Mastectomy is removal of the breast. Other
nearby tissue may also be removed if it appears that cancer may have spread to
All mastectomies remove the whole breast. Because the
size and location of tumors and where the cancer might have spread differ from
one person to another, the amount of other tissue removed during surgery also
Mastectomy procedures include:
Total or simple mastectomy, which is the removal of the whole breast.
Modified radical mastectomy, which is the removal of the
whole breast and the lymph nodes under the arm (axillary lymph nodes).
Radical mastectomy, which is the removal of the breast, chest muscles, and all
of the lymph nodes under the arm (axillary lymph node dissection). This surgery is rarely used now.
Men with breast cancer usually have one of the mastectomy procedures.
Depending on the location of the tumor in the breast or other factors, some women may be able to have a skin-sparing or nipple-sparing mastectomy. Skin-sparing mastectomy leaves most of the skin that
was over the breast, except for the nipple and the areola. Nipple-sparing mastectomy saves the skin over the breast as well as the nipple and areola.
Some women choose to have breast reconstruction after a
mastectomy. Reconstruction can be done during the same surgery as the
mastectomy, or it may be done later as a separate procedure.
Mastectomy is done using
general anesthesia. After your surgery, you will be
taken to a recovery room. A nurse will be able to help with any nausea, pain,
or anxiety you might have.
When you wake up from surgery, you will
have a bandage over the surgery site. You will also have one or two drainage
tubes to collect fluid and keep it from building up around the surgery area. If
these tubes are still in place when you go home, your nurse will teach you how
to take care of them.
Your doctor or nurse will give you instructions on pain control and caring for your incision. Typically, you can remove the bandage and take a shower on the day after the surgery.
people go home within 24 hours after a mastectomy. If you have breast
reconstruction during the same surgery, you may be in the hospital longer.
A physical therapist may
show you exercises while you are still in the hospital. These should help keep
your shoulder from getting stiff. You will need to avoid strenuous activity for
several weeks. Your doctor will let you know how soon you can increase your
Why It Is Done
Mastectomy is done to remove as much
cancer as possible and give the greatest chance of staying cancer-free.
How Well It Works
For early-stage breast cancer, having a lump or part of the breast removed
(breast-conserving surgery) along with radiation therapy has the same survival rate
as mastectomy. But many women still have a
mastectomy, even though it is a more extensive surgery. They may be unwilling
or unable to have the radiation therapy that usually follows breast-conserving
surgery. Or they may feel that by having a mastectomy, they are taking every possible action they can to prevent the return of cancer.
who have metastatic breast cancer do not always have surgery.
Survival may not be increased by having surgery.
Complications can include infection, bleeding,
poor wound healing, or a reaction to the anesthesia used in surgery. Blood or
clear fluid may also collect in the wound and need to be drained. You may have
breast pain and feelings of pulling, pinching, tingling, or numbness.
If you have
lymph nodes removed from under your arm, there is a chance of getting
lymphedema (swelling of the arm). This is because
fluid is less able to drain out of the tissues through the lymph system after
this procedure. Tell your doctor or nurse right away if you have swelling or
pain in your arm on the side where you had your surgery. The nerve that
controls skin sensation on the inner upper arm also is in the area of these
lymph nodes. If the nerve is damaged during surgery, you may have numbness in
What To Think About
Mastectomy may be a better choice than breast-conserving surgery depending on the size of the tumor or if you have two or more tumors that are too far apart.
Radiation therapy is not always needed after mastectomy, so mastectomy can be a good
choice if you don't want to have radiation or if you cannot have radiation
choose to have breast reconstruction either at the same time as mastectomy or
later on. Before you have your mastectomy, talk to your doctor about
reconstruction to decide whether this added procedure is right for
Prophylactic or preventive mastectomy
who know that they are at very high risk for breast cancer—but do not have
breast cancer—choose to have a mastectomy on both breasts. This is called
prophylactic mastectomy. Removing the breasts can greatly lower the risk for breast cancer, but it cannot completely prevent breast cancer. A few women still get breast cancer, because
tiny bits of breast tissue may remain in the skin or underarm after
But it is not yet known whether this surgery
is better than having careful screening and then early treatment of any breast cancer
that may develop.footnote 1
Prophylactic mastectomy is also an option for a woman who has cancer in one
breast. At the time of cancer surgery, some women also have the other breast
Some women who are at high risk for breast
cancer may have their ovaries removed after they are done having children, or
after age 35. Removing the ovaries has been shown to decrease the risk of
breast cancer by 50%.footnote 1
are thinking of having a prophylactic mastectomy, learn as much as you can
about it from your doctors. See if you can also talk to other women who have
had this surgery. Carefully consider how you feel about the benefits and
changes, both physical and emotional.
Davidson NE (2007). Breast cancer. In DC Dale, DD Federman, eds., ACP Medicine, section 12, chap. 7. New York: WebMD.
ByHealthwise Staff Primary Medical ReviewerSarah Marshall, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerLaura S. Dominici, MD - General Surgery,
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