This post discusses the surgical options for a woman with breast cancer – organ conservation vis a vis mastectomy, and how to make the choice appropriate for each woman.
With rising awareness, many women with breast cancer are now diagnosed at an early stage, and they have a very good chance of cure. Surgery is the mainstay of treatment for curable breast cancer. Many women (though not all) with early breast cancer have a choice of the following surgical operations
- Remove the cancer alone and preserve the breast (breast-conserving surgery), or
- Remove the entire breast (mastectomy)
When presented with this choice, women are often unable to decide. The short time span of an out-patient consultation with the surgeon/surgical oncologist may be insufficient to make an informed choice. In my practice, it is quite common for the patient and her family to say “doctor, you tell us which surgery is better.”
An earlier post describes the process of sourcing information for people with cancer. https://drsurajmanjunath.com/guide-to-sourcing-best-cancer-treatment-information/
Obviously, people who are reading this post can access the internet, and to them, I recommend this resource for the practical issues involved in making this choice: https://www.breastcancer.org/treatment/surgery/mast_vs_lump
Conceptually, there are two important points to realize
Firstly, when it comes to long-term survival, neither surgical option has an advantage over the other. In this aspect, both surgical options are equal.
Secondly, the choice of surgical operation depends on factors other than survival benefit, namely
- How keen a woman is to preserve her breast
- How much additional treatment will be required if the breast is preserved
A woman who is eligible for both surgical options should decide after clearly understanding these two concepts. Every woman is an individual in her own right. One woman may want to retain her breast, and not mind undergoing radiotherapy, or additional surgery if required. Another may want the simplicity of a mastectomy, and not be really concerned about losing the breast.
The right choice is therefore unique to each woman, and is based on the right knowledge along with a clear discussion with the treating surgeon.