Deciding Between a Lumpectomy or a Mastectomy Early-stage breast cancer (stage I or II) is the most common invasive breast cancer

in the United States. In early-stage breast cancer the cancer may have spread to nearby lymph nodes but not to distant parts of the body. With treatment, people with earlystage breast cancer usually have a good prognosis. The five-year overall survival for women with early-stage breast cancer is 88%. This means that 88 out of 100 women diagnosed with early- stage breast cancer live five years beyond their diagnosis. Surgical options for those in early-stage breast cancer are either undergoing a lumpectomy or mastectomy. LUMPECTOMY Lumpectomy (breast-conserving) is surgery in which only the tumor is removed from the breast and some surrounding tissue. Women who have lumpectomies usually have lymph nodes under the armpit removed too. Lumpectomies keep the breast in tact and looking a lot like it did before surgery. Surgery requires either general anesthesia, which means you are asleep during the surgery or regional anesthesia, which will only numb that specific part of the body. Surgery usually lasts about an hour and patients often go home the same day. After surgery care will require caring for the bandage, which is usually removed 1-2 weeks after surgery; caring for the surgical drain, which may be removed before you leave the hospital; and exercising the arm to prevent arm and shoulder stiffness. Radiation therapy is followed by the lumpectomy usually lasting 5 to 7 week in duration. MASTECTOMY Mastectomy is surgery that removes all of the breast tissue in the breast with cancer; possibly some of the lymph nodes under the arm and in some cases part of the chest wall muscles are removed. Surgery requires general anesthesia, which means you are asleep during the surgery. Surgery usually lasts about 2 to 3 hours and overnight hospital stay is needed. After surgery care will require caring for the bandage, which is usually removed 1-2 weeks after surgery; caring for the surgical drain, which may be removed before you leave the hospital; exercising the arm to prevent arm and shoulder stiffness; and will need to wait to start wearing a bra or prosthesis. Breast reconstruction can be done later. It may be hard to decide whether to have a lumpectomy or a mastectomy. Please refer to the Decision Aid on the following page. This will allow you to weigh the risks and benefits of each surgery in order to choose the one that is right for you.

Lumpectomy with Radiation Extent of Surgery Hospital Stay Radiation Therapy Overall Survival Chance of Breast Cancer Recurrence Emotional Well-being
Only the tumor is removed, less extensive; general or regional anesthesia Often go home on same day of surgery Routinely done 5 to 7 weeks in duration

Mastectomy
Whole breast is removed, major surgery with general anesthesia Overnight hospital stay needed Sometimes done

Of all the women who underwent a lumpectomy or a mastectomy, 71 out of every 100 were living 10 years later Of all the women who underwent a lumpectomy, 6 out of every 100 have a recurrence with in 5 years; 94 out of 100 do not. Of all the women who underwent a mastectomy, 16 out of every 100 have a recurrence with in 5 years, 84 out of 100 do not.

Of all the women who underwent a lumpectomy or a mastectomy, 66 out of 100 reported that their emotional well-being was the same or better 5 years after surgery.

Long-term Side Effects Pain Numbness

Of all the women who underwent a lumpectomy or mastectomy, 21 out of 100 experienced pain 5 years after surgery, 79 out of 100 did not. Of all the women who underwent a lumpectomy, 55 out of 100 experienced numbness under their arm after 5 years, 45 out of 100 did not. Of all the women who underwent a mastectomy, 69 out of 100 experienced numbness under their arm after 5 years, 31 out of 100 did not.

Physical Functioning

Of all the women who underwent a lumpectomy or a mastectomy, 21 out of 100 reported that their physical functioning was impaired 5 years after surgery, 79 out of 100 did not.

Short-term Side Effects

Women who underwent a lumpectomy or a mastectomy experienced minor bleeding, infection, pain (2-3 weeks), swelling (2-3 weeks), tenderness (2-3 weeks)