Mastectomy is a procedure used to remove the breast. In the past, the standard treatment for breast cancer was radical mastectomy, which required complete removal of the breast. But surgical breakthroughs within the past 20 years have provided women with more and more options. Many women have the option of less invasive breast-conserving surgery.
The type of mastectomy that is right for a patient depends on the following factors:
- Patient age
- Overall health status
- Menopausal status
- tumor size
- Tumor stage (degree of spread)
- Tumor grading (aggressiveness)
- Tumor hormone receptor status
- Whether lymph nodes are involved
What is a total mastectomy?
Total mastectomy, or simple mastectomy, is when the surgeon removes the entire breast, including the nipple. Sometimes the axillary lymph nodes are also removed.
Total mastectomy is most likely if the cancer has not metastasized outside the breast or if the patient is undergoing a preventive mastectomy to reduce the risk of breast cancer.
What is a prophylactic mastectomy?
Women at high risk for breast cancer may choose to undergo a prophylactic mastectomy.
Research shows that up to 90% of women at high risk for breast cancer may be less likely to develop breast cancer after a prophylactic mastectomy.
A complete mastectomy, removing the entire breast and nipple, is usually recommended. Some women will have both breasts removed. This procedure is called a bilateral mastectomy.
Some women who have unilateral breast cancer decide to have a prophylactic mastectomy, which removes the other breast. This reduces the chance of the cancer coming back.
If breast reconstruction is planned, it can be done at the time of the prophylactic mastectomy (immediate reconstruction) or later (delayed reconstruction). During breast reconstruction, the surgeon may use breast implants or his or her own skin flap tissue to reconstruct the breast.
What is breast-conserving surgery?
Patients with stage I or stage II breast cancer may undergo a partial mastectomy, or breast-conserving surgery, in which the tumor and surrounding tissue are removed.
After surgery, radiation therapy to the remaining breast tissue is usually required. During radiation therapy, powerful X-rays are used to target the breast tissue. Radiation therapy kills the cancer cells and stops them from metastasizing or coming back.
Breast-conserving surgery includes the following modalities:
- Mastectomy, which removes the tumor and a small cancer-free area around the tumor.
- Quadrant resection, which removes the tumor and more breast tissue than a mastectomy.
Some patients may need more surgery after breast-conserving surgery. Sometimes it may be necessary to remove the entire breast if there is still cancer in the breast tissue.
What is a classical radical mastectomy?
Radical mastectomy is the complete removal of the breast, including the nipple, and the surgeon also removes the skin, the muscle under the breast, and the lymph nodes. Because radical mastectomy is usually not as effective as other, less damaging mastectomies, it is rarely used today. Doctors will only recommend radical mastectomy if the cancer involves the pectoral muscles.
What is a modified radical mastectomy?
What is a modified radical mastectomy?
Modified radical mastectomy is less invasive and more widely used. The entire breast and axillary lymph nodes are removed, but the pectoralis muscle remains intact and the skin covering the chest wall may be preserved or removed. Postoperatively, breast reconstruction may be performed.