Surgery is a common treatment for breast cancer. Mastectomy is one surgical option. It removes one or both breasts in their entirety. Lumpectomy is another option. It removes only the tumor and a smaller amount of breast tissue.
Depending on how extensive the cancer is, surgery may be combined with radiation or chemotherapy. Talk to your doctor about whether mastectomy is right for you. It is also important to discuss what to expect after the surgery. The follow-up treatment can be more difficult for many women than the surgery.
Mastectomy is the surgical removal of the breast. There are five different kinds of mastectomy:
- modified radical
What type of surgery you need depends on a number of factors. Tumor size and the spread of the cancer are important. However, so are your age and overall health. In addition, some people have strong personal reasons for choosing one type of surgery over another. It’s important to discuss your options with your doctor.
A simple mastectomy is also called a total mastectomy. In this procedure, only the breast is removed. Axillary lymph nodes—the ones in the underarms—are generally left in place. Only lymph nodes within the breast tissue are removed. Muscles underneath the breast are left in place.
A modified radical mastectomy removes breast tissue and axillary lymph nodes. The muscles underneath the breast tissue are not removed.
A radical mastectomy is the most extensive option. In this surgery, the whole breast is removed. Multiple layers of lymph nodes and underlying chest wall muscles are removed as well. This surgery can be disfiguring. It is rarely used. Modified radical mastectomy has largely replaced it as a treatment.
A partial mastectomy is similar to a lumpectomy. However, it removes more tissue. The tumor is removed along with a large portion of surrounding healthy tissue.
Subcutaneous mastectomy is also called “nipple-sparing” mastectomy. This operation removes the entire breast. However, the nipple is kept intact. Nipple-sparing surgery is not performed as often as other procedures. It leaves more breast tissue than other procedures. This increases the risk that the cancer could return. Microscopic amounts of cancer may remain in the breast.
A preventive mastectomy is also called a prophylactic or risk-reducing mastectomy. This surgery is performed before a woman is diagnosed with breast cancer. It is typically used in women at very high risk for developing breast cancer. Removing the breasts is a way to lower their risk.
After surgery, you will stay in the hospital for several days. The day after the operation, you will be taught special exercises. Exercising can help you reduce stiffness in the arm or shoulder on the side of your mastectomy. It can also aid in building your strength.
You will have drains that collect blood and fluid from your incisions. You may have to alter the exercises to accommodate the drains.
If your lymph nodes have been removed, you may be at risk for developing lymphedema. This is the buildup of lymph fluid in your arm, hand, or breast.
The lymph nodes typically help filter lymph fluid through your body and into your blood. Without lymph nodes, the fluid can accumulate in your tissues. Doing the postoperative exercises can reduce your risk of developing this condition.
Signs of lymphedema include:
- heavy feeling or swelling in the arm
- skin of the arm feeling tight
- arm or hand numbness
- reduced flexibility of the arm or hand
If you develop lymphedema, treatment usually involves either massage or prescription compression garments.
After your mastectomy, it is important to stay free of infection. Infection can lead to lymphedema. You can reduce infection risk by:
- getting injections in the opposite arm from the surgery
- wearing protective gloves when cleaning, gardening, or washing dishes
- using an electric razor to avoid cuts
- using sunscreen to prevent sunburn
- not wearing tight clothes or jewelry
- avoiding alcohol
- quitting smoking
- maintaining a healthy weight
Some women choose to have breast reconstruction following a mastectomy. Others do not. They may wear a prosthesis instead. Some women wear nothing.
This is a personal choice. Each woman is different. Discuss your options with your doctor. You should do what makes you feel healthiest and happiest.