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Alternative Names Return to topBreast removal surgery; Subcutaneous mastectomy; Total mastectomy; Simple mastectomy; Modified radical mastectomy
Definition Return to top
A mastectomy is the surgery to remove the entire breast. It is usually done to treat breast cancer.
Description Return to top
You will be given general anesthesia (unconscious and pain-free). The surgeon will make an elliptical cut in your breast:
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.
Mastectomy generally takes 1 to 3 hours.
Why the Procedure is Performed Return to top
WOMAN DIAGNOSED WITH BREAST CANCER
The most common reason for a mastectomy is breast cancer. Mastectomy may treat several types of breast cancer: invasive ductal carcinoma, invasive lobular carcinoma, medullary carcinoma, mucinous and tubular carcinomas, inflammatory carcinoma, Paget's disease, ductal carcinoma in situ (DCIS), and lobular carcinoma in situ (LCIS).
If you are diagnosed with breast cancer, talk to your doctor about your choices:
You and your doctor must consider:
The choice of what is best for you can be difficult. Sometimes, your doctor may recommend one type of surgery. This is because your doctor can tell you what is known about the type of cancer you have and your risk factors. Other times, your doctor will talk with you about two or more surgical treatments that would be good for your cancer.
WOMEN AT HIGH RISK FOR BREAST CANCER
Your doctor may do either a subcutaneous or total mastectomy to reduce your risk of breast cancer if you are at very high risk of developing breast cancer. This is called prophylactic mastectomy.
You may have a higher risk of getting breast cancer if one close family relative, or more, has had breast cancer, especially at an early age. Genetic tests (such as BRCA1 or BRCA2) may also show you have a high risk. This surgery should be done only after very careful thought and discussion with your doctor, a genetic counselor, your family, and others.
Mastectomy greatly reduces, but does not eliminate, the risk of breast cancer.
Risks Return to top
Risks for any surgery are:
The risks for breast removal are:
Risks when you have lymph nodes removed during surgery are:
There are also risks related to breast reconstructive surgery.
Before the Procedure Return to top
You will have many blood and imaging tests (such as CT scans, bone scans, and chest x-ray) after your doctor finds breast cancer. Your surgeon will want to know whether your cancer has spread to the liver, lungs, bones, or somewhere else.
Always tell your doctor or nurse if:
During the week before the surgery:
On the day of the surgery:
After the Procedure Return to top
You may stay in the hospital for 1 to 3 days, depending on the type of surgery you had. If you have a simple mastectomy, you may go home on the same day. Most women go home after 1 to 2 days. You may stay longer if you have breast reconstruction.
Many women go home with drains still in their chest. The doctor then removes them later during an office visit.
You may have pain around the site of your incision after surgery.
Fluid may collect in your armpit. This is called a seroma and is relatively common. It usually goes away on its own, but it may need to be drain.
Outlook (Prognosis) Return to top
Most women recover well after mastectomy.
In addition to surgery, you may need other treatments for breast cancer. These treatments may include hormonal therapy, radiation therapy, and chemotherapy. All have their own side effects. Talk to your doctor.
You breast cancer may respond differently to surgery and other treatments for many reasons. Talk to your doctor about these reasons.
References Return to top
Robson M and Offit K. Clinical practice. Management of an inherited predisposition to breast cancer. N Engl J Med. 2007;357(2): 154-62.
Khatcheressian JL, Wolff AC, Smith TJ, Grunfeld E, Muss HB, Vogel VG, et al.American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol. 2006 Nov 1;24(31):5091-7. Epub 2006 Oct 10.
Abeloff MD, Wolff AC, Weber BL, Zaks TZ, Sacchini V, McCormick B. Cancer of the breast. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 95.
Iglehart JD, Smith BL. Diseases of the breast. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 34.Update Date: 2/26/2009 Updated by: James Lee, M.D., Department of Surgery, Columbia Presbyterian Medical Center, New York, NY. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.