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Mastectomy

Mastectomy is surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer.

For those with early-stage breast cancer, mastectomy may be one treatment option.

There are several types of mastectomies:

  • Total simple mastectomy - This is removal of the breast, nipple and areola. No lymph nodes from the axillae are taken. Recovery from this procedure, if no reconstruction is done at the same time, is usually one to two weeks. Hospitalization varies; for some it may be an outpatient procedure and other patients may require an overnight stay.
  • Modified radical mastectomy - This procedure is removal of the breast, nipple and areola as well as axillary node dissection. Recovery, when surgery is done without reconstruction, is usually two to three weeks.
  • Skin sparing mastectomy - This is the removal of the breast, nipple and areola, keeping the outer skin of the breast intact. It is a special method of performing a mastectomy that allows for a good cosmetic outcome when combined with a reconstruction done at the same time. A tissue expander may also be placed as a space holder for later reconstruction.
  • Nipple sparing mastectomy - A newer technique, this kind of mastectomy is reserved for a smaller number of women with tumors that are not near the nipple areola area. Your surgeon will make an incision on the outer side of the breast or around the edge of the areola and hollow out the breast, removing the areola and keeping the nipple intact. This method involves simultaneous reconstruction. Sometimes the completed reconstruction is done at the same time and in other cases, a tissue expander is inserted as a space holder for later reconstruction.
  • Nipple and areola sparing mastectomy - In this newer procedure, your surgeon will make the incision on the side of your breast or in some cases, around the edge of the areola. The breast will be hollowed out and reconstruction is performed at the same time. In some cases, a tissue expander may be placed as a space holder for later reconstruction
  • Scar sparing mastectomy - This is a fairly new form of surgery. The affected breast is hollowed out. Whether done as skin sparing, nipple sparing, areola sparing or a combination, one goal of this surgery is to minimize the surgical incisions that are visible. It is not uncommon for an entire mastectomy procedure to be performed through an opening that is less than two inches in length.
  • Preventive/prophylactic mastectomy - Prophylactic mastectomy is a surgery designed to remove one or both breasts in order to dramatically reduce the risk of developing breast cancer. Women who test positive for certain genetic mutations like BRCA1 and BRCA2, or who have a strong family, may elect to do this kind of surgery. They may also elect to have their ovaries removed at the same time. Genetic counseling may help to confirm or eliminate any nagging suspicion about family history. When a preventive mastectomy is performed, no lymph nodes need to be removed, since there is no evidence of cancer. For preventive purposes, you should have a mammogram performed within 90 days of the procedure to ensure that the breast tissue being removed is healthy.

Women can undergo simultaneous reconstruction of any kind after mastectomy; there is no medical need to delay reconstruction. All forms of mastectomy listed above are options, excluding modified radical mastectomy. This is a complicated decision and requires the guidance of breast cancer specialists who can explain all the potential risks and complications of taking this extraordinary step.

Last Updated: 7/15/2013