Lumpectomy vs. mastectomy: You may not have a choice.

Lumpectomy vs. mastectomy: You may not have a choice.(ISTOCKPHOTO)If you have early-stage breast cancer (stage I or II), chances are good that you'll be offered a lumpectomy, which takes out just the tumor and a thin margin of cancer-free tissue, instead of a mastectomy, which involves removal of the entire breast.

Sometimes it's the location of your tumor that can make the difference. "Mine was directly under the nipple and it didn't require a deep surgery," reports Theresa Beisley, 43, of Randolph, N.J., who had a stage II diagnosis. "My doctor told me, 'With a lumpectomy we can preserve the feeling of having a whole breast without feeling you're not going to get all the cancer cells.'"

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But there are a few things to keep in mind when considering a lumpectomy.

  1. You may need to have surgery again. The "negative," or cancer-free, margins achieved during a successful lumpectomy aren't always easy to get during the first surgery.
  2. You may want to try chemo first. Your doctor may suggest using drugs to shrink your tumor prior to surgery (what's called neoadjuvant therapy), another factor that may allow you to have a lumpectomy instead of a mastectomy.
  3. You may not have a choice. If your cancer is more advanced, mastectomy may be the best option for clearing your breast of its tumor. "Or if you have cancer in two separate parts of the breast, that's a woman that needs to be treated with mastectomy," says Monica Morrow, MD, chief of the Breast Service in the Department of Surgery at Memorial Sloan-Kettering Cancer Center in New York City.

Much depends on your specific diagnosis, so talk with your breast surgeon and/or oncologist.