Most women with breast cancer have some type of surgery to treat the main breast tumor. The purpose of surgery is to remove as much of the cancer as possible. Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely.Mastectomy 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.
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.
Types of Mastectomy
There are several different types of mastectomy:
- Simple (also called total) mastectomy In this surgery the entire breast is removed, 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).
- Radical mastectomy 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.
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.