Mastectomy Gold Coast
A mastectomy is the surgical removal of the breast. The word comes from the Greek words mastos, meaning breast, and ektomē, meaning cutting out.
Like breast-conserving surgery, a mastectomy is used to remove breast cancer and reduce the risk of it coming back. For much of the 20th century, mastectomy was the standard operation for breast cancer. Today, many people can choose breast-conserving surgery instead, which removes the cancer while keeping the rest of the breast, although this is not suitable for everyone.
Deciding between a mastectomy and breast-conserving surgery can be difficult. Dr John Gault will talk you through your options, the reasons behind his recommendation and what each choice would mean for you.
There are several different types of mastectomy:
Total Mastectomy (Simple Mastectomy)
A total mastectomy removes the whole breast, including the nipple and areola, but not the lymph nodes in the armpit. A sentinel lymph node biopsy is often performed at the same time to check whether the cancer has spread to the lymph nodes.
Prophylactic Mastectomy
See our separate page on prophylactic mastectomy.
Radical Mastectomy (Halsted Mastectomy)
This was the first type of mastectomy, developed in the late 1800s. It removes the breast, the lymph nodes in the armpit and the chest muscles behind the breast. It is rarely performed today, and only in uncommon cases where the cancer has grown into the chest muscles.
Modified Radical Mastectomy
A modified radical mastectomy removes the whole breast together with most of the lymph nodes in the armpit, known as an axillary clearance, while leaving the chest muscles in place. It may be recommended when cancer has spread to the lymph nodes in the armpit.
Nipple Sparing Mastectomy
A nipple-sparing mastectomy removes the breast tissue while keeping the skin of the breast, the nipple and the areola. It is usually performed together with an immediate breast reconstruction, and it is only suitable for some people, depending on factors such as the size of the cancer and how close it is to the nipple.
Skin Sparing Mastectomy
A skin-sparing mastectomy removes the breast tissue, nipple and areola while keeping most of the breast skin, which helps with an immediate breast reconstruction.
Surgery and Recovery
A mastectomy operation normally takes about one hour to complete and usually requires one to two days in hospital. If breast reconstruction is performed at the same time, the operation takes longer and a longer stay may be needed.
After the operation there may be some pain around the chest and armpit, which usually improves over the first few weeks. Numbness of the chest wall and inner upper arm is common and can be long-lasting. Fluid can also collect under the scar, which is called a seroma, and this may need to be drained.
A drain is normally placed during surgery and removed once the fluid has slowed down. Some patients go home with the drain and have it removed by Dr Gault's team at a follow-up appointment.
If lymph nodes have been removed from the armpit, there is a risk of lymphoedema, which is swelling in the arm, hand, breast or chest. The risk is higher when more lymph nodes are removed, and lymphoedema can develop several months or even years after the operation.
Living Without Breast Reconstruction
Some people choose not to have a breast reconstruction after a mastectomy, which is sometimes called going flat. Breast Cancer Network Australia has information and support for Australians making this decision, and Flat Friends, a UK-based organisation, also offers resources for living without breast reconstruction.
Your questions answered
Frequently Asked Questions About Mastectomy
When is a mastectomy recommended instead of breast-conserving surgery?
A mastectomy may be recommended when the cancer is large compared with the size of the breast, when there is cancer in more than one area of the breast, when changes such as DCIS are spread widely through the breast, or when radiotherapy is not possible or has been given to the breast before. Some people also choose a mastectomy for personal reasons, or because they carry a gene change that raises their risk. Dr Gault will explain which options suit your situation.
Is a mastectomy safer than breast-conserving surgery?
Not necessarily. For many people with early breast cancer, breast-conserving surgery followed by radiotherapy offers similar long-term survival to a mastectomy. The best option depends on the features of the cancer, your breast size, your health and your own preferences.
Can I have breast reconstruction at the same time?
Often, yes. Reconstruction can be done during the same operation as the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). Dr Gault performs non-flap reconstruction. If a flap reconstruction, which uses tissue from another part of your body, is a better option for you, he can refer you to an appropriate reconstructive surgeon.
Do I have to have breast reconstruction?
No. Reconstruction is a personal choice, and some people choose to live without it. Others wear an external breast prosthesis, and you may be eligible for reimbursement through the Australian Government's External Breast Prostheses Reimbursement Program. Breast Cancer Network Australia has information to help with this decision.
Will my lymph nodes be removed?
It depends on your situation. For invasive breast cancer, a sentinel lymph node biopsy is often performed during the mastectomy to check the first few lymph nodes. If cancer has already been found in the lymph nodes, an axillary clearance may be recommended. See our axilla surgery page for more information.
How long will I be in hospital?
A mastectomy usually requires one to two days in hospital, and a longer stay may be needed if breast reconstruction is performed at the same time. Dr Gault operates at Pindara Private Hospital, Benowa.
What is recovery like after a mastectomy?
Recovery varies from person to person. You may go home with a drain, and you will usually be advised to avoid heavy lifting for a few weeks. Gentle arm and shoulder exercises help you regain movement, and Gault Surgery patients can access physiotherapy with Tara Redemski, an APA-titled Cancer and Lymphoedema Physiotherapist. Dr Gault and our breast care nurse will give you advice for your own recovery.
What are the risks of a mastectomy?
Like any surgery, a mastectomy carries risks. These can include infection, bleeding, fluid collection under the wound (seroma), problems with wound healing, numbness of the chest wall and inner upper arm, ongoing pain, shoulder stiffness and, if lymph nodes are removed, lymphoedema. There are also risks associated with the anaesthetic. Dr Gault will explain the risks that apply to you before surgery.
Will I need other treatment after a mastectomy?
Some people do. Depending on the type and stage of the cancer, further treatment may include radiotherapy to the chest wall, chemotherapy, hormone therapy or targeted therapy. Your treatment plan is discussed within your multidisciplinary team, and Dr Gault works with your medical and radiation oncologists.
What emotional support is available?
It is common to feel a sense of loss or to have concerns about body image after a mastectomy. Our breast care nurse, Julie, supports you and your family through surgery and recovery and can connect you with other support services. Your GP can also refer you to a psychologist if you would like extra support.
How much does a mastectomy cost?
Costs vary depending on the type of mastectomy, whether reconstruction or lymph node surgery is included, the hospital and your level of health insurance cover. Please contact our rooms on (07) 5539 3999 to discuss the likely costs for your situation. You may also wish to check with your private health fund about your cover and any excess.
How do I book a consultation?
You can book by calling (07) 5539 3999 or by sending a message through the Quick Enquiry form on this page. A referral from your GP or another medical practitioner is needed to claim a Medicare rebate for your consultation. Our rooms are at Suite 11, Pindara Place, 13 Carrara Street, Benowa QLD 4217.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. The information on this page is general in nature and is not a substitute for individual medical advice.