What Is a Mastectomy?
A mastectomy is a surgical procedure to remove breast tissue, most commonly performed to treat or prevent breast cancer. Depending on the individual’s condition, the surgery may remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy). A mastectomy may be recommended for invasive breast cancer, extensive ductal carcinoma in situ (DCIS), recurrence after previous treatment, or as a preventive measure for individuals at high genetic risk.
Why Surgery Is Performed
Mastectomy is used when cancerous or pre‑cancerous tissue involves a large area of the breast, when radiation is not advised or possible, or when a person chooses mastectomy for personal or medical reasons. In some cases, mastectomy is part of a multi‑modal cancer treatment plan that may include chemotherapy, radiation, or hormone therapy.
Types of Mastectomy Procedures
Total (Simple) Mastectomy
This procedure removes all breast tissue, including the nipple and areola, but not the lymph nodes under the arm. It is often used for non‑invasive cancers or as a risk‑reducing surgery.
Modified Radical Mastectomy
This approach removes the entire breast and the nearby lymph nodes under the arm (axillary lymph nodes) but preserves chest muscles. It is commonly used for invasive breast cancer to help prevent spread.
Skin‑Sparing and Nipple‑Sparing Mastectomy
When appropriate, surgeons can preserve most of the breast skin — and sometimes the nipple — to facilitate reconstruction with a more natural appearance. These techniques are chosen based on cancer location, size, and individual anatomy.
Reconstruction Options
Many patients choose breast reconstruction at the time of mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). Reconstruction may use implants or the patient’s own tissue (autologous reconstruction). Your surgeon and reconstructive specialist will discuss options based on your goals, anatomy, and overall health.
What to Expect During Surgery
Mastectomy is performed under general anesthesia in a hospital or surgical center. The length of surgery varies based on the type of mastectomy and whether reconstruction is performed at the same time. Your surgeon will explain the planned approach, what will be removed, and how your chest will be closed.
Recovery and Aftercare
After mastectomy, patients may stay in the hospital for observation, especially if reconstruction was performed. Recovery focuses on pain management, wound care, and gradual return to activity. Key elements include:
- Guidance on drain care if surgical drains are placed
- Pain control and scar care
- Physical therapy or exercises to maintain shoulder range of motion
- Follow‑up with surgical and oncology teams
Most patients resume light activity within a few weeks, with full recovery varying based on the extent of surgery and whether reconstruction was done.
Benefits of Mastectomy
- Removal of cancerous tissue to reduce recurrence risk
- Prevention for individuals at high inherited risk
- Option to combine with reconstruction for aesthetic outcomes
- Can be part of curative treatment when disease is localized
Risks and Considerations
As with all major surgery, mastectomy carries potential risks, including bleeding, infection, pain, changes in sensation, and anesthesia‑related complications. Reconstruction may have additional considerations such as implant issues or flap viability. Your surgical team will review risks specific to your health, options to minimize them, and supportive care through recovery.
