Mastectomy

Mastectomy is a surgical procedure that involves removing one or both breasts, partially or completely, to treat or prevent breast cancer.

Mastectomy: What You Need to Know

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Mastectomy is a surgical procedure that involves removing one or both breasts, partially or completely, to treat or prevent breast cancer. It is one of the main treatment options for women with breast cancer, along with breast-conserving surgery (lumpectomy) and radiation therapy.

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Types of mastectomy

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There are different types of mastectomy, depending on how much breast tissue and skin are removed, and whether the nipple and areola (the dark area around the nipple) are preserved or not. The most common types of mastectomy are:

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  • Simple (or total) mastectomy: The surgeon removes the entire breast, including the nipple, areola, and skin. A few underarm lymph nodes may also be removed to check for cancer spread.
  • Modified radical mastectomy: The surgeon removes the entire breast, along with the underarm lymph nodes (axillary lymph node dissection). This type of mastectomy is more extensive than a simple mastectomy and may cause more side effects, such as swelling and numbness in the arm.
  • Skin-sparing mastectomy: The surgeon removes the breast tissue, nipple, and areola, but leaves most of the skin over the breast intact. This type of mastectomy allows for more natural-looking breast reconstruction after the surgery, using implants or tissue from other parts of the body.
  • Nipple-sparing mastectomy: The surgeon removes the breast tissue, but preserves the nipple, areola, and skin. This type of mastectomy also offers a better cosmetic outcome after reconstruction, but it may not be suitable for larger tumours or those that are close to the nipple.

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Reasons for mastectomy

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A mastectomy may be recommended for women with breast cancer who:

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  • Have two or more tumours in separate areas of the breast
  • Have widespread or malignant-appearing calcium deposits (microcalcifications) throughout the breast
  • Have previously had radiation therapy to the breast region and the cancer has recurred
  • Are pregnant and radiation poses an unacceptable risk to the unborn child
  • Have a large tumour relative to the size of the breast
  • Have a connective tissue disease, such as scleroderma or lupus, that may affect the skin's response to radiation
  • Carry a gene mutation that gives them a high risk of developing a second cancer in the breast

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Some women may also choose to have a mastectomy over a lumpectomy for personal reasons, such as preference, convenience, or peace of mind.

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Risks and complications of mastectomy

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Like any surgery, mastectomy carries some risks and complications, such as:

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  • Bleeding
  • Infection
  • Pain
  • Scarring
  • Nerve damage
  • Lymphedema (swelling of the arm due to fluid buildup)
  • Difficulty moving the shoulder
  • Changes in body image and self-esteem

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Some of these complications can be prevented or managed with proper care and follow-up. Women who undergo mastectomy should discuss their options for breast reconstruction with their surgeon before or after the surgery.

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Sources

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[1] Mayo Clinic. (2021). Mastectomy. Retrieved from https://www.mayoclinic.org/tests-procedures/mastectomy/about/pac-20394670

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[2] American Cancer Society. (2020). Mastectomy. Retrieved from https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer/mastectomy.html

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[3] Wikipedia. (2021). Mastectomy. Retrieved from https://en.wikipedia.org/wiki/Mastectomy

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[4] Merriam-Webster. (n.d.). Mastectomy. Retrieved from https://www.merriam-webster.com/dictionary/mastectomy