Lumpectomy vs. Mastectomy: How to Decide What’s Best for You
January 13, 2025 By: General Surgery Team

Content medically reviewed by Troy Duininck, MD
Facing a breast cancer diagnosis can be overwhelming. In most situations surgery is necessary, and often you have a choice between breast-conserving surgery (lumpectomy) or having your breast removed (mastectomy). Lumpectomy vs. mastectomy might feel like a daunting decision.
“I’m often asked if it’s better to have a lumpectomy or a mastectomy, but the answer varies by individual and depends on several factors, including the stage of the cancer and your personal preferences,” said Dr. Troy Duininck, general surgeon at Essentia Health. “Your breast cancer treatment team at Essentia Health will help you weigh the benefits and risks of all surgical options and guide you to making the right choice for your situation.”
What Is a Lumpectomy?
Also called breast-conserving surgery or partial mastectomy, a lumpectomy is an option for many patients diagnosed with early-stage breast cancer. In this type of breast cancer surgery, a surgeon removes the tumor while preserving healthy breast tissue. How much of the breast needs to be removed depends on several factors –
- The location of the tumor within the breast
- The size of your breast
- The size of the tumor
“Most people who have breast-conserving surgery also need radiation therapy, which means you must be able and prepared to go to additional appointments,” Dr. Duininck said.
In general, you are a candidate for lumpectomy if you –
- Are not pregnant (or, if you are pregnant, don’t need immediate radiation therapy)
- Do not have inflammatory breast cancer, a rare type of cancer in which cancerous cells obstruct lymph vessels in the skin, making the breast look red and swollen (inflamed)
- Have just one tumor in the breast, or multiple tumors that are located close together and can be removed together without changing the look of the breast dramatically
- Have not had previous radiation therapy on the affected breast
- Have a tumor smaller than two inches and is small relative to your overall breast size
What Is a Mastectomy?
A mastectomy is surgery that involves removing the entire breast rather than just the small part of the breast containing cancer.
“In some cases, lumpectomy is not possible due to factors such as the size and location of the cancer. In other cases, some people may choose to have a mastectomy for personal reasons, such as not wanting radiation treatment,” Dr. Duininck said. “But every situation is unique, and some people still need additional treatment after a mastectomy. Your treatment team will discuss your individual diagnosis and options with you.”
There are several types of mastectomies –
- Simple (total) mastectomy. The surgeon removes the entire breast. This includes the nipple, areola and some skin.
- Modified radical mastectomy. This is a simple mastectomy combined with the removal of the underarm lymph nodes (axillary lymph nodes).
- Radical mastectomy. This procedure includes removing the pectoral (chest wall) muscles under the breast. This is more of a historical procedure and is not an operation that is currently used in the management of breast cancer.
- Skin-sparing mastectomy. In this type of mastectomy, the surgeon removes the same amount of breast tissue as in a simple mastectomy but leaves the skin in place over the breast. During the procedure, the surgeon can also reconstruct the breast using implants or tissue from other parts of the body. This technique is used in conjunction with a reconstruction procedure that would be done at the same time by a plastic surgeon.
- Nipple-sparing mastectomy. This is similar to a skin-sparing mastectomy but also saves the nipple and areola. This can be an option for early-stage cancers in which there is no sign of disease in the nipple, and it is also used in cases of higher risk when a patient is having a mastectomy for prophylaxis or risk reduction.
- Double mastectomy. This procedure removes both breasts. Some people may choose to have a double mastectomy as a preventive surgery if they are at very high risk for developing breast cancer, such as those with a gene mutation that carries significant breast cancer risk.
Benefits and Risks: Lumpectomy vs. Mastectomy
Both types of procedures have advantages. The biggest advantage of a lumpectomy is that you can keep most of your breast. The appearance and sensation of your breast may not change much. Additionally, recovery time is faster and easier than that of mastectomy, as lumpectomy is a less invasive procedure. Most people can return to normal activities within two weeks after a lumpectomy.
For some, having a mastectomy brings greater peace of mind, although it is important to note that long-term survival rates are the same for mastectomy and lumpectomy with radiation in most cases. Additionally, radiation therapy may be avoided in many cases with mastectomy.However, both types of surgery also come with drawbacks. Some of the possible disadvantages of lumpectomy include –
- Having four to six weeks of radiation therapy, five days per week, in most cases
- Risk of cancer recurring in the same breast, which can sometimes lead to another lumpectomy or a mastectomy
- Need for additional surgery if cancer is found at the margin of the lumpectomy tissue. A mastectomy is a more extensive and invasive surgery.
Possible disadvantages include –
- Longer recovery time, with most patients returning to regular activities within about four weeks
- More possible short-term side effects, such as limited arm and shoulder movement, numbness, and pain
- The psychological and physical effects of permanent loss of your breast
Some patients who have a mastectomy also choose to have breast reconstruction surgery. This can sometimes be done at the same time as mastectomy but is sometimes a separate procedure. Your provider will usually work with a plastic surgeon, who can discuss reconstruction options with you.