Mastectomy

Definition

A mastectomy is the surgery to remove the entire breast. It is usually done to treat breast cancer.

Alternative Names

Breast removal surgery; Subcutaneous mastectomy; Total mastectomy; Simple mastectomy; Modified radical mastectomy

Description

You will be given general anesthesia (unconscious and pain-free). The surgeon will make an elliptical cut in your breast:

• For a subcutaneous mastectomy, the surgeon removes the entire breast but leaves the nipple and areola (the pigmented circle around the nipple) in place.
• For a total or simple mastectomy, the surgeon cuts breast tissue free from the skin and muscle and removes it. The nipple and the areola are also removed. The surgeon may do a biopsy of nearby lymph nodes to see if the cancer has spread.
• For a modified radical mastectomy, the surgeon removes the entire breast along with the lining over some of the muscles. Some of the lymph nodes underneath the arm are also removed.
• For a radical mastectomy, the surgeon removes the overlying skin, all of the lymph nodes underneath the arm, and the chest muscles. This surgery is not done unless breast cancer has spread to your chest wall muscles.
• The skin is closed with sutures (stitches) or tape (Steri-Strips).

One or two small plastic drains or tubes are usually left in your chest to remove extra fluid from where the breast tissue used to be.

Your surgeon may be able to reconstruct the breast (with artificial implants or tissue from your own body) during the same operation. You may also choose to have reconstruction later.

See also:

• Breast reconstruction - natural tissue
• Breast reconstruction - implants

Mastectomy generally takes 1 to 3 hours.

Risks

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
• Blood loss
• Heart attack or stroke during surgery
• Reactions to medications

The risks for breast removal are:

• Skin loss or long-term wounds on the chest wall
• Bleeding into the area where the breast used to be. Sometimes a second operation is needed to control bleeding.

Risks when you have lymph nodes removed during surgery are:

• Shoulder pain and stiffness occur in most women. Some may have severe stabbing or burning pain. They may also feel pins and needles where the breast used to be and underneath their arm.
• Swelling of the arm (called lymphedema) on the same side as the breast that is removed. This swelling is not common, but it can be an ongoing problem.
• Damage to nerves. This may cause numbing on the inside of the arm or weakness in muscles of the back and chest wall.

There are also risks related to breast reconstructive surgery.