American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Mastectomy

Your surgeon will remove all the breast tissue. This may include the overlying skin, the nipple and areola, and the lymph nodes. A drainage tube may come out of the wound site. See Wound and Drain Care. Recovery time varies from 2 to 6 weeks depending on how much tissue was removed.

Picture of a Mastectomy cut

Types of Mastectomy

There are different types of mastectomies and the options depend on your cancer type.

Simple Total Mastectomy

Removes all breast tissue, including the nipple, areola, and some overlying skin. The muscle beneath the breast is not removed. Your lymph nodes will be checked for cancer. You will have a scar across the site where the breast was removed.

Skin-Sparing Mastectomy

Removes all breast tissue but leaves as much healthy breast skin as possible. This procedure is done when the plan is for immediate reconstruction of the breast, nipple, and areola. This option allows for more natural looking reconstruction. This is not a safe option if there is a possibility that tumor cells are close to the skin.

Nipple-Sparing Mastectomy

Removes all breast tissue but leaves the nipple, areola, and overlying skin. The scar from this surgery is usually placed in a skin fold or on the side of the breast. This option allows for more natural looking reconstruction. This is not recommended if the cancer includes the nipple or Paget's disease or if cancer is detected in the margins.

Modified Radical Mastectomy

Removes all breast tissue, including the nipple, areola, and axillary lymph nodes. The chest wall muscle is left intact. This procedure decreases the chance of recurrence to 1 percent per year.

Modified Radical Mastectomy

Radical Mastectomy

A radical mastectomy removes all breast tissue, including the nipple, areola, axillary lymph nodes, skin, and the chest wall muscles under the breast. This is only done when breast cancer has spread to the muscle beneath the breast. Reconstruction or breast prosthesis are options.

Prophylactic Mastectomy

A prophylactic mastectomy removes all breast tissue before cancer has been found, reducing the chance of breast cancer. This is usually done when there is a strong family history of breast cancer or a BRCA gene mutation. This saves axillary lymph nodes and allows for immediate or later breast reconstruction.

Contralateral Prophylactic Mastectomy

Contralateral Prophylactic Mastectomy is the removal of the healthy breast in someone who has or has had breast cancer in the other breast. This allows for immediate or later reconstruction of both breasts. You may be offered this option if:

  • You know you have a gene mutation linked to breast cancer, including BRCA1, BRCA2, or PALB2
  • You have a strong family history of breast cancer in more than one first-degree relative, such as a mother, sister, or daughter

Salvage Mastectomy

A second surgery can be done if cancer has returned in a previously treated breast. The amount of breast tissue removed will depend on the size of the tumor and if it has spread to your lymph nodes.

Possible Complications after Mastectomy

  • Following a mastectomy there may be scarring, numbness, or change of sensation at and around the scar(s) or radiation areas
  • Bleeding and an infection (less than 1 percent for the average women with no other health issues)
  • Lymphedema (swelling of the arm); the risk is 17 percent.19
  • Pain at the breast site, chest wall, and arm pit
  • Burning or shooting nerve (neuropathic) pain in the chest wall, armpit, and/or arm; pain that does not decrease over time is called postmastectomy pain syndrome
  • Need for additional surgery (less than 1 percent for the average women with no other health problems)

Ask your doctor about all your treatment options based on your reports. This will help you make the best treatment decisions to prevent recurrence. Multimodality treatment (a combination of treatments working together) may provide long-term disease control.