Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. This type of procedure is usually done to treat breast cancer; however, in some cases women and some men believed to be at high risk of breast cancer have the surgery done to prevent cancer (see Preventive Mastectomy). Cancer risk assessment and prevention services are available through Cooper’s Cancer Genetics Program.
Mastectomy vs Lumpectomy
While mastectomy involves the removal of all or a large portion of the breast tissue, lumpectomy (a treatment option for some breast cancer patients) is an operation in which a small amount of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast.
The decision to perform mastectomy vs. lumpectomy is based on various factors including breast size, the amount of cancerous tissue, biologic aggressiveness of a breast cancer and other factors.
Both mastectomy and lumpectomy are often combined with chemotherapy and/or radiation treatment depending on the type and stage of breast cancer.
Types of Mastectomies
Total (Also Called Simple) Mastectomy
A total mastectomy removes the entire breast, but not the lymph nodes under the arm or the muscle tissue beneath the breast. Sometimes both breasts are removed, especially when mastectomy is done to try to prevent cancer. If a hospital stay is needed, most women can go home the next day.
Tissue- and Nipple-sparing Mastectomy
For some women who are planning on having reconstruction right away, a skin/tissue-sparing mastectomy can be done. With this procedure, most of the skin over the breast (other than the nipple and areola) is left intact. This can work as well as a simple mastectomy. The amount of breast tissue removed is the same as with a simple mastectomy. Although this approach has not been used for as long as the more standard type of mastectomy, many women prefer it because there is less scar tissue and the reconstructed breast seems more natural. Another option for some women is nipple-sparing mastectomy. This is like a skin-sparing mastectomy but the nipple and areola are left behind. This procedure is more often an option for women who have a small, early-stage cancer near the outer part of the breast, with no signs of cancer in the skin or near the nipple.
Modified Radical Mastectomy
This operation is a simple mastectomy combined with surgery to remove lymph nodes under the arm (called an axillary lymph node dissection).
This is a major operation where the surgeon removes the entire breast, many of the lymph nodes under the arm, and the muscles of the chest wall under the breast. This surgery was once very common, but it is rarely done now because less extensive surgery often works just as well. But this operation may still be done if the cancer is growing into the muscles under the breast.
Preparing of Mastectomies
Before your mastectomy, you will meet with your surgeon and anesthesiologist, who will go over the surgery itself, the plan for your anesthesia, and your best options for breast reconstruction.
You and your doctors will also go over any medications, vitamins and supplements you are currently taking to make sure they will not interfere with your surgery or post-surgery care.
They will also give you instructions for eating and drinking before surgery, as well as what you should bring along with you for your hospital stay.
What to Expect After a Mastectomy
Patients who have had a mastectomy may stay in the hospital for one to three days depending on the type of surgery. Patients who have immediate reconstruction following their mastectomy may stay a little longer. Follow a mastectomy many women go home with drains in their chest. Their surgeon will remove the drains during a follow up office visit.
You may need additional cancer treatment after your mastectomy. This further treatment may include chemotherapy, hormone therapy, radiation therapy or targeted therapy – or a combination – depending on the type of breast cancer you have and whether it has spread to other parts of your body. Our specialists will review the best options for you if you need further treatment after your surgery.
When you are ready to be discharged from the hospital after your surgery, our doctors and health care providers will go over the medications you need to take as well as how to care for your incisions, stitches and any drains. They will also go over potential complications to be aware of and what you should do if they occur, exercises that may help in your recovery, and when you may start wearing a prosthesis or bra.
You may be able engage in some normal activities and limited exercises within the first few days or a week after your surgery. The length of time to fully recovery will be different for each person but it generally takes about four weeks for a return to normal activities after a mastectomy. Be sure to follow the instructions and advice of your doctors before attempting to return to full activities.
To help speed your recovery, be sure to get plenty of rest, take your medications, keep the incision site dry and do the exercises recommended by your doctor. Be sure to reach out to your doctor if you are having problems, or have questions or concerns.
Why Choose MD Anderson at Cooper
The Janet Knowles Breast Cancer Center at MD Anderson Cancer Center at Cooper is South Jersey’s leading cancer center and patient’s top choice for breast cancer care. Our board-certified surgeons combine their expertise using state-of-the-art surgical techniques and advanced clinical care with personalized support services to ensure that you receive the breast cancer care you need and expect.
Our surgeons and their teams guide you step-by-step so you know exactly what to expect during your mastectomy and recovery. And we’ll be with you along the way to provide resources, information and cancer care support services to you and your family.
To make an appointment with a breast cancer expert at MD Anderson at Cooper, call 855.MDA.COOPER (855.832.2667).