Lumpectomy vs. mastectomy

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DURHAM, N.C. - It's a decision more than 232,000 women diagnosed with breast cancer will have to make in this country this year, whether to have a lumpectomy or mastectomy.

"I have girlfriends that have gone through this unfortunately. Some chose a lumpectomy. Some chose a mastectomy," said Jennifer Kajcienski, a breast cancer survivor.

But Dr. Shelly Hwang, a professor of Surgery at Duke University School of Medicine, says more and more women are opting for mastectomies.

"There's this trend toward women just doing more. So if they have a choice between lumpectomy and mastectomy, they'll choose to have a mastectomy," said Hwang.

The latest numbers show 70 percent of those women don't have a proven medical reason.  That's where Hwang hopes a new study she led at Duke University could help. 

The team analyzed more than 112,00 women with early-stage breast cancer, about half of whom had a lumpectomy with radiation and the other half underwent a mastectomy.

"You would think the more surgery you did, the more aggressive you were, the better patients would do from their breast cancer. But we found that that wasn't actually true," Hwang said.

Those who received less-invasive treatment in all age groups had improved survival rates.

"For the majority of women who have the choice, they don't need to feel like they are being pressured to do the more aggressive surgery to get a better outcome," Hwang said.

After three rounds of chemo, Kajcienski's lump disappeared without surgery.  But she says if it came down to it, she'd do whatever it takes to make sure she survives breast cancer.

"I mean, we can live without parts of our body.  Our kids and our families need us," she said.

While a lumpectomy may prove to be more advantageous to most with early-stage breast cancer, the authors of the study say a double mastectomy could make more sense for a woman with a strong family history of cancer or for those who've tested positive for genetic mutations, as was the case for Angelina Jolie.

Additional Information:

A breast cancer diagnosis can be life-changing for a woman. Even more so if she decides to have a lumpectomy or mastectomy. But how do you know which one is right for you?

Lumpectomy: A lumpectomy is a procedure in which cancer cells or other abnormal tissue is removed.  They are sometimes called breast-saving surgeries, because unlike a mastectomy, only part of the breast is removed.  Essentially, doctors removed the abnormal tissue (the ‘lump') and usually some surrounding tissue as well, in an effort to avoid malignancy.  A lumpectomy can also be used as a confirmation surgery, when a diagnosis is not quite certain. (Source:

Mastectomy:  A mastectomy involves the removal of all tissue in one or both breasts.  They are usually performed if you have two or more tumors in different parts of the breast.  The underlying idea of a mastectomy is to remove any potentially problematic tissue in the breast before the cancer becomes malignant.  The surgery may be the only option for some women diagnosed with early stage breast cancer.  These surgeries can be done as a preventative measure as well, which is growing in popularity.  Often, women will choose to have a breast reconstruction surgery as part of their mastectomy.  Newer mastectomy techniques are leaving more skin, which allows for a more natural shape.  (Source:

Genetic testing is becoming a more popular way to screen for breast cancer, so preventative measures can be taken; especially as genetic sequencing becomes a cheaper and cheaper option.  You can be at an increased risk of breast cancer if someone in your family was diagnosed with the disease.  If they were diagnosed after 50, your risk is even greater. (Source: prophylactic-mastectomy/WO00060)

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