Mastectomy is a surgical procedure involving the entire or partial removal of the breast. The purpose of mastectomy is to treat or prevent breast cancer.
When used to treat breast cancer, the procedure involves the removal of cancerous tissues along with adjacent normal tissues. This helps to prevent tumor recurrence. In high-risk individuals, mastectomy is used to remove breast tissues that are extremely prone to cancer development.
Types of Mastectomy
There are three forms mastectomy, each designed to complement a unique array of scenarios:
- Partial: Partial mastectomy, also known as segmental mastectomy, involves removing the tumorous tissues in the breast, along with some normal tissue surrounding the tumor. This method is used primarily to treat breast cancer patients with localized tumors.
- Total: A total (simple) mastectomy involves the removal of the entire breast. This surgical procedure complements patients with more advanced forms of breast cancer, and/or patients who are genetically predisposed to breast cancer development.
- Radical: Radical mastectomy involves the entire removal of the breast, along with the removal of all adjacent lymph nodes under the arm. This procedure may also involve the removal of chest wall muscles which are prone to breast cancer metastasis (spread).
Is Mastectomy Right for You?
Mastectomy is a radical surgery, involving the removal of large amounts of tissues. This procedure does not complement every breast cancer patient, and anyone considering undergoing a mastectomy should collect as much information about the procedure as possible. If your doctor recommends a mastectomy, don’t be afraid to seek a second or third opinion. Most good physicians will welcome another physician’s input.
A doctor might recommend mastectomy under the following circumstances:
- Multiple Tumors: If you have two or more tumors located in separate areas of the breast, a mastectomy may be the only way to remove ALL of the tumorous tissue,
- Genetic Mutations: Certain genetic mutations, such as BRCA1 and BRCA2 gene anomalies, may lead to breast cancer development. If you carry such a mutation, you and your healthcare provider should discuss mastectomy as a preventative care option.
- Previous Radiation Treatment: If you have been treated with radiotherapy in the breast region in the past, your healthy cells may not be able to tolerate more radiation. As a result, the best option for tumor removal might be mastectomy.
- Pregnancy: Radiotherapy and certain chemical agents (chemotherapy) used to treat cancer can damage the fetus. As a result, pregnant women with breast cancer often undergo the surgical removal of the breast in order to protect the health and development of the fetus.
- Aggressive Cancer: Breast cancers with extensive metastases (spreading) may necessitate a radical mastectomy.
- Large Tumor: Patients with a large breast tumor may choose to have a mastectomy because there usually isn’t enough healthy tissue left after the surgery to achieve positive cosmetic results.
- Hardships Associated with Radiotherapy: If you do not live near a radiation facility, it may not be practical for you to receive daily treatment for five to six weeks. As a result, you may want to consider surgical removal of the breast.
Preparing for Surgery
Prior to your surgery, you will discuss you operation with a surgeon and anesthesiologist. Together, you will examine your medical history and evaluate other health factors and possible surgical outcomes. Don’t hesitate to ask your surgeon and anesthesiologist questions. Make sure you understand your surgery and its risk factors.
You will be asked to discontinue the use of blood-thinning medications prior to surgery. These medications, such as aspirin and anti-inflammatory drugs (i.e. ibuprofin), may cause excessive bleeding during the mastectomy. Your doctor will also evaluate any other medications that you are taking to determine how they will interact with your surgery.
Your doctor may request you to consume a special diet and/or limit your consumption of alcohol and nicotine before surgery. It is very important to adhere to all pre-surgery guidelines. This will help ensure the best possible outcome for your mastectomy.
During Surgery
During a mastectomy procedure, a surgeon makes an incision across a portion of your chest. This incision will allow for the removal of the breast and any affected nearby tissues. The extent of the incision depends on how much tissue will be removed. Radical mastectomies, for example, will require a larger incision than a partial mastectomy.
Samples of the tumorous tissues will be sent to a laboratory for microscopic evaluation. This will help your team of doctors better understand the behavior of your cancer. In some cases, a plastic surgeon will perform breast reconstruction immediately following mastectomy.
What Happens After Surgery?
Following mastectomy, you will be taken to a post-operative unit of the hospital where a nurse will monitor your recovery. Typically, you will recover in a hospital environment for two to ten days after surgery. During this time, you will be given literature and advice on how to care for your incision and change your dressings.
Your doctor will prescribe pain medications to help you cope with any discomfort and/or swelling associated with the surgery. Once you leave the hospital, examine the incision daily. If you notice any signs of infection (rash, redness, excessive swelling), report this to your doctor immediately.
Risk Factors and Side Effects
Mastectomy, as with all forms of surgery, carries a risk of infection. Your doctor will discuss with you how to minimize your chances of developing a surgery-related infection. Anesthesia commonly causes adverse or allergic reactions. Once again, your doctor will discuss the possible side effects of your anesthesia plan.
Cosmetically, mastectomy will result in a drastic reduction in breast size and shape. As a result, many women choose to have breast reconstruction surgery performed following mastectomy.
Other side effects associated with mastectomy are common to all surgical procedures. These effects may include:
- Infection
- Bleeding
- Tissue Damage
- Pain
- Nausea
- General Feelings of Discomfort
These side effects are often temporal, subsiding within days. If they persist, you will be prescribed medications and/or therapies that will drastically minimize or reverse their impact.
Resources
National Institute of Health (NIH) Family of Sites
