Making Treatment DecisionsFact Sheet
One major decision you may face with early breast cancer is whether to have mastectomy or lumpectomy (also called breast conserving surgery) plus radiation therapy. Both surgeries are equally effective in treating early breast cancer.
Overall survival is the same for mastectomy versus lumpectomy plus radiation therapy. 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 mastectomy versus lumpectomy plus radiation therapy in the treatment of early breast cancer, visit Breast Cancer Research.
Although the choice between mastectomy and lumpectomy plus radiation therapy will not affect your survival, it may affect your risk of breast cancer recurrence (the return of cancer, relapse).
Local recurrence is the return of cancer to the breast, chest wall or lymph nodes after treatment. Most local recurrences occur within the first five 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. It is the main cause of breast cancer death.
The risk of distant recurrence is the same for people who have mastectomy and those who have lumpectomy plus radiation therapy .
Learn about treatment for distant recurrence (metastatic or advanced breast cancer).
The chance of local recurrence in 10 years is about seven to 12 percent for women who have lumpectomy plus radiation therapy .
The risk of local recurrence 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 [4,13]:
Chemotherapy, targeted therapy and/or hormone therapy can lower the risk of breast cancer recurrence after lumpectomy plus radiation therapy .
With mastectomy, the best predictor of local recurrence is how far the cancer has spread in the lymph nodes in the underarm area. The chance of local recurrence in five years is about six percent for women when the lymph nodes do not contain cancer .
For those who have cancer in one to three nodes, the chance of local recurrence in five years is about 16 percent. Radiation therapy can reduce this risk to about two percent .
The chance of local recurrence increases to about 26 percent when cancer is in four or more lymph nodes . Radiation therapy to the chest wall after mastectomy is usually given when four or more nodes contain cancer. This reduces the risk of local recurrence in five years to about six percent .
Learn more about breast cancer recurrence.