A mastectomy is a surgical procedure to remove the breast(s) in a patient with breast cancer. It is one of the most commonly used and effective options for treating breast cancer because it removes all traces of cancer, and reduces the risk of its recurrence.
Types of Mastectomy
There are several different mastectomy procedures designed to eradicate the cancer but retain as much of the natural breast as possible. Some of the most commonly used techniques include:
A subcutaneous mastectomy removes all breast tissue but leaves the skin, nipple and areola. The breast is then immediately reconstructed. This operation is performed less often than simple or total mastectomy because it leaves behind more breast tissue in which cancer can, potentially, reoccur.
In a partial mastectomy, only the malignant breast tissue and some of the healthy tissue around it are removed. Although lumpectomy is considered a form of partial mastectomy, it removes less tissue than a partial mastectomy does.
Total (Simple) Mastectomy
The entire breast is removed during a total mastectomy. Lymph nodes are not removed unless they are a part of the tissue already being excised.
Modified Radical Mastectomy
A modified radical mastectomy, in addition to removing the breast, removes lymph nodes under the arm, which are then dissected to see if the cancer has spread within the body. However, no muscles are removed from beneath the breast.
The most extensive type of mastectomy, a radical mastectomy removes the entire breast, a greater number of lymph nodes than are removed in the modified radical mastectomy, and the chest wall muscles that lie beneath the breast. Radical mastectomy, which used to be a common form of treatment, is now rarely performed. In most instances, modified radical mastectomy has proven to be just as effective and less disfiguring.
A preventive mastectomy is an elective surgery performed on women who have a high genetic or familial risk of breast cancer. Also called prophylactic mastectomy, it usually takes the form of a total or subcutaneous mastectomy, and can reduce the occurrence of breast cancer by 90 percent.
Recovery and Reconstruction After Mastectomy
Depending on the extent of the procedure, mastectomy usually requires a one- to three-day hospital stay, but some women may be able to go home the same day. A drain, which will be removed approximately two weeks later, may be attached to the chest to collect fluid. If mastectomy and reconstruction are performed at the same time, the hospital stay will be longer.
The goal of breast reconstruction, which many women opt for after having a mastectomy, is to match the appearance of the other breast, and to eliminate the need for an external prosthesis. Reconstruction, which may involve a breast implant or skin grafts, can be performed at the same time as the mastectomy or at a later date.
A follow-up appointment with the surgeon usually takes place one week after the surgery. The surgeon will check that the incision is healing properly, and that no other complications have arisen.
Risks of Mastectomy
Certain risks are associated with mastectomy, and may include:
- Fluid-collection underneath the scar left by the incision
- Numbness of the skin along the incision site
- Mild to moderate tenderness in the area adjacent to the incision
- Heightened sensitivity to touch in the surgical area
- Delayed healing of the incision
- Increased risk of infection in the surgical area
- Formation of scar tissue