Many cases of breast cancer can be treated by removing the tumor itself and some of the surrounding tissue. Treatment may also include chemotherapy, radiation or hormone therapy. Treatments for breast cancer are continually evolving, offering patients greater choices and improved outcomes. Surgeons with the Johns Hopkins Breast Center are on the front lines of developing and performing the most innovative oncologic procedures. Talk to your surgical oncologist about your treatment options.

Do I have to decide what I’m going to do right away?

Many treatment centers will discuss treatment options at the time of diagnosis, but that doesn’t mean you can’t take your time to decide. At The Johns Hopkins Hospital, patients receive their diagnosis from their radiologist and have some time before coming in to discuss treatment options with a surgical oncologist. Taking your time may help you make the treatment choice that’s right for you.

Will having a double mastectomy lower my chances of recurrence?

Regardless of whether you choose to have a lumpectomy or mastectomy, the recurrence rate remains at approximately 10 percent in the treated breast and about 0.5 percent per year in the breast that has not been treated. The risk of getting a different cancer is about 2 percent.

While a breast tumor is worrisome and will require treatment, it may not be fatal. The real risk to your life is if the cancer spreads to another part of the body, such as the lymph nodes, bones and lungs. Removing the entire breast does not affect the rate at which the disease spreads. 

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