When it comes to triple negative breast cancer (TNBC), the choice between a mastectomy and a lumpectomy depends on several personal and medical factors. Both are considered equally effective treatments overall, but there are some key differences to consider.
A lumpectomy (breast-conserving surgery) removes just the tumor Show Full Answer
When it comes to triple negative breast cancer (TNBC), the choice between a mastectomy and a lumpectomy depends on several personal and medical factors. Both are considered equally effective treatments overall, but there are some key differences to consider.
A lumpectomy (breast-conserving surgery) removes just the tumor and a small amount of surrounding tissue. It's typically followed by radiation therapy. A mastectomy removes the entire breast and may be followed by reconstruction.
Here's a quick comparison to help frame the conversation with your care team:
Lumpectomy may be a good fit if you:
- Have a small tumor relative to your breast size
- Want to preserve as much breast tissue as possible
- Are able to safely receive radiation after surgery
- Have a single tumor visible on imaging
Mastectomy may be considered if you:
- Have a large tumor or multiple tumors
- Have cancer that has spread throughout the breast
- Prefer to reduce the risk of local recurrence
- Have a BRCA1 or BRCA2 gene mutation (common in TNBC) In terms of recurrence risk, lumpectomy followed by radiation carries about a 5–10% chance of cancer returning in the same breast, compared to around 5% after mastectomy. So the difference is relatively small.
For TNBC specifically, chemotherapy is often given before surgery (neoadjuvant therapy) to shrink the tumor, which can sometimes make a lumpectomy possible even when the tumor was initially too large for one.
The best path forward is really a shared decision between you and your oncology team, taking into account your tumor characteristics, genetics, and personal preferences. A second opinion is always a reasonable step if you're feeling unsure.
July 12
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