A mastectomy is surgery to remove the entire breast, including the skin, nipple, and areola. It is usually done to treat breast cancer.
You will be given general anesthesia (you will be asleep and pain-free). There are different types of mastectomy procedures. Which one your surgeon uses depends on the type of breast problem you have.
The surgeon will make a cut in your breast:
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.
If all the cancer tissue is removed, a plastic surgeon may be able to reconstruct the breast (with artificial implants or tissue from your own body) during the same operation. You may also choose to have reconstruction later.
See also:
Mastectomy usually takes 2 - 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. Sometimes, it is hard to know whether lumpectomy or mastectomy is best. 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 either a subcutaneous or total mastectomy to reduce your risk of breast cancer. This is called prophylactic mastectomy.
You may have a higher risk of getting breast cancer if one or more close family relatives has had breast cancer, especially at an early age. Genetic tests (such as BRCA1 or BRCA2) may also show that you have a high risk. This surgery should be done only after very careful thought and discussion with your doctor, a genetic counselor, your family, and others.
Mastectomy greatly reduces, but does not eliminate, the risk of breast cancer.
Risks for any surgery are:
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:
You may have many blood and imaging tests (such as CT scans, bone scans, and chest x-ray) after your doctor finds breast cancer. Your surgeon will want to know whether your cancer has spread to the lymph nodes, liver, lungs, bones, or somewhere else.
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.
You may stay in the hospital for 1 - 3 days, depending on the type of surgery you had. If you have a simple mastectomy, you may go home on the same day. Most women go home after 1 - 2 days. You may stay longer if you have breast reconstruction.
Many women go home with drains 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 can 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 quickly goes away. 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 their own side effects. Talk to your doctor.
Breast removal surgery; Subcutaneous mastectomy; Total mastectomy; Simple mastectomy; Modified radical mastectomy
Carlson RW, Allred DC, Anderson BO, Burstein HJ, Carter WB, Edge SB, et al. Breast cancer. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology. v2. 2010.
Iglehart JD, Smith BL. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 34.
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.
Updated by: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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