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Compare the Types of Surgery

The charts in this section can help you compare the different surgeries with each other. See how the surgeries are alike and how they are different.

Before Surgery

Is this surgery right for me?

Breast-Sparing SurgeryMost women with DCIS or breast cancer can choose to have breast-sparing surgery, usually followed by radiation therapy.
MastectomyMost women with DCIS or breast cancer can choose to have a mastectomy.

A mastectomy may be a better choice for you if:
  • You have small breasts and a large area of DCIS or cancer.
  • You have DCIS or cancer in more than one part of your breast.
  • The DCIS or cancer is under the nipple.
  • You are not able to receive radiation therapy.
Mastectomy with ReconstructionIf you have a mastectomy, you might also want breast reconstruction surgery.

You can choose to have reconstruction surgery at the same time as your mastectomy or wait and have it later.

Recovering from Surgery

Will I have pain?

Most people have some pain after surgery.

Talk with your doctor or nurse before surgery about ways to control pain after surgery. Also, tell them if your pain control is not working. To learn more about pain control, see Related Resources.

How long before I can return to normal activities?

Breast-Sparing SurgeryMost women are ready to return to most of their usual activities within 5 to 10 days.
MastectomyIt may take 3 to 4 weeks to feel mostly normal after a mastectomy.
Mastectomy with ReconstructionYour recovery will depend on the type of reconstruction you have. It can take 6 to 8 weeks or longer to fully recover from breast reconstruction.

What other problems might I have?

Breast-Sparing SurgeryYou may feel very tired and have skin changes from radiation therapy.
MastectomyYou may feel out of balance if you had large breasts and do not have reconstruction surgery. This may also lead to neck and shoulder pain.
Mastectomy with ReconstructionYou may not like how your breast-like shape looks.
If you have an implant:
  • Your breast may harden and can become painful.
  • You will likely need more surgery if your implant breaks or leaks.
If you have flap surgery, you may lose strength in the part of your body where a muscle was removed.

What other types of treatment might I need?

If you chose to have breast sparing surgery, you will usually need radiation therapy. Radiation treatments are usually given 5 days a week for 5 to 8 weeks.

If you have a mastectomy, you may still need radiation therapy.

No matter which surgery you choose, you might need:

  • Chemotherapy
  • Hormone therapy
  • Targeted therapy

Life After Surgery

What will my breast look like?

Breast-Sparing SurgeryYour breast should look a lot like it did before surgery.

But if your tumor is large, your breast may look different or smaller after breast-sparing surgery.

You will have a small scar where the surgeon cut to remove the DCIS or cancer. The length of the scar will depend on how large an incision the surgeon needed to make.
MastectomyYour breast and nipple will be removed. You will have a flat chest on the side of your body where the breast was removed.

You will have a scar over the place where your breast was removed. The length of the scar will depend on the size of your breast. If you have smaller breasts, your scar is likely to be smaller than if you have larger breasts.
Mastectomy with ReconstructionYou will have a breast-like shape, but your breast will not look or feel like it did before surgery. And, it will not look or feel like your other breast.

You will have scars where the surgeon stitched skin together to make the new breast-like shape.

If you have tissue flap reconstruction, you will have scars around the new breast, as well as the area where the surgeon removed the muscle, fat, and skin to make the new breast-like shape.

To get a better idea of what to expect, ask your surgeon if you can see before and after pictures of other women who have had different types of surgery.

Remember, even though surgery leaves scars where the surgeon cut the skin and stitched it back together, they tend to fade over time.

Will my breast have feeling?

Breast-Sparing SurgeryYes. You should still have feeling in your breast, nipple, and areola (the dark area around your nipple).
MastectomyMaybe. After surgery, the skin around where the surgeon cut and maybe the area under your arm will be numb (have no feeling).

This numb feeling may improve over 1 to 2 years, but it will never feel like it once did. Also, the skin where your breast was may feel tight.
Mastectomy with ReconstructionNo. The area around your breast will not have feeling.

Will I need more surgery?

Breast-Sparing SurgeryIf the surgeon does not remove all the DCIS or cancer the first time, you may need more surgery.
MastectomyIf you have problems after your mastectomy, you may need more surgery.
Mastectomy with ReconstructionYou will need more than one surgery to build a new breast-like shape. The number of surgeries you need will depend on the type of reconstruction you have and if you choose to have a nipple or areola added.

Some women may also decide to have surgery on the opposite breast to help it match the new breast-like shape better.

If you have an implant, you are likely to need surgery many years later to remove or replace it.

With all three surgeries, you may need more surgery to remove lymph nodes from under your arm. Having your lymph nodes removed can cause lymphedema.

Will the type of surgery I have affect how long I live?

No. Research has shown that women who have breast-sparing surgery live as long as women who have a mastectomy. This does not change if you also have reconstruction.

What are the chances that my cancer will return in the same area?

Breast-Sparing SurgeryThere is a chance that your cancer will come back in the same breast. But if it does, it is not likely to affect how long you live. About 10% of women (1 out of every 10) who have breast-sparing surgery along with radiation therapy get cancer in the same breast within 12 years. If this happens, you can be effectively treated with a mastectomy.
MastectomyThere is a smaller chance that your cancer will return in the same area than if you have breast-sparing surgery. About 5% of women (1 out of every 20) who have a mastectomy will get cancer on the same side of their chest within 12 years.
Mastectomy with ReconstructionYour chances are the same as mastectomy, since breast reconstruction surgery does not affect the chances of the cancer returning.
  • Posted: March 1, 2013