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Breast Cancer: Early-Stage Breast Cancer: Choosing Your Surgery


About Health Crossroads

If you’ve come to this Web site, you’re probably at a crossroad. You may be making a medical decision about which path will lead to the treatment that’s best for you, or you may be looking for the best way to participate in your care.

Each Crossroad on this Web site has been carefully researched and written to help you find the right path for you.

About This Decision

You have a choice in breast cancer surgery. Whether you have mastectomy (removal of the breast) or lumpectomy (removal of the tumor) with radiation, it will not make a difference in how long you live.

But there are other important differences between the surgeries. How you feel about those differences is key to which treatment will be best for you.

This Crossroad is intended to support you in making a decision about breast cancer surgery. The goal is to help you sort out how you feel about the differences between mastectomy and lumpectomy with radiation.

Is This Information for You?

This Crossroad is for women with early-stage invasive breast cancer (Stages I and II) who are able to choose either mastectomy or lumpectomy.

It is not intended for women with certain medical conditions that may limit or otherwise influence their treatment options. These include:
  • Pregnancy
  • Health problems that make anesthesia or surgery life-threatening
  • DCIS (ductal carcinoma in situ)
  • LCIS (lobular carcinoma in situ)
  • Inflammatory breast cancer.
The program is also not for women with cancer in certain locations. This includes women with:
  • Tumors fixed to the chest wall
  • Cancer in more than one part of the breast
  • Cancer in lymph nodes near the collarbone
  • Cancer with extensive growth in underarm lymph nodes
  • Cancer that has spread beyond the breast and lymph node area.
Women who have breast cancer that is related to genetic mutations that increase the risk of breast cancer (BRCA1 or BRCA2) may have to consider other factors when choosing their treatment. These mutations increase the risk of developing cancer in either breast.

Medical Editor: Joann G. Elmore, MD, MPH

Reviewed/Updated: 9/30/2013
adjuvant therapy

Treatment, such as chemotherapy, radiation therapy, hormone therapy, or biological therapy, that is given in addition to surgery.

axillary lymph node dissection

Procedure in which a surgeon removes all or most of the lymph nodes in the underarm area. Axillary lymph node dissection removes more lymph nodes than sentinel node biopsy.

axillary nodes

Lymph nodes found under the arm that drain lymph fluid from the breast.

biological therapy

Treatment that targets cancer cells that make too much of a protein called HER2/neu. Trastuzumab (Herceptin®) is the biological therapy available to women with early-stage breast cancer that is HER2/neu-positive. Other biological therapies are being tested in clinical trials.


Chemotherapy involves taking drugs that target cancer cells throughout the body. Some are taken by mouth and others are injected by needle directly into the bloodstream over the course of a few hours.


Tubes in the body that carry body fluids. In the breast, ducts carry milk to the nipple.

hormone therapy

Treatment that blocks or removes hormones. To slow or stop the growth of breast cancer, medications may be given to block the body's natural hormones. Sometimes surgery is needed to remove the source of hormones. Hormone therapy treats cancer in the whole body. Hormone therapy is only effective for women with hormone receptor-positive tumors. Also called endocrine therapy.


Round sac-like structures in the breast where milk is produced. Also called lobes.

local therapy

Therapy, such as surgery and radiation, that treats cancer in the breast and breast area only, including the lymph nodes under the arm. Local therapies do not treat cancer cells that may have spread to other parts of the body.


A buildup of excess fluid that causes swelling in the arm after lymph vessels or lymph nodes in the underarm are removed or treated with radiation.

lymph nodes

A collection of immune system cells that help defend the body from the spread of infections and cancer. Lymph nodes that filter lymph fluid from the breast are located behind the chest wall, near the collarbone, and in the armpit, or axillary area. If cancer cells break off from a primary tumor, often the first place they are trapped is in the axillary lymph nodes. Sometimes the immune system traps cancer cells in the lymph nodes to keep the cancer from spreading.


The edge or border of the tissue removed in cancer surgery. The margin is described as negative or clear if there are no cancer cells at the edge of the tissue, suggesting that all of the cancer has been removed. The margin is described as positive or involved if there are cancer cells at the edge of the tissue, suggesting that not all of the cancer has been removed.


The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called secondary tumors and contain cells that are like those in the original (primary) tumor. The plural is metastases.

primary tumor

The original tumor in the breast.


A breast prosthesis is a breast-shaped form worn under clothing after a mastectomy to create the appearance of a normal breast.

radiation therapy

A local therapy that uses high-energy x-rays to kill any cancer cells that may be left in the breast or breast area after surgery.

sentinel node biopsy

Procedure in which a dye and/or radioactive marker is injected near a breast tumor and flows into the sentinel lymph node(s), the first lymph node(s) that cancer is likely to spread to from the primary tumor. A surgeon then looks for the sentinel lymph node(s) and removes it (or them) to check for the presence of cancer cells. Sentinel node biopsy removes fewer lymph nodes than axillary lymph node dissection.

systemic therapy

Treatment with drugs that travel through the bloodstream, reaching and affecting cells all over the body. Chemotherapy, hormone therapy, and biological therapy are systemic treatments for breast cancer.

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