One major decision you may face with early breast cancer is whether to have a lumpectomy (also called breast conserving surgery) plus radiation therapy or a mastectomy. They are equally effective in treating early breast cancer.
Overall survival is the same for lumpectomy plus radiation therapy versus mastectomy. This means both treatments lower the risk of dying (from breast cancer or other cause) by the same amount.
For a summary of research studies on lumpectomy plus radiation therapy versus mastectomy in the treatment of early breast cancer, visit the Breast Cancer Research Studies section.
The choice between lumpectomy plus radiation therapy versus mastectomy will not affect your survival.
However, it may affect your risk of breast cancer recurrence (the return of cancer) within the breast.
Local recurrence is the return of cancer to the breast, chest wall or lymph nodes after treatment.
Most local recurrences occur within the first 5 years after diagnosis .
If you have a recurrence, you will need more treatment.
Learn more about treatment for local recurrence.
Distant recurrence (metastasis) occurs when cancer spreads beyond the breast to other organs such as the bones, liver, lungs or brain.
The risk of distant recurrence is the same for people who have lumpectomy plus radiation therapy and those who have mastectomy .
Learn about treatment for distant recurrence (metastatic or advanced breast cancer).
The chance of local recurrence in 10 years is about 3-15 percent for women who have lumpectomy plus radiation therapy .
The risk of local recurrence depends on tumor characteristics such as hormone receptor status and HER2 status.
It also depends on whether or not the tumor margins and the lymph nodes in the underarm area contain cancer cells. The chance of local recurrence is lower when [4,14]:
Chemotherapy, hormone therapy and/or targeted therapy can lower the risk of breast cancer recurrence after lumpectomy plus radiation therapy .
With mastectomy, the best predictor of local recurrence is whether the lymph nodes in the underarm area contain cancer. The more lymph nodes with cancer there are, the higher the risk of recurrence .
When the lymph nodes do not contain cancer, the chance of local recurrence in 5 years is about 6 percent .
When there is cancer in the lymph nodes, the chance of local recurrence in 5 years is about 23 percent without radiation therapy following mastectomy . Radiation therapy can reduce this risk to about 6 percent .
Learn more about breast cancer recurrence.
Making Treatment Decisions
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