A mastectomy is surgery to remove the entire breast. Most of the time, some of the skin and the nipple are also removed. The surgery is most often done to treat breast cancer.
Breast removal surgery; Subcutaneous mastectomy; Total mastectomy; Simple mastectomy; Modified radical mastectomy
Before surgery begins, you will be given general anesthesia. This means you will be asleep and pain-free during surgery.
There are different types of mastectomies. Which one your surgeon performs depends on the type of breast problem you have.
The surgeon will make a cut in your breast and perform one of these operations:
One or two small plastic drains or tubes are usually left in your chest to remove extra fluid from where the breast tissue used to be.
A plastic surgeon may be able to reconstruct the breast during the same operation. You may also choose to have breast reconstruction with implants or natural tissue later. If you have reconstruction, a skin or nipple sparing mastectomy may be an option. With skin sparing, the nipple and areola are removed along with the breast, but only a small amount of skin is removed. Nipple sparing mastectomy is removal of the breast, but leaving all of the skin and the nipple and areola.
Mastectomy will take about 2 to 3 hours.
WOMAN DIAGNOSED WITH BREAST CANCER
The most common reason for a mastectomy is breast cancer.
If you are diagnosed with breast cancer, talk to your doctor about your choices:
You and your doctor should consider:
The choice of what is best for you can be difficult. You and the health care providers who are treating your breast cancer will decide together what is best.
WOMEN AT HIGH RISK FOR BREAST CANCER
Women who have a very high risk of developing breast cancer may choose to have a preventive (or prophylactic) mastectomy to reduce the risk of breast cancer.
You may be more likely to get breast cancer if one or more close family relatives has had the disease, especially at an early age. Genetic tests (such as BRCA1 or BRCA2) may help show that you have a high risk.
Prophylactic mastectomy should be done only after very careful thought and discussion with your doctor, a genetic counselor, your family, and loved ones.
Mastectomy greatly reduces the risk of breast cancer, but does not eliminate it.
Scabbing, blistering, or skin loss along the edge of the surgical cut may occur.
Risks when more invasive surgery, such as a radical mastectomy, is done are:
Always tell your doctor or nurse if:
During the week before the surgery:
On the day of the surgery:
Your doctor or nurse will tell you when to arrive at the hospital.
Most women stay in the hospital for 1 - 3 days after a mastectomy. The time you stay will depend on the type of surgery you had. If you have a simple mastectomy, you might go home on the same day. You may be in the hospital longer if you have breast reconstruction.
Many women go home with drainage tubes still in their chest. The doctor will remove them later during an office visit. A nurse will teach you how to look after the drain, or you might be able to have a home care nurse help you.
You may have pain around the site of your cut after surgery. The pain is moderate after the first day and then goes away over a period of a few weeks. You will receive pain medicines before you are released from the hospital.
Fluid may collect in the area of your mastectomy after all the drains are removed. This is called a seroma. It usually goes away on its own, but it may need to be drained using a needle (aspiration).
Most women recover well after mastectomy.
In addition to surgery, you may need other treatments for breast cancer. These treatments may include hormonal therapy, radiation therapy, and chemotherapy. All have side effects, so you should talk to your doctor about the choices.
National Comprehensive Cancer Network. Breast cancer, v1.2014. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. 2013.
Hunt KK, Green MC, Buchholz TA. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 36.
Cuzick J, DeCensi A, Arun B, Brown PH, Catiglione M, Dunn B, et al. Preventive therapy for breast cancer: a consensus statement. Lancet Oncol. 2011;12:496-503.
Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569-575.