Deciding On Surgery

Deciding On Surgery

December 14, 2021
Everett Bonner, MD
Everett Bonner, MD

Breast Surgery



When you’re trying to make that decision, should I do a lumpectomy or partial mastectomy with the addition of radiation at some point in your treatment plan, or should I get a total mastectomy? You have to look at what do you want for yourself from a cosmetic standpoint, from a treatment standpoint. With all things being equal with the long-term survivability and prognosis factors between a lumpectomy and radiation and mastectomy, it comes down to, what do you want for yourself?


When you have a lumpectomy with radiation, the sensation of the breasts, the contour of the breast and the cosmetic outcome of your breasts looks very good. It’s your breast, and everything you had before cancer is there when you finish your treatment. Mastectomy does have some significant cosmetic changes in your breast. Whether you do a skin sparing mastectomy, a nipple sparing mastectomy, which can be done in particular patients, although your breast looks the same, it definitely does not feel the same.


The breast is numb. The nipples are numb. There’s no more reaction at all. And it doesn’t even feel like it’s your own breasts. And then there’s the whole reconstruction side of that after a mastectomy. And that’s either with tissue expanders, or implants or tissue from your own body moved up and to replace that. Things are different. There’s increasing complications and infections. There’s also bleeding that’s involved.


So it’s not all of a sudden, “I just want to get my mastectomy. I want my breasts removed. Everything is going to be great.” There are some things that need to be considered, and some long-term things that need to be considered. There are second surgeries that need to be involved. So it’s not all one size fits all, and don’t always have that knee jerk reaction that mastectomy is going to be the best thing, because it’s not necessarily the best thing for you.


Key Takeaways

1. When deciding on surgery, you need to consider cosmetic and treatment questions.

2. With a lumpectomy and radiation, cosmetically your breasts might look very good while a mastectomy does cause some significant cosmetic changes.

3. There are also complications, infections, and bleeding that can be involved.

4. There are second surgeries that need to be involved.

5. It’s not all one size fits all – mastectomy is not necessarily the best thing for you.