A mastectomy is another name for breast removal surgery. You might need surgery to remove your breast tissue if you have breast cancer or have a high risk of getting breast cancer. There are several different types of mastectomy. There are also different options for reconstructing or replacing your breasts after surgery.
A mastectomy is a surgical procedure to remove some or all of your breast tissue. It’s both a treatment and prevention for breast cancer. If you have breast cancer, surgery will always be part of your treatment plan. If you have a high risk of developing breast cancer, your healthcare provider may recommend a preventative mastectomy to help halt the development of breast cancer in the future.
There are many types of mastectomies, which remove part or all of your breast tissue. There are also many ways to reconstruct your breast following removal. These are some of the discussions you will have with your healthcare provider. As you map out your breast cancer treatment plan together, you'll have a series of choices to make.
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When you have breast cancer, the best hope of defeating it is to remove the cancer cells from your body. That means removing any tissue where cancer cells exist. This can be a relatively minor or a relatively major operation, depending on how large the tumor is and how much tissue needs removed.
People who carry certain genetic mutations in their DNA have up to an 85% chance of developing breast cancer in their lifetimes. Genetic testing can help determine if you carry any of these genes, which include BRCA1 and BRCA2, p53 and PTEN. If you do carry these genes, there are many methods for preventing cancer, including a prophylactic mastectomy. This can reduce your breast cancer risk by about 90%. A small risk remains because a few breast cells will always exist.
Surgery is the primary recommended treatment if you have:
When the tumor is small enough to be completely eliminated by removing only a third or less of your breast tissue, your healthcare provider may recommend a partial mastectomy (lumpectomy). Large tumors often require a complete mastectomy (removal of your entire breast). So, while you may only need to have part of your breast removed in earlier stages, it all depends on your breast size and the size of the tumor.
You may be at higher risk of developing a second cancer if you're genetically predisposed or if you've had breast cancer before. So, under those circumstances, a complete mastectomy can help treat your current cancer and prevent a second cancer in the future. Stage IV (metastatic breast cancer) is too far advanced for effective treatment with surgery.
This is really a subjective question since there’s no standard definition of “major” surgery. What is important to know is that there are several different types of mastectomies that you might have, some more extensive than others. A simple lumpectomy usually takes about an hour, while a total mastectomy may take longer. Having breast reconstruction done in the same surgery takes even longer.
Technically, a lumpectomy is a type of mastectomy (partial mastectomy). But most people think of a mastectomy as a total mastectomy — removal of your whole breast or both breasts. If you're planning your cancer treatment in the early stages, you may have a choice between a total mastectomy and a lumpectomy. If you choose a lumpectomy, your healthcare provider will want to follow it with radiation therapy and will discuss any other additional treatments.
You may prefer a lumpectomy to minimize your surgery and recovery time and to preserve as much of your original breast as possible. However, you may prefer a mastectomy if it means you can avoid radiation therapy. Some people choose mastectomy because they prefer the cosmetic results of a complete breast replacement to reconstructing their original breast.
It depends. If the tumor is a safe distance from your nipple, and if there are no signs of cancer infiltrating your nipple, you may be a candidate for a nipple-sparing mastectomy. This means your surgeon will remove your breast tissue but spare the skin and nipple.
Mastectomies go by different names depending on how much tissue your surgeon removes:
You and your healthcare provider will discuss your condition, your treatment options and your breast reconstruction preferences in detail before making a plan. That plan will include the type of mastectomy you have, any additional cancer therapies you may need and any additional cosmetic surgeries you may want. You’ll figure out how all of these variables fit together before scheduling your surgery.
You’ll probably spend the night in the hospital, possibly longer, if you had more extensive surgery. Your healthcare team will teach you how to care for your wound and your surgical drain at home.
You may wait for lab results to determine your next steps. Your healthcare team will check the breast tissue and lymph nodes they removed to ensure they got all of the cancer. They’ll usually have your results within a couple of weeks. Most of the time, there’s no need for additional surgery. But occasionally, they may need to remove additional lymph nodes or a wider margin of tissue in the area.
You may also need additional cancer treatment after surgery, such as radiation or chemotherapy. Some people prefer to complete these treatments before beginning the process of breast reconstruction. Even if you’ve begun your breast reconstruction, you might need additional follow-up surgeries (revision surgery) to achieve the final cosmetic result you want.
Early complications from the procedure can include:
Delayed complications can include:
It may take four to six weeks to feel fully recovered. Wound healing takes place in about three weeks. You may feel tired, sore and stiff at first, in your chest and through your arm and shoulder. Most people manage with mild pain relievers, and the stiffness improves with exercise. Your healthcare provider will give you specific exercises to do to help your recovery. They’ll let you know when it’s safe to do heavier work.
Your nerves are the slowest part of your body to heal, and you may feel a variety of sensations as they heal over the next several months. Most people feel numb throughout their chest after surgery, but you may also feel momentary twinges, tenderness or phantom sensations. Many people regain some of the sensation in their chest after about two years. However, it may never be quite the same as before.
Absolutely. Surgery may or may not be the end of your breast cancer journey, but it's likely to be a deciding factor in your treatment that can bring a lot of relief. And while losing your breasts can bring many emotions, many people are very satisfied with their breast reconstruction results. Many different types of cosmetic options are available to help you feel comfortable with your new, reconstructed cancer-free breasts.
After your mastectomy, you may benefit from various supplemental wellness services to help restore your quality of life. That might mean counseling or support groups to address your mental and emotional health or physical rehabilitation therapies to help restore your full range of motion. It might also mean complementary medicine such as meditation or yoga, biofeedback or massage.
A note from Cleveland Clinic
When you’re planning for a mastectomy, you have a lot of choices to make in a short amount of time. Your healthcare provider wants to remove the cancer as soon as possible, but you also need to understand the different options and risks before you. The time pressure, together with the different emotions and concerns you have to sort through, can make the planning process feel overwhelming.
Remember that your healthcare team is at your disposal to talk you through all of your questions and concerns, as many times as necessary. There’s also a wealth of resources online provided by people who have been through the process and want to help others walk through it. When you’ve made it through the surgery and you’re in the recovery phase, your support network will be just as important.
Last reviewed by a Cleveland Clinic medical professional on 07/25/2022.
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