Mastectomy
Procedure
(Breast Surgery; Surgery for Breast Cancer; Surgery to Remove a Breast)
Definition
A mastectomy is surgery to remove breast tissue. There are two types:
- Breast conserving:
- Lumpectomy —The tumor and some normal tissue around it are taken out.
- Partial mastectomy—Part of the breast that has cancer and some normal tissue around it are taken out. The lymph nodes or the lining of the chest muscle may also be taken out.
- Breast tissue removal mastectomy types:
- Simple—The whole breast is taken out. This includes the nipple and areola.
- Skin sparing—The skin that covers the breast is left except for the nipple and areola. This is like a simple mastectomy. It is done when reconstruction is planned.
- Modified radical—The whole breast, some lymph nodes in the armpit, and any affected chest muscles are taken out.
- Radical—The whole breast, lymph nodes, and muscles of the chest wall are taken out (rare).
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Reasons for Procedure
A mastectomy is done to:
- Treat breast cancer —removes cancer cells and any affected tissue
- Prevent breast cancer—removes one or both breasts in women with a high risk of getting cancer
- Treat side effects from a past treatment—some people who have immune system problems may not be able to have radiation therapy
A mastectomy may also be done as a gender affirmation surgery.
Possible Complications
All surgeries have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- A buildup of clear fluid in the cut
- Lymphedema —swelling of the arm caused by a buildup of fluid in lymph nodes
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging for a ride to and from surgery
Anesthesia
The doctor may give:
- A sedative—you will feel relaxed
- general anesthesia—you will be asleep
Description of the Procedure
For breast conserving surgery, a cut is made at the site of the tumor. The tumor is taken out. A small bit of normal tissue around it is also taken out.
For breast tissue removal surgery, the whole breast and fatty tissue are taken out. The doctor may also need to remove lymph nodes and some chest muscles. Tissue that is taken out will be tested. If you have skin sparing surgery, the skin around the breast will be kept.
The doctor will place a tube to drain blood and fluids. The site will be closed with stitches.
How Long Will It Take?
1 to 3 hours
Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and swelling are common in the first few weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is 1 to 3 days. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff may give you pain medicine.
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your wounds covered
During your stay, you can also take steps to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Keeping your wounds covered
At Home
It will take about 4 weeks to fully heal. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay your return to work.
Problems to Look Out For
Call the doctor if you are not getting better or you have problems such as:
- Signs of infection, such as fever and chills
- Redness, swelling, or increased pain at the site of the wound
- Increased bleeding or other leakage from the wound
- Cough, breathing problems, or chest pain
- Nausea and vomiting that is severe or that lasts a long time
- Redness, warmth, swelling, stiffness, or hardness in the arm or hand on the side of the body where the lymph nodes were taken out
- New or worsening pain and swelling in the feet, calves, or legs
- Lumps or skin changes in the tissue that is left on mastectomy side
- Lumps, skin changes, or nipple drainage in remaining breast
- Symptoms of depression that last at least 2 weeks or longer
If you think you have an emergency, call for medical help right away.
American Cancer Society
Breast Cancer
CANADIAN RESOURCES:
Canadian Cancer Society
Women's Health Matters—Women's College Hospital
American Cancer Society
Breast Cancer
CANADIAN RESOURCES:
Canadian Cancer Society
Women's Health Matters—Women's College Hospital
References
- Breast cancer in women. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/breast-cancer-in-women.
- Mastectomy. BreastCancer.org website. Available at: https://www.breastcancer.org/treatment/surgery/mastectomy.
- Surgery for breast cancer. American Cancer Society. Available at: https://www.cancer.org/cancer/types/breast-cancer/treatment/surgery-for-breast-cancer.html.
- Treatment options. BreastCancer.org website. Available at: https://www.breastcancer.org/treatment.
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