Choosing the best surgical option for breast cancer
Charles Castillo, MD, is a general surgeon at Banner Good Samaritan Medical Center in Phoenix.
Question: Is mastectomy the best surgical option for breast cancer?
Answer: Thirty to 40 years ago, mastectomy, removal of the entire breast in which cancer has been detected as well as surrounding lymph nodes, was considered the only treatment option for breast cancer patients. Today, extensive research has proven that breast conservation therapy can be just as effective, especially for patients with early stages of breast cancer.
Breast conservation therapy involves a surgical procedure called a lumpectomy, which targets the actual tumor for removal, along with a sentinel lymph node biopsy, to assess if cancer is present in the nodes. If no cancer is found in the sentinel node, removing additional nodes is unnecessary and the risk for complications like arm swelling is reduced.
Breast conservation therapy allows a woman to avoid more radical surgery and delivers a treatment option with equivalent survival rates to mastectomy for many patients.
However, because each case is different, not all patients can benefit from breast conservation therapy. Some patients with more advanced stages of breast cancer will require a mastectomy, and follow-up treatment such as radiation and chemotherapy. But sometimes, a patient whose cancer has progressed can undergo chemotherapy prior to surgery, to shrink the existing tumor and make her a candidate for breast conservation therapy.
We are fortunate that research advancements have enabled us to identify effective alternatives to mastectomy that are less invasive, leading to faster recoveries and less physical impact. Nonetheless, a patient should talk with her oncologist, surgeon and other health care providers to consider all available treatment options and choose the one that best fits her particular case.
Reviewed April 2010