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Mastectomy

A mastectomy is removal of all of the tissue from one or both breasts from the chest wall.

Breast surgeons perform a number of different types of mastectomy operations. The basic difference between them all is the amount of skin that is removed.  Like all aspects of breast cancer surgery, the type of mastectomy performed depends on a patient’s individual situation.

If you require, or are considering, a mastectomy Dr Lancashire will explain what is entailed and which type is most suitable for you.

‘Total’ or ‘Simple’ mastectomy

This is the most common type of mastectomy. The breast tissue is removed through an incision that also removes the nipple and areola. No muscles are removed. It may also be called a modified radical mastectomy if the lymph nodes under the armpit are removed.

Skin-sparing mastectomy

With a skin-sparing mastectomy, the nipple and areola are removed with the breast tissue but through a smaller incision to preserve more skin on the chest wall. This kind of mastectomy is usually combined with an immediate reconstruction.

Nipple-sparing mastectomy

Also known as a ‘subcutaneous mastectomy’, this is usually performed from the fold underneath the breast or via an incision around the areola. The nipple, areola and skin overlying the breast are preserved. This is performed in conjunction with an immediate breast reconstruction.

Radical (Halsted) mastectomy

‘Halsted’ or ‘radical’ mastectomies are now rarely performed. They involve removing the breast, armpit lymph nodes and the muscles under the breast on the chest wall. They are usually reserved for breast cancers that have spread into the muscles and chest wall.

Prophylactic mastectomy

A prophylactic or ‘risk-reducing’ mastectomy is the removal of an otherwise ‘healthy’ breast to reduce the risk of developing breast cancer in the future. They are done in the same manner as the above listed mastectomies. You can read more about prophylactic mastectomies here.

What can I expect?

A mastectomy can take an hour or so to complete. When combined with a breast reconstruction, the surgery can be significantly longer.

Most people are surprised with how little pain or discomfort they have after a mastectomy. There may be some discomfort and numbness around the incision or on the inside of the upper arm. There will usually be at least one drain placed under the skin to remove the build-up of any fluid that usually accumulates. There may be a second drain if an axillary clearance or a reconstruction is performed. Your drain may still be in place when you go home after your operation.

Dr Lancashire will explain to you at length what to expect before and after your operation, and how to manage your wound and any drains you may have. Information about the post-operative care of your wounds, dressings and drains is also available on this website here.

Follow the links below for more on breast cancer management: 

Breast conserving surgery

Axillary surgery

Oncoplastic breast surgery

Prophylactic mastectomy

Breast Reconstruction

Endocrine Therapy

Radiotherapy

Using the internet