Mastectomy is the surgical removal of breast tissue. Performed as a treatment or preventive measure for breast cancer, this procedure removes both healthy and cancerous tissue. Mastectomy is typically recommended for women whose breast cancer has progressed to a stage in which lumpectomy is no longer recommended as treatment. However, other women choose to undergo a mastectomy at an earlier stage in the breast cancer treatment process or as a preventive measure. Women may undergo mastectomy surgery in one or both breasts.
Preventive Mastectomy, Lumpectomy, and Mastectomy
Many women who have been diagnosed with early-stage breast cancer choose to undergo a lumpectomy rather than full mastectomy. Lumpectomy targets only the tumor, whereas mastectomy includes complete removal of all breast tissue. On the other hand, some women with a family history of breast cancer or other risk factors choose preventive mastectomy, or having the breast tissue removed prior to a diagnosis of cancer.
Mastectomy is performed for the treatment of many types of breast cancer. In general, mastectomy is recommended over lumpectomy if the breast has two or more tumors, a large tumor related to the overall breast size, or widespread calcium deposits, or if you have already undergone radiation or lumpectomy.
The Mastectomy Procedure
Mastectomy is the most drastic surgical measure for treating breast cancer. Still, modern surgical techniques allow for more breast skin to be preserved, enabling better results from reconstructive surgery. Studies have shown that physically removing the tumor is the most effective way to treat breast cancer. Removal an examination of the tumor can also guide subsequent treatment decisions.
There are several types of mastectomy procedures which vary in the amounts of breast tissue removed.
- Modified radical mastectomy includes the removal of all breast tissue, skin, areola, and nipple. Some of the chest wall may also be removed, along with the lymph nodes in the armpit.
- Simple or total mastectomy does not include removal of underlying chest tissues.
- Skin-sparing mastectomy involves removal of the breast tissue nipple, and areola, leaving the breast skin to be used during breast reconstruction, which is typically performed during the same session as this mastectomy.
Mastectomy procedures are performed with general anesthesia and usually take two to three hours, followed by one or two nights in the hospital. A double mastectomy – involving both breasts – typically takes longer to perform, as do procedures involving reconstructive surgery. During the procedure, the surgeon creates an incision around the breast, usually in an elliptical shape. The necessary tissues are then removed, and the incision is closed with sutures.
Breast reconstruction, which restores a more natural contour to the breast, may be done during the same surgical procedure as your mastectomy. It can also be performed as a second procedure at a later date. Some women choose not to have their breasts reconstructed after they have been removed by mastectomy. If desired, breast reconstruction is performed using breast implants, natural tissue, or a combination of these two methods. Oncoplastic surgeons are often trained to do both mastectomy and reconstruction; other surgeons specialize in one or the other.
During the recovery process, patients can expect to feel some level of pain, soreness, and tenderness. Following mastectomy surgery, potential risks include bleeding, infection, chest wall pain, or tingling. The incision may itch as it heals or leave behind a noticeable scar. Some patients also experience stiffness or pain in the shoulder area or numbness in the armpit region, a side effect of lymph node removal.
Following the mastectomy, tests are conducted on the removed tissue. The pathology results should be available about a week after the surgery, and will be explained by your doctor.