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Lumpectomy vs Mastechtomy

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Category: TNBC Forums
Forum Name: TNBC Talk
Forum Description: A place to chat
Printed Date: Feb 25 2021 at 8:08am
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Topic: Lumpectomy vs Mastechtomy
Posted By: Debaura211
Subject: Lumpectomy vs Mastechtomy
Date Posted: Aug 03 2020 at 11:14am
This forum has helped me explore the different choices we have in our treatment of TNBC, often not enough bur sometimes too many. I am finishing up chemo - TC/AC next week and have to make a decision about surgery - lumpectomy or mastectomy.

I've had a partial response with tumor in left breast now under 1 cm; no known lymph node involvement. Two surgeons and med. onc. have recommended lumpectomy but now I'm wondering whether a mastectomy would be the better option. Ive lost sleep over the possibility of same site recurrence even though the docs tell me the odds of this are only 3-5% . I understand with a lumpectomy I will need radiation, and with a mastectomy, if more than 3 nodes are removed, I'll also need radiation. I'm 65 years old, not concerned about either having yearly mammograms or reconstruction. I want to have confidence in my decision; I've done my research and read forum postings, but its still a tough call for me.

I'll ultimately make this decision for myself, of course, but just wondered how others make it. Thanks for listening.

Posted By: 123Donna
Date Posted: Aug 03 2020 at 7:11pm

This is a tough decision and when given the choice, a very personal one.  Sometimes having a genetic mutation or larger tumor or node involvement, may limit surgery options.  There have been studies suggesting that lumpectomy plus radiation has a better overall disease free survival than mastectomy without radiation.  I'll try to find the links and post for you.

Published in" rel="nofollow - Oncology

Journal Scan / Research · June 12, 2019

Survival of T1-2N0M0 Triple-Negative Breast Cancer Treated With Breast-Conserving Therapy vs Mastectomy

  • This analysis of the SEER database was undertaken to evaluate outcomes with breast-conserving therapy (BCT) vs mastectomy among patients with T1-2N0M0 triple-negative breast cancer. Both overall survival and breast cancer–specific survival were better with BCT.
  • There was no evidence of a survival benefit with radiotherapy following mastectomy in patients with T1-2N0M0 disease. BCT was associated with superior overall survival relative to either mastectomy alone or mastectomy with radiotherapy." rel="nofollow -

Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer


The aim of this study is to compare the treatment outcomes of breast conserving surgery (BCS) plus radiotherapy (RT) versus mastectomy for patients with pT1-2N1 triple-negative breast cancer (TNBC).

Materials and Methods

Using two multicenter retrospective studies on breast cancer, a pooled analysis was performed among 320 patients with pT1-2N1 TNBC. All patients who underwent BCS (n=212) receivedwhole breast RTwith orwithoutregional nodal RT,while nonewho underwent mastectomy (n=108)received it. All patients received taxane-based adjuvant chemotherapy. The median follow-up periods were 65 months in the BCS+RT group, and 74 months in the mastectomy group.


The median age of all patients was 48 years (range, 24 to 70 years). Mastectomy group had more patients with multiple tumors (p < 0.001), no lymphovascular invasion (p=0.001), higher number of involved lymph node (p=0.028), and higher nodal ratio ≥ 0.2 (p=0.037). Other characteristics were not significantly different between the two groups. The 5-year locoregionalrecurrence-free, disease-free, and overall survivalrates of BCS+RT group versus mastectomy group were 94.6% versus 87.7%, 89.5% versus 80.4%, and 95.0% versus 87.8%, respectively, and the differences were statistically significant after adjusting for covariates (p=0.010, p=0.006, and p=0.005, respectively).


In pT1-2N1 TNBC, breast conservation therapy achieved better locoregional recurrencefree, disease-free, and overall survival rates compared with mastectomy." rel="nofollow -

DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

Posted By: Debaura211
Date Posted: Aug 04 2020 at 9:32am
I've been following your posts on this site and they've been most helpful. Your response with these articles came at a time of anxiety and second-guessing and took that away, for which I am grateful. All I can do is go with the best information I have at the time, and factor in personal considerations. Although no two cases are the same, I'm sticking with lumpectomy with radiation, with confidence.

Thank you.

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