Breast Conservation vs Mastectomy

For decades it has been thought that lumpectomy and radiation was equivalent to mastectomy in the treatment of early breast cancer. Equivalent in that no matter which procedure is done, the long term survival from breast cancer is the same. Today the evidence is tending to show that breast conservation with lumpectomy and radiation may even have a better survival benefit than mastectomy. So why are more women opting for mastectomy if it doesn’t mean longer survival? Some patients require mastectomy. Patients with a genetic predisposition can have up to an 85% chance of developing breast cancer. These patients require prophylactic mastectomies to prevent the development of a future breast cancer which could threaten their lives. Patients with extensive cancers that are too large for lumpectomy require mastectomy. Mastectomy may be the only option in patients with multi-centric breast cancer which means disease is in more than one quadrant of the breast or patients with recurrent breast cancer. However, the majority of breast cancer patients do not require mastectomy. The “Angelina Jolie” trend began when this famous actress opted for bilateral mastectomies with reconstruction after she was diagnosed with the breast cancer gene. But most breast cancers are found in an early stage and only 5% of breast cancer patients have the genetic mutation. In these patients breast conservation is still the best choice. There are less risks of complications and breast conservation may result in better survival. Lumpectomy with radiation is still the treatment of choice for early breast cancer.