Treatment decisions for breast cancer

It is helpful to think about the possible advantages and disadvantages of each operation before you make a decision.

Making treatment decisions

Breast-conserving surgery and a mastectomy work equally well in treating early breast cancer. This means your surgeon and specialist nurse may ask you to decide which type of surgery you feel is right for you.

Your surgeon and specialist nurse can explain what is involved and any possible side effects of each treatment. They will help you decide on the treatment that is best for you.

Having breast surgery can affect your body image, sex life and relationships. It is important to take your time and have all the information you need to make the right decision.

It is helpful to think about the possible advantages and disadvantages of each type of surgery before making a decision.

Breast-conserving surgery and radiotherapy

Advantages

  • It aims to keep most of your breast tissue and a good breast shape.
  • You may recover faster than with a mastectomy and have a lower risk of complications.
  • It may be less likely to affect your sex life and relationships.

Disadvantages

  • You may need more than one operation to get clear margins.
  • You need at least 3 weeks of radiotherapy after surgery (some women will also need radiotherapy after a mastectomy).
  • Radiotherapy has short-term side effects. Some women may also have long-term side effects.

Mastectomy

Advantages

  • You may not need radiotherapy after a mastectomy. But some women will need it. Ask your cancer doctor about this.
  • You may feel less worried after the operation because the breast tissue has been removed.

Disadvantages

  • You lose your breast permanently.
  • It may take longer to recover after a mastectomy, and there is a slightly higher risk of complications.
  • It changes your appearance, which may affect your confidence, sex life and relationships.
  • If you want breast reconstruction, you need a longer operation and possibly more surgery. But reconstruction may help to reduce some of the other disadvantages.

Your surgeon and specialist nurse can answer any questions you may have and tell you what to expect. They may be able to show you photographs of other women who have had surgery.

Talking to other people who have already had surgery can also help. Your specialist nurse may know whether there is a local cancer support group, where you can talk to someone who has had a similar operation.

Or you can visit our Online Community to talk to people who have been affected by breast cancer, share your experience, and ask an expert your questions.

About our information

  • References

    Below is a sample of the sources used in our breast cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    European Society for Medical Oncology. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of oncology 26 (supplement 5): v8–v30. 2015.

    Morrow M, et al. Chapter 79: malignant tumors of the breast. DeVita, Hellman and Rosenberg’s cancer: principals and practice of oncology (10th edition). Lippincott Williams and Wilkins. 2014.

    National Institute for Health and Care Excellence (NICE). Early and locally advanced breast cancer: diagnosis and management. July 2018.

    Scottish Intercollegiate Guidelines Network. SIGN 134. Treatment of primary breast cancer: a national clinical guideline. September 2013.


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Rebecca Roylance, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.