Mastectomy

What you should know

• Mastectomy (mas-TEK-to-me) is surgery to remove the breast. It may be done to treat breast cancer (tumor) and keep the cancer from spreading. Mastectomy is usually done if there is more than one tumor present in the breast. It may also be done if the size of the tumor is big in relation to the size of your breast. Sometimes, mastectomy is done as a form of prevention in women who are at a very high risk of getting breast cancer.
  
  
• Mastectomy may be done on one or both breasts and may be total, modified radical, or radical. Total mastectomy is removal of the whole breast, without taking out any other part. In a modified radical mastectomy, axillary (underarm) lymph nodes are also removed in addition to the breast. Radical mastectomy is removal of all the breast, axillary lymph nodes, and chest muscles under the breast. The type of mastectomy to be done will depend on what type or how far the cancer has spread. You and your caregiver will decide which type of breast removal surgery is right for you.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

There are always risks with having surgery. You may bleed more than usual, get an infection, have trouble breathing, or get blood clots. Your blood vessels or nerves may get injured while having the surgery. You may have scars, shoulder stiffness, or swelling around the area where the breast was removed. If breast reconstruction has not been done, you may have the stress of living without a breast. If left untreated, breast cancer may spread throughout your body. Call your caregiver if you are worried or have questions about your surgery, medicine, or care.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using any of your present medicines. These may include aspirin, ibuprofen, or blood thinners.
  
  
• Ask your caregiver before using any over-the-counter or herbal medicine or supplement. If you regularly use these medicines or supplements, tell your caregiver.
  
  
• Tell your caregiver if you know or think you might be pregnant.
  
  
• You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
  
  
• You may need to have blood and urine tests, a mammogram, chest x-ray, and other tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given a pill to help you sleep.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Do not wear contact lenses on the day of your surgery. You may wear glasses.
  
  
• Caregivers will insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery. Tell your caregiver if you or any member of your family has had a problem using anesthesia in the past.
  
  
• You will be asked to sign a legal piece of paper (informed consent). It gives a caregiver permission to do the procedure. If you are unable to give your consent, someone who has permission can sign this form for you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You may be given medicine to help you relax or make you drowsy. You will be taken on a cart to the operating room. You may be given a general anesthesia to keep you completely asleep during surgery. Caregivers will clean your chest and the areas around the breast. Sheets will be put over you to keep the surgery area clean.
  
  
• Caregivers will make an incision (cut) in your breast area. The breast tissue together with the cancer will be removed, with or without the axillary (underarm) lymph nodes. The chest muscles under your breast may also be removed. Thin rubber tubes may be put into your skin to drain blood from your incision. The incisions will be closed with stitches (thread) and covered with bandages.

After surgery:

You are taken to a room where your heart and breathing will be monitored. Do not get out of bed until your caregiver says it is okay. A bandage may cover wounds to help prevent infection. You may be able to go home after some time passes. An adult will need to drive you home and should stay with you for 24 hours. If you cannot go home, you will be taken to a hospital room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your appointment on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the area where surgery will be done.
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• You feel a new lump in your chest or other breast, or axilla (underarm), or see or feel other changes.
  
  
• You have discharge coming from your breast.
  
  
• You have redness, swelling, or severe pain in the breast.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.